title: Symptoms of multiple sclerosis in women in relation to sex steroid exposure.
abstract: 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.
authors.affiliation: 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
authors.forename: Per
authors.initials: P
authors.lastname: Holmqvist
authors.forename: Malin
authors.initials: M
authors.lastname: Wallberg
authors.forename: Mats
authors.initials: M
authors.lastname: Hammar
authors.forename: A-M
authors.initials: AM
authors.lastname: Landtblom
authors.forename: Jan
authors.initials: J
authors.lastname: Brynhildsen
mesh_terms: 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
chemical_list: D003276:Contraceptives, Oral; D012739:Gonadal Steroid Hormones