Hi! I was wondering if any ladies out there noticed their ms symptoms worsening during perimenopause/menopause?
I was diagnosed at the age of 57 after they took me off HRT so I naturally associated menopause and no HRT with worsening MS symptoms. Simultaneously the initial research on estriol had recently been published.
Consequently, I did a lot of reading about hormones and MS and as I result I’m currently on 8mg estriol/500mg bioidential progesterone (recommended dose after I had my hormone levels tested) and have been for many years, doing well.
Some points I think it’s important to consider—
(a) With respect to progesterone, you may also wish to search the site for posts about that too. I personally think it’s important if you do “HRT” that you only consider bioidentical progesterone, not MPA.Progesterone and neuroprotection
In addition, we discuss fundamental differences in the neurobiology of progesterone and the clinically used, synthetic progestin, medroxyprogesterone acetate that may offer an explanation for the negative findings of the combined estrogen/progestin arm of the Women's Health Initiative-Memory Study (WHIMS) and suggest that the type of progestin used may dictate the outcome of either pre-clinical or clinical studies that addresses brain function.
to one of my earlier posts also identifies issues with synthetic “progestins” and risks of HRT. Bottom line, at least at that time, they were considering synthetic progestins to be the culprit in the risks associated with HRT. Unfortunately some of the links in that post no longer work.
(b) Progesterone has lots of neuroprotective properties that may be relevant to MS. It is a “neurosteroid” produced by the brain, in the brain, for the brain. Here are some rather random links about it.Non-Classical Progesterone Signalling Molecules in the Nervous System
A TSPO ligand is protective in a mouse model of MS
spotlight shifted to progesterone (P4 )
P4 also modulates such diverse neural processes as cognitive functions and emotion (1, 2), neurogenesis (3-5), neuroinflammation (6), neuroprotection (7-9) and neuronal cell death (10).
The full article is available for free at the link.
Local production of neurosteroids such as progesterone and allopregnanolone confers neuroprotection in central nervous system (CNS) inflammatory diseases.
There is substantial evidence indicating that promotion of neurosteroid synthesis may be beneficial in CNS diseases. It has been previously reported that MS patients show a drop in neurosteroid levels, and treatment with the neurosteroid allopregnanolone leads to a partial rescue in mice, causing downregulation of microglial activation and infiltration of peripheral immune cells, and protecting the myelin sheath (Noorbakhsh et al, 2011). Other studies have also shown that the neurosteroid progesterone is beneficial in the mouse model of MS (Giatti et al, 2012; Yu et al, 2010). The increase in neurosteroid production by etifoxine could lead to similar effects as direct neurosteroid treatment, along with offering the direct downregulation of immune cell activity.
I wonder if we really need a “drug” to increase the level of neurosteroids in our brains to provide neuroprotection and remyelination or if we simply need to have adequate levels of hormones ???. Allopregnanolone, identified as deficient in the brains of people with MS, is a metabolite of the hormone progesterone. Progesterone induced neuroprotection: Factors that may predict therapeutic efficacy
the efficacy of these hormones may depend on a variety of factors, including the type of hormone used (ex. progesterone versus medroxyprogesterone acetate), the duration of the postmenopausal period prior to initiating the hormone intervention, and potentially, the age of the subject. The latter two factors relate to the proposed existence of a "window of therapeutic opportunity" for steroid hormones in the brain.
It’s my impression that the current thinking is that if you’d like to consider HRT, it may be better to do it “sooner”, rather than “later”, i.e., the “window of therapeutic opportunity”. Progesterone synthesis in the nevous system: implications for myelination and myelin repair
Stimulating the formation of endogenous progesterone is currently explored as an alternative strategy for neuroprotection, axonal regeneration, and myelin repair.
That’s enough really. LOL….I think it’s well worth your time to have your “free” hormone levels tested (saliva testing is one way) and to supplement hormones in accordance with test results to hopefully yield “balanced” hormone levels. There’s lots of interaction among them and it does not appear to be a good idea to have one particular hormone level too high and another low, etc. I had zero progesterone when I had my hormone levels tested. Hence the 500 mg script for it. In women at least, progesterone levels also start to drop way before estrogen levels as we age
All the best to you as you consider this....feel free to pm me if you've questions. Sorry you're so warm a lot.