Symptoms of multiple sclerosis in women in relation to sex steroid exposure

Holmqvist, Per; Wallberg, Malin; Hammar, Mats; Landtblom, Anne‐Marie; Brynhildsen, Jan

doi:10.1016/j.maturitas.2005.10.003

Cited by 77 publications

(54 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A worsening of MS symptoms at the time of menopause was reported by 40%, whereas 56% reported no change and 5% a decrease in symptoms [106]. An earlier study reported worsening symptoms in 54% and an improvement in 75% of those who had tried hormone replacement therapy [107].…”

Section: Menopausementioning

confidence: 99%

Female Gender and Reproductive Factors Affecting Risk, Relapses and Progression in Multiple Sclerosis

D’hooghe

D’Hooghe²,

Keyser

2013

Gynecol Obstet Invest

View full text Add to dashboard Cite

Multiple sclerosis (MS), a chronic inflammatory demyelina-ting and degenerative disease of the central nervous system, is a frequent cause of neurological disability in young adults. Female predominance has increased over the last decades. Although female gender carries a higher risk of developing relapsing remitting MS, being female and at child-bearing age also appears to provide some protection against cognitive decline and against progressive onset MS, an adverse predictive factor when considering long-term disability in MS. The risk of MS in women has been associated with an earlier age at menarche. In most studies, parity did not impact MS risk. However, the recently published association of higher parity and offspring number with a reduced risk of a first demyelinating event suggests a potential suppressive effect. Pregnancy in MS patients has been associated with a reduced relapse rate and a reduction of neurological symptoms, especially in the third trimester. Despite the increased relapse risk in the postpartum period, there is no indication of an adverse effect of childbirth on the long-term course of MS. Fertility treatment in MS has been associated with an 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.

show abstract

Section: Menopausementioning

confidence: 99%

Female Gender and Reproductive Factors Affecting Risk, Relapses and Progression in Multiple Sclerosis

D’hooghe

D’Hooghe²,

Keyser

2013

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…Some studies have suggested a delay in the age of disease onset (DO) associated with OC use [6,7]. Nevertheless, despite its practical interest for MS women who decide to take this preventive method of conception, only few inconclusive studies have addressed the impact of its use on the prognosis of the disease [8,9]. These studies are complicated by the influences of potential confounders and by modification of the effect of OC use from differential treatment effects ("interaction bias").…”

Section: Introductionmentioning

confidence: 99%

Oral contraceptive use and clinical outcomes in patients with multiple sclerosis

Sena¹,

Couderc²,

Vasconcelos³

et al. 2012

Journal of the Neurological Sciences

View full text Add to dashboard Cite

Experimental and clinical data suggest a role of sex steroids in the pathogenesis of multiple sclerosis (MS). Scant information is available about the potential effect of oral contraceptive (OC) use on the prognosis of the disease. We aimed to evaluate this. The study population consisted of 132 women with relapsing-remitting MS before receiving disease modifying treatment and a mean disease duration 6.2 (SD 5.1) years. Three groups of patients were distinguished according to their OC behavior: [1] never-users, patients who never used OC [2] past-users, patients who stopped OC use before disease onset, and [3] after-users, those who used these drugs after disease onset. Multiple linear and logistic regression models were used to analyze the association between oral contraceptive use and annualized relapse rates, disability accumulation and severity of the disease. After-user patients had lower Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Severity Score (MSSS) values than never users (p b 0.001 and p = 0.002, respectively) and past users (p = 0.010 and p = 0.002, respectively). These patients were also more likely to have a benign disease course (MSSS b 2.5) than never and past users together (OR: 4.52, 95%CI: 2.13-9.56, p b 0.001). This effect remained significant after adjustment for confounders, including smoking and childbirths (OR: 2.97, 95%CI: 1.24, 6.54, p = 0.011 and for MSSS β: − 1.04; 95% C.I. − 1.78, − 0.30, p = 0.006). These results suggest that OC use in women with relapsing-remitting MS is possible associated with a milder disabling disease course.

show abstract

“…Little data are available about the impact of hormonal decline during menopause on the course of MS. Smith and Studd [129] have found increased disability in 54% of menopausal women with MS and Holmquist et al [130] have reported worsening of MS symptoms related to menopause in 40% of the patients.…”

Section: Clinical Evidence For the Effects Of Sex Hormones On Diseasementioning

confidence: 99%

Sex Hormones and Multiple Sclerosis

Trenova¹

2016

Trending Topics in Multiple Sclerosis

View full text Add to dashboard Cite

Experimental and clinical data about the influence of sex hormones on the course of multiple sclerosis (MS) grow rapidly during the past two decades. Estrogens, progesterone, and androgens have been shown to ameliorate experimental autoimmune encephalomyelitis (EAE) in animals, and pregnancy in women is associated with a dramatic reduction in disease activity. Immunomodulatory and neuroprotective properties of sex hormones are the most probable underlying mechanisms, creating a background for testing similar hormonal treatments in humans. Several pilot studies in this field present promising results, but larger trials are necessary to identify the adverse events and to estimate precisely the place of sex steroids in multiple sclerosis therapeutic strategies.The objective of this chapter is to summarize the recent advances in the research about the effects of sex steroids in EAE and MS and to create a ground for the development of more powerful treatments in the future.

show abstract

Symptoms of multiple sclerosis in women in relation to sex steroid exposure

Cited by 77 publications

References 17 publications

Female Gender and Reproductive Factors Affecting Risk, Relapses and Progression in Multiple Sclerosis

Female Gender and Reproductive Factors Affecting Risk, Relapses and Progression in Multiple Sclerosis

Oral contraceptive use and clinical outcomes in patients with multiple sclerosis

Sex Hormones and Multiple Sclerosis

Contact Info

Product

Resources

About