Hormones: The Basic Facts
Do sex hormones play a role in MS?
Do male sex hormones play a role in MS?
Some animal studies suggest that this may be because testosterone levels are high enough in young men to prevent these diseases. Studies in mice with an MS-model disease show a distinct link between low testosterone and worsening disease. Testosterone levels in men begin to decline modestly after the age of 30. There is also some evidence that MS may take a more aggressive course in men, once it begins. This sex-related difference warrants more research.
Do female sex hormones play a role in MS?
Pregnancy and MS relapses
In a 1998 study of 254 pregnant women with MS, Pregnancy in Multiple Sclerosis (or PRIMS), a 71% reduction in relapses was reported during the third trimester. Rates then increased during the first three months postpartum, returning to pre-pregnancy rates.
Can we predict who is most likely to relapse after giving birth?
Does pregnancy affect MS-related disability?
We don't know yet. The PRIMS study showed that disability continued to accumulate for the next two years at a rate unaffected by pregnancy and the postpartum period. However, two smaller studies that followed participants for longer periods of time, found that later development of disability was reduced with pregnancy, and one of these studies showed that a full-term pregnancy increased the time interval to reach a common disability end-point, such as needing a cane or crutch.
An earlier study from 1995, which followed women with relapsing-remitting MS, found a significantly decreased risk of the disease evolving into secondary progressive MS in those women who became pregnant after MS onset.
Can pregnancy prevent MS?
Why is pregnancy temporarily protective?
Two estrogens, estradiol and estriol, have been shown to be protective in animal models of MS when given in doses equal to or greater than those found in pregnancy. Estradiol is an estrogen associated with the menstrual cycle and estriol is unique to pregnancy.
Studies in 2002 and 2003 of estriol in pill form taken by women with MS showed that treatment caused a decrease in lesions on MRI and induced a favorable effect on immune responses. Further trials of estriol treatment for MS are now in the planning stages.
Treatment with a combination of pregnancy factors is becoming an increasingly attractive idea, and estrogens, progesterone, and/or others are primary candidates for use in future trials looking for ways to prevent the postpartum relapse.
Could estrogens in oral contraceptives protect in MS?
What does the future hold for estrogens and MS treatment?
|Copyright © National Multiple Sclerosis Society, 2005|