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Multiple Sclerosis Symptoms in Females

A cartoon of a woman with multiple sclerosis.

Multiple sclerosis (MS) is a potentially disabling disease of the central nervous system that can have an unpredictable course. It belongs to a group of conditions called autoimmune diseases. The National MS Society estimates there are nearly 1 million people with MS in the United States. This debilitating condition is up to four times more common in women than men. There is no cure for multiple sclerosis. However, treatments can reduce the severity of MS symptoms and slow the progression of the disease.

Please continue reading to learn more about the common symptoms of multiple sclerosis and how it affects women in particular.

How does MS affect the central nervous system (brain and spinal cord)?

Multiple sclerosis (MS) is an autoimmune condition. It occurs when the immune system attacks the myelin, which is a protective sheath that covers nerve fibers. As a result, communication between nerve cells and the rest of the body is affected, causing a variety of symptoms. 

Notably, multiple sclerosis symptoms tend to relapse and remit, i.e., come and go. A person with multiple sclerosis will therefore notice symptom variation. They may have periods (lasting days to weeks) with a flare of MS symptoms, followed by a period (lasting months or even years) when the disease is quiet and symptoms subside. 

In about 20-40% of people who develop MS, approximately 10-20 years after the onset of MS symptoms, there can be a steady progression of symptoms without periods of remission. This is called secondary progressive MS. Ultimately, such MS patients develop permanent nerve damage.

What are 3 warning signs of MS?

The most common early signs of MS include:

  • Vision problems, including eye pain or flashes of light with eye movement, temporary loss of vision, blurry vision, and/or color blindness
  • Numbness and tingling in different parts of the body
  • Lhermitte sign (electric-shock-like sensations with certain neck movements such as bending the neck forward)
  • Unsteadiness while walking, poor coordination, and balance problems
  • Severe and painful spasms
  • Involuntary muscle spasms
  • Muscle weakness and stiffness
  • Clinically significant pain
  • Vertigo
  • Fatigue
  • Slurred speech
  • Mood changes
  • Cognitive problems
  • Sexual dysfunction
  • Bowel problems (constipation, diarrhea, loss of bowel control)
  • Bladder symptoms (most common bladder symptoms include frequency, urgency, frequent nighttime urination, incontinence, and inability to empty the bladder completely)

What is typically the first symptom of MS?

The first noticeable symptom of multiple sclerosis can vary from person to person. However, in many people with MS, optic neuritis (inflammation of the optic nerves) is a very common symptom. Consequently, vision problems are the first obvious sign of this autoimmune disease. Eye symptoms often lead to the diagnosis of MS. This may be partly because the neurologic symptoms detailed above, such as numbness and tingling, nerve pain, and painful muscle spasms, are nonspecific and can be attributed to other health conditions before a more in-depth evaluation reveals multiple sclerosis.

Why is MS more common in women? 

As noted, MS affects women more than men. This has led scientists to examine possible causes and study the effects of multiple sclerosis in women. 

Sex hormones

Scientists believe sex hormones such as estrogen and testosterone may play a role in developing MS. Before puberty, there is no striking difference between boys and girls developing MS. However, MS commonly affects adolescent girls and young women much more than adolescent boys and young men.

Obesity and body fat distribution

The increasing incidence of multiple sclerosis may be related to obesity and body fat distribution. Women tend to carry more weight around their midsection, and this is known to be associated with more inflammation in the body, which could be a risk factor for MS.

Low vitamin D levels

Research has shown that multiple sclerosis tends to affect people who live away from the equator, where there is less exposure to sunlight. Exposure to sunlight is necessary for the skin to make vitamin D. Some women, such as pregnant and lactating women are at a higher risk of vitamin D deficiency. Scientists believe there is a link between vitamin D levels and the risk of developing MS. In people with an MS diagnosis, those with higher vitamin D levels and more outdoor exercise tend to have fewer relapses. 

What are the early signs of MS in women?

Early symptoms of MS in women are the common symptoms mentioned above. Additionally, women may experience the following.

Sexual problems

MS can affect sexual function in women, causing loss of libido (sexual desire), impaired ability to orgasm, loss of sensation in the genitalia, and reduced vaginal lubrication.

Irregular menstrual cycles

Women diagnosed with MS tend to have more irregular menstrual cycles and other symptoms associated with menstrual periods. 

Pregnancy and reproductive issues

Pregnant women tend to have fewer symptoms of MS. This may be because the body suppresses the immune system during pregnancy. However, the disease tends to flare in the postpartum period (after childbirth).

What is the treatment for multiple sclerosis in women?

Healthcare providers take an individualized approach to controlling multiple sclerosis in both women and men. This means the primary symptoms dictate the treatment. For example, if sexual problems, cognitive dysfunction, or chronic pain are your most common symptom, treatment will be directed towards relieving those specific symptoms. 

In people with mild MS symptoms, no treatment may be necessary. In others with more severe symptoms, corticosteroids and disease-modifying medication combined with treatments like plasmapheresis (plasma exchange) and physical therapy may be prescribed to manage multiple sclerosis symptoms, speed up recovery from MS attacks, and slow disease progression. 

 

References:

  1. https://www.nationalmssociety.org/About-the-Society/News/Landmark-Study-Estimates-Nearly%C2%A01-Million-in-the-U
  2. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Bladder-Dysfunction
  3. https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269
  4. https://www.mssociety.org.uk/about-ms/signs-and-symptoms/early-signs-of-ms
  5. https://www.hopkinsmedicine.org/health/conditions-and-diseases/multiple-sclerosis-ms/multiple-sclerosis-why-are-women-more-at-risk
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990512/
  7. https://n.neurology.org/content/90/15_Supplement/P4.355