MS is 3 times more common among women than men and is more prevalent in women of childbearing age than in any other age group. Learn why this might be, how the disease course differs in women and what it means for your fertility.
Why is multiple sclerosis more common in women?
Doctors don’t know for certain why MS affects more women than men. Studies point to the roles of female hormones, vitamin D, inflammation and obesity. The fact that so many more women than men have MS suggests that sex hormones such as testosterone and estrogen play a role.
Learn more about the possible causes of MS.
Symptoms for women living with multiple sclerosis
For the most part, the symptoms of MS in women and men are the same. But women’s symptoms may worsen during times like menstruation, pregnancy and menopause when hormones fluctuate.
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. Others have shown that in women who take oral contraception, MS symptoms do not worsen as much before their period starts (Smith, R & Studd, JW, 1992; Zorgdrager A & De Keyser, 1997). These findings have all come from relatively small studies. More research is needed to fully understand the relationship between MS and the menstrual cycle.
There is no evidence that MS impairs fertility. A woman with MS can still get pregnant. And pregnancy and breastfeeding do not affect the disease course in most women.
Family planning for someone with MS does involve many unique considerations. Be sure to share your plans with your MS healthcare provider, including the use of fertility treatment and the timing of stopping contraception and disease-modifying therapies.
Contraception and MS
The risks of taking an oral contraception pill (OCP) are no different for a woman with MS than it is for a woman who does not have MS. There is no evidence that OCPs and DMTs reduce each other’s effectiveness (Kaisey et al, 2018). However, some medications used to treat MS symptoms will interact with OCPs. 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.
Fertility treatments and MS
A 2022 study of 110 fertility cycles did not find an increased risk of relapses after fertility treatments. And it found that continuing DMT during fertility treatments may reduce the risk of relapse during this period. More research is needed to fully understand the impact of fertility treatments on MS.
Read more about female fertility and MS on the Pregnancy and Reproductive Issues page.
MS does not appear to affect the age of menopause onset. But the symptoms of MS and menopause may impact each other in the following ways:
- In some women, MS symptoms worsen during menopause.
- For some, the hot flashes associated with menopause may bring on MS symptoms or make them worse.
- Menopause may make issues with mood, sleep, fatigue, cognitive problems or bladder function more challenging.
- Osteoporosis is more common in people with MS than those without MS. Osteoporosis risk increases in women after menopause as does the risk of fractures.
As during any phase of life, be sure to discuss any new or worsening MS symptoms with your MS healthcare provider.
Hormone replacement therapy (HRT) and MS
There have not been any large studies of women with MS using HRT during menopause. If you have questions, discuss the use of HRT with your gynecologic care provider.
Life expectancy of people with MS
Studies have shown that people with MS do have a somewhat shorter life expectancy. But that gap between those with MS and the general population has been shrinking. We expect this trend to continue.
If you live with MS, it is important to prioritize healthy behaviors, including:
- Eating a nutritious diet
- Getting regular exercise
- Not smoking or vaping
- Keeping up with preventive care
- Managing other medical conditions
Research shows that these good habits contribute to overall health and can impact a person’s MS progression and lifespan.
Support for women living with MS
If you live with MS, connecting with people who share common life experiences or goals for support, education and mutual aid can be helpful. With community, you might:
- Learn new strategies for preventing or confronting problems.
- Find emotional and other support — and the opportunity to help others.
- Build confidence in your ability to cope and address issues.
Come together with others through the National MS Society. A number of support groups specifically for women meet in person or virtually. An MS Navigator can help you connect with these and other forms of support.