It is more likely for women to have multiple sclerosis (MS), an autoimmune disease that impacts the central nervous system (composed of the spinal cord and brain). People diagnosed with multiple sclerosis get symptoms due to demyelination or damage to the myelin, the covering on the neuron’s axon.
Women have twice as great a chance of getting MS than men, the National Institute of Neurological Disorders and Stroke said. But rates of MS adjust with the age it begins. For example, men usually develop MS in their 30s or 40s, while it occurs in women earlier. When the gender ratio of MS is recorded before age 20, the rate of women with MS is greater than men at 3:2:1, said Rhonda Voskuhl and Barbara S. Giesser, authors of the chapter “Gender and Reproductive Issues in Multiple Sclerosis” in the book Primer on Multiple Sclerosis.
One part of MS research studies the condition during and after pregnancy. Researchers do not think that MS hurts a pregnancy or leads to a greater risk of stillbirth, miscarriage, premature delivery, miscarriage or eclampsia. Women with MS who become pregnant may have a reduction in disease exacerbation, the National Multiple Sclerosis Society said. The decrease usually happenings in the second and third trimesters.
While pregnant, women with MS must think about how their disease-modifying medication may impact their unborn child. Mitoxantrone, cyclophosphamide and azathioprine, disease-modifying medications for MS, have a category D FDA pregnancy risk, Voskuhl and Giesser said. With a category D risk there is “evidence of fetal harm in humans; use may be justified in some circumstances.”
Women with MS who are contemplating getting pregnant should discuss their medicine with their doctor. While disease exacerbation diminishes when pregnant, the possibility of a relapse may rise after giving birth- about three to six months after.
“To prevent relapses during this postpartum period, many women with [multiple sclerosis] will choose to resume disease-modifying drugs within two weeks after delivery of their child,” Voskuhl and Giesser said.
Female MS patients often also experience sexual dysfunction. They have a hard time achieving an orgasm and they may have little feeling in the vagina, the Merck Manual said. Reduced libido may also occur; men and women may experience this.
Besides “primary sexual dysfunction,” those with MS may also have “secondary sexual dysfunction,” such as bowel and bladder problems, and “tertiary sexual dysfunction,” such as self-esteem and body image issues. Symptoms of secondary and tertiary sexual dysfunction can impact sexual expression. Forty to 80 percent of women with MS go through sexual changes from the disease, the Multiple Sclerosis International Federation said. Doctors may have patients answer the Multiple Sclerosis Intimacy and Sexuality Questionnaire, a 19-question survey, to figure out sexual-related issues.
Resources:
Voskuhl, R. and Giesser, B.S. “Gender and Reproductive Issues in Multiple Sclerosis.” In Giesser, B.S. (Ed.) Primer on Multiple Sclerosi ; Oxford University Press; 2011
National Institute of Neurological Disorders and Stroke: Multiple Sclerosis: Hope Through Research
http://www.ninds.nih.gov/disorders/multiple_sclerosis/detail_multiple_sc...
National Multiple Sclerosis Society: Epidemiology of MS
http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-a...
National Multiple Sclerosis Society: Pregnancy and Reproductive Issues
http://www.nationalmssociety.org/living-with-multiple-sclerosis/healthy-...
Merck Manual Home Edition: Multiple Sclerosis (MS)
http://www.merckmanuals.com/home/sec06/ch092/ch092b.html
The Multiple Sclerosis International Federation: Sexual Changes in MS
http://www.msif.org/en/about_ms/ms_by_topic/relationships_intimacy_sexua...
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