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Good news for women managing both MS and menopause: a large Swedish study found that hormone replacement therapy (HRT) is safe for MS patients and may even slow disability progression. Over a 13-year follow-up, HRT users showed a 29% lower risk of reaching a key disability milestone. Researchers say clinicians shouldn't hesitate to prescribe HRT just because a patient has MS.
Good news for women navigating both MS and menopause: a landmark Swedish study has found that hormone replacement therapy (HRT) is not only safe for women with multiple sclerosis (MS) but may also offer a modest protective effect against disability progression — a finding that surprised even the researchers.
The nationwide study, presented at ECTRIMS-ACTRIMS 2026, drew on data from 7,390 women in the Swedish MS Registry over a median follow-up of 13 years. It's the first large, real-world study to examine HRT use in the era of highly effective disease-modifying therapies (DMTs) — a critical gap, since many women on these newer treatments are now entering menopause.
By the Numbers:
Why it matters: Declining estrogen after menopause may accelerate disability in MS, and this study offers the strongest evidence yet that HRT is safe — and potentially neuroprotective — in this population. Clinicians are encouraged not to withhold HRT from MS patients out of caution.
