Symptoms of multiple sclerosis in women in relation to sex steroid exposure.
OBJECTIVE
To investigate if women with multiple sclerosis (MS) experience changes in MS symptoms related to pregnancy, the postpartum period, menopause or use of oral contraception (OC) or postmenopausal hormone therapy (HT).


METHODS
Women with diagnosed MS were recruited from registers of all MS patients known in two counties of Sweden, respectively. Ninety-four women were recruited in Linköping and 52 in Sundsvall. The women answered a questionnaire with categorized alternatives regarding their MS symptoms related to menstruation, pregnancy, delivery, menopause and use of OC or HT.


RESULTS
Forty percent of the women reported worsening of MS symptoms related to menopause, whereas 56% reported no change of symptoms and 5% reported decreased symptoms. More than a fourth of the women reported decreased symptoms during pregnancy, 64% reported unchanged symptoms and 10% reported increased symptoms. Every third woman reported increased symptoms after delivery, 59% reported no change and 5% reported decreased symptoms. Few women reported changes in MS symptoms in relation to use of HT or OC.


CONCLUSIONS
The presented data indicate a relationship between high-oestrogen states and ameliorated symptoms whereas low-oestrogen states seem to relate to a worsening of the disease. A majority of women, however, reported no changes in MS symptoms in relation to the different oestrogen states.
Holmqvist
Per
P
Division of Obstetrics & Gynaecology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, and Department of Obstetrics & Gynaecology, County Hospital Sundsvall, Sweden. per.holmqvist@lvn.se
Wallberg
Malin
M
Hammar
Mats
M
Landtblom
A-M
AM
Brynhildsen
Jan
J
D000328:Adult; D000368:Aged; D003276:Contraceptives, Oral; D015914:Estrogen Replacement Therapy; D005260:Female; D012739:Gonadal Steroid Hormones / Q000378:metabolism*; D006801:Humans; D008593:Menopause / Q000378:metabolism; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000378:metabolism*; D049590:Postpartum Period / Q000378:metabolism; D011247:Pregnancy
D003276:Contraceptives, Oral; D012739:Gonadal Steroid Hormones