Women's Issues By and large, women experience the same problems as men with myasthenia, but may have extra difficulties at the time of monthly periods, pregnancy, and the change of life (menopause). In around two thirds of women, the myasthenia symptoms can get worse before and during their periods, sometimes lasting into the third day, regardless of any discomfort / pain. They may be able to increase the dosage of their pyridostigmine The contraceptive pill, contraceptive cooper coil and contraceptive implants are safe for people with myasthenia. Around the menopause, myasthenia can flare up and may demand higher doses of pyridostigmine or side effects. Hormone replacement therapy (HRT) is perfectly acceptable. Calcium supplements may be important. Bone thinning (osteoporosis) is likelier from now on and even more so if mobility is restricted by myasthenia or if the patient is taking steroids. However, it can then be prevented by a variety of drugs. General fatigue, anxiety about physical limitations from myasthenia and drug side effects, can have indirect implications.