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Overview of MS women's health issues

MS is three times more common in women than in men and is more prevalent in women of childbearing age than in any other age group. Many women report their MS symptoms fluctuate during their menstrual cycle and at menopause.

Contraception with Multiple Sclerosis
The risks of taking an oral contraception pill (OPC) is no different for a woman with MS than it is for a woman who does not have MS. There is no evidence the OCPs reduce the effectiveness of DMTs. Conversely, there is no evidence that DMTs reduce the effectiveness of OCPs (Kaisey et al, 2018). However, some medications used to treat MS symptoms will interact with OPCs. Be sure to tell your MS healthcare provider and your gynecologic care provider of all the medications and supplements you are taking to ensure there are no interactions.

Menstrual cycle impact on MS

Many women report that their MS symptoms temporarily worsen around the time of their period. A few studies have confirmed this  and others have shown that women on oral contraception have less worsening of their MS symptoms prior to the start of their period (Smith, R & Studd, JW, 1992; Zorgdrager A & De Keyser , 1997). These findings have all come from relatively small studies, and more research is needed to fully characterize the relationship between MS and the menstrual cycle.

Menopause and MS

The age of menopause onset does not appear to be affected by MS. Some women experience a worsening of their MS symptoms during menopause. And for some, the hot flashes associated with menopause may intensify or bring on MS symptoms. Menopause may make issues with mood, sleep, fatigue, cognitive problems or bladder function more challenging (Kaisey et al, 2018). You should discuss any new or worsening MS symptoms with your MS healthcare provider.

There have not been any large studies of women with MS using hormone replacement therapy (HRT) during menopause. If you have questions, discuss the use of HRT with your gynecologic care provider.

Reviewed by Barbara Giesser, MD, October 2019

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