The interplay of multiple sclerosis and menstrual cycle: Which one affects the other one? (original) (raw)
Related papers
MRI in multiple sclerosis during the menstrual cycle: Relationship with sex hormone patterns
Neurology, 1999
Article abstract We investigated MRI activity in MS during the menstrual cycle in relation to physiologic sex hormone fluctuations. Eight women with relapsingremitting MS were submitted to serial brain gadolinium-enhanced MRI examinations over a 3-month period in two alternate follicular and luteal phases of the menstrual cycle. The ratio of progesterone/17-beta-estradiol during the luteal phase was significantly associated with both number (r = 0.6, p = 0.03) and volume (r = 0.7, p = 0.009) of enhancing lesions, providing support for a role of these hormones as immunomodulatory factors in MS.
Effects of Sex-Related Factors on Disability Risk in Women with Multiple Sclerosis
Journal of Multiple Sclerosis Research
Objective: It has been reported that estrogen may affect T helper (Th) 1 and Th-2 lymphocytes and the ratio of Th-1 to Th-2, which play an essential role in the immunopathogenesis of multiple sclerosis (MS). Therefore, hormonal changes during transitional periods, such as pregnancy and menopause, may affect the activity of the disease at different phases of the menstrual cycle. This study aimed to determine the association of MS in women with variables, such as menarche age, menstrual order, menopausal age, and disease-related factors, such as disability level and the number of relapses. Materials and Methods: This descriptive study enrolled 281 women with MS. The participants were evaluated using a simple and short survey by the researchers. A neurologist evaluated the Expanded Disability Status Scale (EDSS) score, the number of attacks, and disease duration. Results: Sixty-seven (23.8%) of 281 patients had entered menopause. There was no significant difference in the EDSS score of women with MS with or without menopause (p>0.05). Sixty patients (21.4%) had children after MS. There was no significant difference between the number of relapses before (1.87±1.46) and after having a child (3.15±3.59) (p>0.05). Additionally, the last EDSS score (2.46±2.07) was not different from the EDSS score after having a child (2.35±1.81) (p>0.05). It was found that 80.4% of the patients had a regular menstrual cycle, whereas 19.6% of them had an irregular cycle. The EDSS score was significantly higher in women with irregular menstrual cycles than in women with regular menstrual cycles (p<0.05). The age at menarche in the study group (13.07) was found to be earlier than the average age at menarche in Turkey (13.3) (p<0.05). Conclusion: This study suggested that menopause and childbearing may not affect disability level or the number of attacks in women with MS. Additionally, women with MS have an earlier age at menarche compared with the general population. Future studies should investigate earlier age at menarche as a possible risk factor in MS.
Premenstrual Multiple Sclerosis Pseudoexacerbations
Archives of Neurology, 2006
Background: Many women with multiple sclerosis (MS) experience transient neurologic symptom worsening and fatigue in conjunction with the menstrual cycle. Aspirin reduces MS fatigue in some patients. Objective: To describe 3 women with MS who experienced stereotypic, temperature-independent neurologic symptoms and diurnal fatigue in the mid-to-late luteal phase of the menstrual cycle. Aspirin treatment prevented the symptoms.
Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2012
Sex-related differences in the severity of multiple sclerosis (MS) could be influenced by the sex hormones. This cohort (historical) study evaluated the sex hormone levels during menstrual cycle and their correlation with disease severity in MS. Patients with MS had significantly lower testosterone, dehydroepiandrosterone sulfate and prolactin levels than controls in the follicular and luteal phase but lower estradiol levels only in the follicular phase. A positive correlation coefficient between follicle stimulating hormone and disease severity, and a reverse correlation with estradiol were found. The hormone-related modulation of disease severity supports the suggestion that sex hormones play a role in MS disease.
Gynecologic and Obstetric Investigation, 2013
increased relapse risk in the following 3-month period, especially when the procedure did not result in pregnancy and gonadotrophin-releasing hormone agonists were used. Altogether, there is substantial evidence to support a regulatory role of sex steroid hormones in MS. In the absence of correlations with single hormone blood levels, we can only speculate about the underlying mechanisms. In conclusion, the increased MS risk in women and the changes in relapse and progression risk in association with reproductive events suggest significant and complex interactions between immune, neuroendocrine and reproductive systems in MS.
