TY - JOUR
T1 - Sex effects across the lifespan in women with multiple sclerosis
AU - Krysko, Kristen M.
AU - Graves, Jennifer S.
AU - Dobson, Ruth
AU - Altintas, Ayse
AU - Amato, Maria Pia
AU - Bernard, Jacqueline
AU - Bonavita, Simona
AU - Bove, Riley
AU - Cavalla, Paola
AU - Clerico, Marinella
AU - Corona, Teresa
AU - Doshi, Anisha
AU - Fragoso, Yara
AU - Jacobs, Dina
AU - Jokubaitis, Vilija
AU - Landi, Doriana
AU - Llamosa, Gloria
AU - Longbrake, Erin E.
AU - Maillart, Elisabeth
AU - Marta, Monica
AU - Midaglia, Luciana
AU - Shah, Suma
AU - Tintore, Mar
AU - van der Walt, Anneke
AU - Voskuhl, Rhonda
AU - Wang, Yujie
AU - Zabad, Rana K.
AU - Zeydan, Burcu
AU - Houtchens, Maria
AU - Hellwig, Kerstin
AU - on behalf of the International Women in MS (iWiMS)
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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 sex on MS susceptibility, effects of pregnancy on MS disease activity, and management strategies around pregnancy, including risks associated with DMT use before and during pregnancy, and while breastfeeding. We also review reproductive aging and sexual dysfunction in women with MS.
AB - 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 sex on MS susceptibility, effects of pregnancy on MS disease activity, and management strategies around pregnancy, including risks associated with DMT use before and during pregnancy, and while breastfeeding. We also review reproductive aging and sexual dysfunction in women with MS.
KW - breastfeeding
KW - multiple sclerosis
KW - pregnancy
KW - sex differences
KW - sex hormones
KW - women
UR - http://www.scopus.com/inward/record.url?scp=85087311298&partnerID=8YFLogxK
U2 - 10.1177/1756286420936166
DO - 10.1177/1756286420936166
M3 - Review Article
AN - SCOPUS:85087311298
SN - 1756-2856
VL - 13
JO - Therapeutic Advances in Neurological Disorders
JF - Therapeutic Advances in Neurological Disorders
ER -