The Unique Impact of MS on Women

Multiple Sclerosis in Women vs. Men

Living with multiple sclerosis presents a unique challenge for women. What are the symptoms of ms in a woman? How will ms affect me sexually? Can I get pregnant with MS? These are all questions that may be running through your mind.

Until relatively recently, most of the medical and rehabilitation research focused on either males exclusively or mixed populations without examining gender differences. As an example, prior to 1990, there was only one publication that examined the unique demographics of women with functional or cognitive challenges.

When the unique challenges experienced by women with chronic medical conditions were explored, it was found – on a population level – that women have increased difficulty accessing basic medical care, surgical procedures, eyeglasses, dental care, prescriptions, and mental health interventions. These types of findings prompted the medical world to take notice. New lines of research produced a better understanding of the prevalence of MS among women and the unique considerations needed for assessment and treatment in this gender.

Previously it was thought that MS affected females to males 2:1. We now know the ratio is much higher at 4:1. This disease often strikes young adults from the ages of 15-45 years; for women – childbearing years. Furthermore, the same disease process that impacts walking, balance, sensory changes, vision, and cognition, also has a unique impact on the sexual health of women.

In this article, you will learn a few things we know about health conditions that uniquely impact women with MS.

Mental Health in Women with MS

• MS can impact all stages of a women’s life both physically & psychologically.
• Depression, stress, and low self-esteem are more common among women with MS.
• Peer support and social relationships among women protect against depression, stress, low self-esteem, and promote increased independence and self-efficacy.

Sexual Health in Women with MS

• Changing family roles & responsibilities caused by MS, may create challenges in having and maintaining intimacy.
• There is no evidence that menstruation or menopause impacts relapse rate or progression of MS.
• Between 40-85% of women experience changes in their sexual functioning including decreased genital sensation, libido or sexual interest, vaginal lubrication, and difficulty reaching orgasm.
• Despite a number of options for treatment or intervention, many medical providers don’t ask about sexual symptoms, and patients rarely talk about these changes.
• Women with physical disabilities are rarely offered contraceptive information or options.
• Communication is key!

Pregnancy and MS

• Pregnancy has NOT been shown to adversely affect MS progression.
• Relapse rates of MS decline during pregnancy & pregnancy is often considered a “protective” time in a women’s life.
• MS does NOT appear to impact the risk for miscarriage, pre- eclampsia, pre-term labor, C-section, child mortality or congenital abnormalities.
• While the diagnosis of MS does not necessitate high-risk healthcare during conception/pregnancy, the symptoms of MS may require greater attention and management.
• NONE of the MS treatments are indicated or approved for use during pregnancy or breastfeeding.  However, some MS medications pose less risk than others, so please discuss specific questions or concerns with your Neurologist and OB-GYN.
• Ideally, women should be off any MS treatment 1-3 months before conceiving. (Discuss with your own MD)

Conclusion

Understanding the unique healthcare challenges faced by women with MS has grown exponentially.  However, one of the remaining difficulties is discomfort and stigma around sexual and reproductive health. Let’s reduce this difficulty by: increasing your awareness of these conditions, helping you know what questions to ask, and learning to effectively communicate with your medical provider.