Multiple sclerosis (MS) is not strictly a women's disease, but it often affects women. Decisions regarding birth control, childbearing and hormone replacement therapy can affect the symptoms in women. While women do not have a different set of symptoms, they can see an increase or decrease in symptoms as their hormones fluctuate. Women are also more likely to have an earlier onset of symptoms then men and thus may get earlier diagnoses.
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MS was first described clinically in 1868 by Dr. Jean-Martin Charcot at the University of Paris. As late as the 1920s, it was thought that men contracted MS more frequently than women. That was largely due to women who suffered from MS being misdiagnosed as having "hysteria"—the sometimes subjective nature of the symptoms being compounded by the fact that flare-ups in women can follow their menstrual cycle.
Women are most often diagnosed with MS during their childbearing years and often are diagnosed during or after pregnancy. Hormones associated with pregnancy can put the disease into remission, especially during the third trimester, but the postpartum period can trigger symptoms. Studies of progestin and estradiol hope to show the protective qualities of female hormones against MS symptoms. The hormone fluctuations found in the childbearing years bring symptoms to the forefront and hasten diagnosis.
While women may experience a remission of symptoms late in pregnancy, pregnancy itself can aggravate certain symptoms. Problems with gait and balance can be exacerbated by the added weight of pregnancy and the shift in a woman's centre of gravity. Existing bladder and bowel problems can also worsen during pregnancy. Fatigue can be an issue as well. Pregnancy has not been shown, however, to affect the overall course of the disease.
As with many autoimmune diseases, women are diagnosed with MS about twice as often as men are. Additionally, whites are twice as likely to contract MS than people of colour. White women of Scandinavian descent living above the 37th parallel (roughly from southern Virginia to San Francisco and north), aged 20 to 40 with a family history of MS are the most likely to contract the disease. Whereas early-onset MS is even more likely to affect women than men (about three to one), late-onset MS is more likely to affect men.
A 2006 Mayo Clinic study showed that although MS is not considered a hereditary disease, men are more likely than women to transmit the disease to their children. A 2007 study at Oxford University, however, showed that men and women pass on the disease at about the same rate. A study at Wayne State University in 2006 showed that women have higher levels of a protein associated with the damage MS causes and that testosterone has neuroprotective qualities. Women also have a higher rate of turnover for the cells that repair damage caused by MS. Studies continue to look at the role of hormones in affecting and treating MS.
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