Symptom Management


By MSF Staff and reviewed by the MSF Medical Advisory Board
If you find yourself attributing every physical and emotional symptom you experience to MS, you are in good company. But if you are in your early-to mid-40s, some symptoms, such as weight gain, sleep disturbances, or volatile mood swings, may have nothing to do with MS. You may be among the 80 percent of all women who will experience perimenopause.
Literally translated, perimeno-pause means ‘around menopause’ and refers to that transitional time when hormonal changes begin and various ‘symptoms’ result. The average age of onset is between 45 and 47, but some women begin experiencing symptoms as early as their 30s. You can still become pregnant during perimenopause, although fertility does decrease.
Symptoms of Perimenopause Include:
  • Irregular periods (cycles may be longer, shorter, heavier or lighter)
  • Hot flashes
  • Night sweats
  • Excessive sweating
  • Sleeping difficulties
  • Weight, skin and hair changes
  • Joint and muscle aches
  • Vaginal dryness
  • Mood swings, poor concentration, forgetfulness, and/or depression
  • Decreased sex drive
  • Change in body odor
  • Cravings for carbohydrates and/or sugar
  • Headaches
Fortunately, there are many things that you can do to sustain or improve your physical and emotional health during this transitional time.
Cool It!
If heat exacerbates your MS, hot flashes, night sweats and excessive sweating may concern you. Be active. Buy a small portable fan. Get a cooling vest or cooling pillow. Drink plenty of cool water and monitor your caffeine intake. Too much caffeine can exacerbate stress, irritability, fatigue, and hot flashes. 
Talk With Your Doctor
If fatigue is a problem, find out if you are taking any sedating medications that might be changed. Some medications, such as the selective serotonin release inhibitors used to treat depression, simultaneously provide a stimulating effect to fight fatigue.
A positive attitude can make all the difference. If you need support, seek counseling or join an online support group. Talk on the phone or have lunch with your friends more often. Nothing lifts your spirits more than sharing mid-life stories with a good friend! Rather than falling into the “I’m too old,” mindset, why not try, “I’ll never be younger than I am today?” Perimenopause is also a good time to quit smoking, which can contribute to the early onset of menopause.
Metabolism slows during perimenopause. For many women, this means weight gain. Avoid fad diets. Instead, focus on positive long-term lifestyle changes. Watch portion sizes and add soy and flax to your diet – both are natural estrogen replacements and packed with nutrition.
Exercise improves self-esteem, increases energy, burns calories, and leads to a sense of accomplishment. It also reduces stress, depression and anxiety. Regardless of your abilities or your fitness level, there is an exercise program for you. Don’t forget to add a healthy dose of fresh air and sunshine.
Cognitive Exercise
Use it or lose it, as the old saying goes. Crossword puzzles, word jumbles, and TV game shows all keep your mind working and they’re fun! Listen to music or books on tape. Remember, your brain is a muscle too – work it out!
Nutritional Supplements
During perimenopause, many women turn to St. John’s wort, black cohosh, ginkgo biloba, evening primrose oil, and other nutritional supplements. These must be used with caution in women with MS. Always speak to your doctor to learn of any potential harmful effects or interactions with other medications.
On a final note, there is sometimes a tendency for MS to flare during hormonal changes. For some women, taking birth control pills or another estrogen product may be of some benefit. However, more studies are needed to confirm these findings.
For more information or inspiration, check out the following resources:
Changing Course: Women's Inspiring Stories of Menopause, Midlife and Moving Forward
By Yitta Halberstam
Adams Media Corporation, 2003
The Change Before the Change: Everything You Need to Know to Stay Healthy in the Decade Before Menopause
By Laura Corio
Bantam, 2002
Could It Be…Perimenopause?
By Laurie Ashner and Steven R. Goldstein
Little Brown, 1998
Thank you to Daniel Williams, Ph.D. for his assistance with this article.
(Last reviewed 7/2009)