Multiple sclerosis gender issues: clinical practices of women neurologists.
Substantially more women than men develop multiple sclerosis (MS), but information about the effects of MS and gender-specific issues such as pregnancy, breastfeeding, menstruation and hormone use is lacking. A survey study of neurologists' practice patterns was undertaken to elicit information about gender-specific topics and the use of disease-modifying MS therapies (DMT) including the interferons and glatiramer acetate (GA). A total of 147 surveys were returned. Half of respondents require patients to discontinue DMT during pregnancy, while 35% encourage discontinuation. Among those who allow patients to continue therapy, half consider GA to be safer during pregnancy than the interferons. Nearly 86% of respondents do not use DMT in patients who are breastfeeding. Among the 11% who actually prescribe during breastfeeding, most recommend GA. Neurologists generally leave the decision to breastfeed up to patients, and most refer patients to obstetrician/gynaecologists for counselling about contraception or hormone replacement therapy. The survey results described here provide insight into how neurologists manage reproductive health issues among women with MS.
Coyle
P K
PK
MS Comprehensive Care Center, SUNY at Stony Brook, New York, NY, USA. pcoyle@notes.cc.sunysb.edu
Christie
S
S
Fodor
P
P
Fuchs
K
K
Giesser
B
B
Gutierrez
A
A
Lynn
J
J
Weinstock-Guttman
B
B
Pardo
L
L
D001942:Breast Feeding; D003267:Contraception; D015914:Estrogen Replacement Therapy; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008599:Menstruation Disturbances / Q000628:therapy; D009103:Multiple Sclerosis / Q000628:therapy*; D009462:Neurology; D010822:Physicians, Women; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy; D011364:Professional Practice; D016387:Women's Health