BACKGROUND Sex hormones play a role in both the risk and the prognosis of multiple sclerosis (MS). Considering all stages of women's reproductive life, data regarding the influence of menopause on MS and vice versa are scarce. OBJECTIVE The aim of this study was to review the evidence addressing the relationship between menopause and MS. METHODS A literature search through PubMed was conducted, selecting studies that assessed (1) the influence of menopause in the MS course, (2) the influence of MS and disease-modifying drugs (DMD) on the development of menopause and (3) the effect of hormone replacement therapy (HRT) on symptoms of menopausal MS patients. RESULTS (1) Most studies suggest menopause may transitorily aggravate MS symptoms. Two studies found an inflexion point on the Expanding Disability Status Scale (EDSS) with clinical worsening during the menopausal transition. Another study considering full EDSS trajectories from clinically isolated syndrome to postmenopause did not find such an EDSS inflection; (2) MS and DMD do not seem to alter the age of menopause onset; and (3) HRT in menopausal MS patients has not shown consistent benefits. CONCLUSION Menopause seems to be associated with transient symptom worsening, but the existence of an inflection in disability progression is still controversial. Properly designed studies are necessary to achieve conclusive results.

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更年期和多发性硬化症：对预后的影响以及疾病缓解药物和激素替代疗法的作用

背景技术性激素在多发性硬化症(MS)的风险和预后中都起作用。考虑到女性生殖生活的各个阶段，有关更年期对 MS 影响的数据非常少，反之亦然。目的 本研究的目的是回顾更年期与 MS 之间关系的证据。方激素替代疗法 (HRT) 对绝经期 MS 患者症状的影响。结果 (1) 大多数研究表明更年期可能会暂时加重 MS 症状。两项研究发现扩展残疾状态量表 (EDSS) 的拐点在绝经过渡期间临床恶化。另一项考虑从临床孤立综合征到绝经后的完整 EDSS 轨迹的研究没有发现这种 EDSS 拐点。(2) MS 和 DMD 似乎不会改变更年期开始的年龄；(3) 绝经期 MS 患者的 HRT 并未显示出一致的益处。结论 更年期似乎与短暂症状恶化有关，但残疾进展是否存在拐点仍存在争议。正确设计的研究对于取得结论性结果是必要的。(2) MS 和 DMD 似乎不会改变更年期开始的年龄；(3) 绝经期 MS 患者的 HRT 并未显示出一致的益处。结论 更年期似乎与短暂症状恶化有关，但残疾进展是否存在拐点仍存在争议。正确设计的研究对于取得结论性结果是必要的。(2) MS 和 DMD 似乎不会改变更年期开始的年龄；(3) 绝经期 MS 患者的 HRT 并未显示出一致的益处。结论 更年期似乎与短暂症状恶化有关，但残疾进展是否存在拐点仍存在争议。正确设计的研究对于取得结论性结果是必要的。