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.
MS Comprehensive Care Center, SUNY at Stony Brook, New York, NY, USA. pcoyle@notes.cc.sunysb.edu
P K
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Coyle
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Christie
P
P
Fodor
K
K
Fuchs
B
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Giesser
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Gutierrez
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Lynn
B
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Weinstock-Guttman
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Pardo
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