It seems to me that the response to the menopause, like so many things in our condition, is both confusing and inconsistent between individuals. We see this in such a range of things, our reaction to inoculations and to infections, alcohol sensitivity, variation in sleep patterns.
I guess that this is also compounded by unconnected variation between people in how they respond to the menopause and some overlap between symptoms of ME and the menopause pause meaning at times it may not be clear what is menopause and what is ME.
It does raise the question, what does this variation tell us about our condition. It may be that the variations becomes entirely understandable when we know what we should be looking at. For example over a number of years I became confused by the variation in my response to exertion; it could be that sitting at the computer caused more of a crash than moving relatively heavy things in the garden. It was only when I realised that I had gradually been developing orthostatic intolerance and up to a certain point being upright triggered PEM quicker than physical exertion, that is the negative effects of being upright stopped me doing things more more quickly than over exertion triggered a crash. Once I was aware of this, that the key variable was time spent upright, the appearant inconsistences entirely made sense.
Do those that experience a change in their ME associated with the menopause get a sense or not that it directly interacting with the ME or if it is an indirect, though potentially cumulative, factor, such as we might see with a cold in someone with such as MND being more disabling than in a healthy person? Presumably in that situation the cummulative impact of the cold and MND is because the person has less 'spare capacity' or resilience to deal with the additional infection even though the impact of both together can be extreme (eg the cold can results a chest infection that in turn can potentionally be fatal). However given that ME occurs more commonly in women it would not be surprising if there could be a direct interaction between ME and the menopause.
It could be if ME does turn out to be several similar diseases that this will explain the variation we see, though, until we have widely used assesment of biomarkers and/or a comprehensive natural history of the condition, it may be impossible to tease out any clear patterns.
Reading everyone's accounts, I did wonder if we ever see a re emergence of ME symptoms at the menopause in people that are in complete remission. For example though my ME had a sudden onset associated with glandular fever (EBV) after several years I believed myself to have completely recovered, until a bad dose of flue triggered a relapse that was worse than the initial presentation. Do we ever see such a pattern associated with the menopause?