Gender issues in multiple sclerosis.
Multiple sclerosis is an inflammatory demyelinating disorder of the CNS that also has features of a neurodegenerative disease. Gender influences both susceptibility to multiple sclerosis and the clinical course of disease. The basis for these differences may include genetic and immunological factors. The immunological differences between men and women may be mediated through the effects of the sex hormones. It can be speculated that there may also be gender differences in the ability of males and females to repair damage in the CNS. Multiple sclerosis is also influenced by pregnancy, with fewer relapses in pregnancy and increased numbers of relapses post-partum. This effect is likely to be mediated by the hormones produced in pregnancy, which include the steroid and other pregnancy-specific hormones. Pregnancy may also lead to a more favorable clinical course of multiple sclerosis. These observations lead to the possibility of treating multiple sclerosis patients with steroid or pregnancy hormones or the growth factors found in pregnancy.
McCombe
Pamela A
PA
Department of Neurology, Royal Brisbane Hospital, Herston, Queensland 4029, Australia. p.mccombe@medicine.herston