I am a 50 year old menopausal woman who has had MS for 14 years. Yes, menopause has affected my MS in a few ways. Specifically fatigue, fatigue, fatigue!! The hot flashes are random and often, so they do interrupt my already comprimised sleep. Additionally, menopause causes insomia, thus further interrupting my sleep. Add the PMS symptoms and I have to fight the fatigue daily. After doing extensive research, I have decided that hormone replacement therapy is not for me, so I have taken steps to eat healthier, exercise more, keep my mind active, and my attitude positive. Most days I feel like the "little engine that could", and I just remind myself that I am almost over this hurdle. Best wishes to all my menopausal MS sisters!!!