MRI in multiple sclerosis during the menstrual cycle: Relationship with sex hormone patterns

Abstract

We investigated MRI activity in MS during the menstrual cycle in relation to physiologic sex hormone fluctuations. Eight women with relapsing-remitting 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.

Estrogen anti-inflammatory activity in brain: A therapeutic opportunity for menopause and neurodegenerative diseases

“…This sexual dimorphism may be due to multiple factors; certainly gender-related differences in immune responsiveness are part of the cause, but sex hormones are likely to play a significant role ( [64,110]) as indicated by a series of observations: (a) the first clinical symptoms of MS develop post-puberty; (b) increased levels of sex hormones produced during pregnancy are associated with a significant reduction in the severity of MS; (c) MS clinical symptoms are often exacerbated postpartum, a time characterized by significant alternations in sex hormone levels; (d) MS symptoms are altered also during the menstrual cycle ( [1,16,45,127,188]). …”

Age at onset of multiple sclerosis is correlated to use of combined oral contraceptives and childbirth before diagnosis

“…Magnetic Resonance Imaging (MRI) is the most important imaging method used to diagnose and evaluate the progression of MS. Changes in disease activity on MRI scans have been shown to be related to female steroid sex hormones although the results are partially contradictory (16)(17).…”

Sex Hormones and Multiple Sclerosis

“…Intracortical lesions are more frequent in men [135]. The relationship between sex hormone levels and tissue damage has been explored in MS. A MRI study of disease activity during different phases of the menstrual cycle has shown significant correlation between progesterone/17β-estradiol (PEL) ratio in the luteal phase and the number of gadolinium-enhanced CNS lesions [136,137]. Another study has found a significantly higher number of Gd-enhanced lesions in women with abnormally low testosterone levels.…”