Revisiting Managing Menopause While You're Managing MS with Dr. Riley Bove

·22 min·2 clips

Why do 300,000 women with MS face uncertainty about menopause symptoms that mimic their disease?

This episode of RealTalk MS is a replay of a March 2025 interview, part of a year-end tradition revisiting popular conversations. Host John Strum introduces the topic by noting that women represent two-thirds of the MS population, yet there's limited data on women's health issues in MS. He highlights that an estimated 300,000 women with MS in the U.S. are in peri- or post-menopause, making this a critical area of focus. Dr. Riley Bove, a neurologist and founding director of the Sex and Gender Enriched Neurology Program at UCSF, joins as the guest. She begins by defining perimenopause as the menopausal transition around the final menstrual period and post-menopause as the years after. Dr. Bove details how symptoms like sleep disturbances, cognitive changes, mood swings, and bladder issues overlap between perimenopause and MS, complicating diagnosis. She advises women to consult both neurologists and primary care doctors more frequently to differentiate causes. The discussion explores how perimenopause might affect MS progression, possibly through behavioral changes like reduced exercise or dietary shifts, and potentially direct hormonal impacts on brain health. Dr. Bove explains estrogen's pleiotropic effects on bones, blood vessels, and the brain, and notes the challenges in translating animal studies to humans. She describes blood tests like FSH levels to determine menopausal status. For women with MS using steroids, she recommends earlier bone density screening starting at age 50 due to increased risk. Dr. Bove lists less-known menopausal complications such as joint pain, genitourinary syndrome, and cognitive concerns. She categorizes menopause impacts into reproductive health, immunology, and neurological health, mentioning treatments like hormone replacement therapy, non-hormonal options like Vioza, and cognitive therapy. On HRT, she follows general population guidelines, noting benefits for hot flashes and bone health but cautioning for those at high cancer or blood clot risk. The episode concludes with a focus on post-menopause life, emphasizing that proactive symptom management can optimize well-being and prevent disability progression.

As heard by us

A measured guide to the blurred symptom territory between menopause and MS.

Real Talk MS gives the overlap between menopause and multiple sclerosis a careful, useful frame, with neurologist Dr. Riley Beauvais helping sort symptoms that can make a changing body harder to interpret.

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Why you'd press play

When menopause and MS symptoms blur together, press play for a clearer, calmer map.

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