Patients report worse MS symptoms after menopause: Findings from an online cohort
Multiple sclerosis and related disorders, 2015
Many women with multiple sclerosis (MS) are postmenopausal, yet the impact of menopause on MS symptoms is unknown. To investigate patient-reported impact of menopause in a large online research platform, PatientsLikeMe (PLM). A detailed reproductive history survey was deployed to PLM members, and responses were linked to PLM׳s prospectively collected patient-reported severity score (MS Rating Scale, MSRS). The MSRS has previously shown good correlation with physician-derived EDSS scores. Of the 513 respondents, 55% were postmenopausal; 54% of these reported induced menopause. Median age at natural menopause was 51. Surgical menopause occurred at an earlier age (p<0.001) and was associated with more hormone replacement therapy use (p=0.02) than natural menopause. Postmenopausal status, surgical menopause, and earlier age at menopause were all associated with worse MSRS scores (p≤0.01) in regressions adjusting for age, disease type and duration. Postmenopausal patients in this stud...
Multiple Sclerosis and to Be Woman
https://www.ijhsr.org/IJHSR\_Vol.8\_Issue.7\_July2018/IJHSR\_Abstract.045.html, 2018
Multiple sclerosis (MS) a disease that is chronic, neurological and inflammatory, involves the white matter of the central nervous system. It is demyelinating and progressive, progresses with remissions, and can cause permanent disability. It is often seen in young adults. MS is two times more common in women than in men. It is similar to many chronic diseases in terms of its general symptoms. It affects the life quality of individuals during the reproductive period. It is quite important to evaluate MS in terms of women's life cycles because the rate of the disease increases in women between the ages of 20 and 40-the most productive period-and because approximately 70% of MS patients are women. In this review, the natural course of life of women with MS was investigated based on up-to-date guidelines and the literature, including their sexual lives, use of contraceptives, pregnancies, giving birth, postpartum period, breastfeeding, assisted reproductive techniques and menopause periods. It was aimed in this review to take into account especially the period of woman's life when preparing treatment programs for women with MS. It was also aimed to have healthcare professionals and nurses to establish healthcare processes in this direction. In conclusion, results reveal that there are limited numbers of studies on the subject and that there is a need to conduct more extensive studies on the subjects that controversial issues.
Sex effects across the lifespan in women with multiple sclerosis
Therapeutic Advances in Neurological Disorders
Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating central nervous system disorder that is more common in women, with onset often during reproductive years. The female:male sex ratio of MS rose in several regions over the last century, suggesting a possible sex by environmental interaction increasing MS risk in women. Since many with MS are in their childbearing years, family planning, including contraceptive and disease-modifying therapy (DMT) counselling, are important aspects of MS care in women. While some DMTs are likely harmful to the developing fetus, others can be used shortly before or until pregnancy is confirmed. Overall, pregnancy decreases risk of MS relapses, whereas relapse risk may increase postpartum, although pregnancy does not appear to be harmful for long-term prognosis of MS. However, ovarian aging may contribute to disability progression in women with MS. Here, we review sex effects across the lifespan in women with MS, including the effect of ...
Journal of Neurology, 2012
Female gender and hormones have been associated with disease activity in multiple sclerosis (MS). We investigated age at menarche, use of oral contraceptives and pregnancy in relation to progression of disability in relapsing onset and progressive onset MS. We conducted a cross-sectional survey among individuals with MS, registered by the Flemish MS Society in Belgium. A time-toevent analysis and Cox proportional hazard regression were performed with time to Expanded Disability Status Score (EDSS) of 6 (requires a cane) as outcome measure. Hazard ratios for the time from onset and the time from birth were adjusted for age at onset and immunomodulatory treatment. Data on 973 women with definite MS were collected. In the relapsing onset group, women with at least two pregnancies had a reduced risk to reach EDSS 6 compared with nulliparous women. In the progressive onset group, later age at menarche was associated with a reduced risk to reach EDSS 6, whereas oral contraceptive use was associated with a higher risk of reaching EDSS 6. Our study corroborates the association of pregnancies with a reduced progression of disability in relapsing onset MS. In progressive onset MS, a slower progression was found in women with a later onset of menarche and a more rapid progression occurred when women reported the use of oral contraceptives.