MS is more common in women than men, so this research paper is a review of the evidence for how gender and hormones can affect MS.
The review identifies several differences in MS between men and women. For example men are more likely to develop primary progressive MS and have worse cognitive symptoms. There is an increasing proportion of women developing MS, and vitamin D has been shown to have a greater effect on the immune system in women with MS than in men.
Pregnancy also has a large effect on a woman’s MS, with less MS activity during pregnancy and an increase risk of having a relapse in the months after giving birth.
All of this evidence points to an important role of the sex hormones in MS. It will be important to work out what is going on and understand the effects that hormones have on the immune system particularly during pregnancy. This could help develop new strategies for the treatment of MS, such as treating men and women is different ways as they might respond to therapies differently.
MS is thought to be an autoimmune condition as the immune system attacks the myelin covering of nerves in the central nervous system. In common with many other autoimmune conditions, MS occurs more often in women than in men and the proportion of women is going up. Due to this gender difference, the effect of sex hormones on MS has been an area of interest for researchers.
This research paper is a review of the evidence for how gender and hormones can affect MS.
The review concludes that it will be important to work out what is going on and understand the effects that hormones have on the immune system and autoimmune conditions. Of particular interest is what is happening during pregnancy when MS activity decreases. This could help when choosing treatments as men and women might respond to therapies differently and it might even provide a way of using hormones as a treatment, as some researchers have already tried in some small studies.
Hormonal and gender-related immune changes in multiple sclerosis.
Acta Neurol Scand. 2015;132(199):62-70. doi: 10.1111/ane.12433.
Read the full text of this paper
Who gets MS and why is a complex subject but, at the moment, it occurs in about three times more women than men and research suggests the proportion of women with MS is increasing.
The reasons why it is generally more common in women than men are not really known. To try and work out why, there is an active area of research around hormones, as the ratio of men and women being diagnosed with MS is equal before puberty and after the menopause, when hormonal differences are not as extreme. Additionally many women with MS find that their MS changes around their period, during pregnancy and at the menopause when their hormone levels change. Some researchers have started to look at the role of sex hormones as potential treatments for MS with some studies suggesting they could have both an anti-inflammatory and neuroprotective effect.
As this review shows although we can see the differences in MS between men and women but more work is needed to work out if hormones are the reason for the gender differences and if so what specific effects do hormones have on the immune system.
To read more about pregnancy in MS, our A-Z on pregnancy and parenthood contains helpful information about the health aspects of MS and becoming a parent.