Multiple sclerosis (MS) is an autoimmune disease that is three times as common in women as in men. Though the symptoms and treatments often look similar, how the disease shows up can be different for women.
Jasmin Patel, MD, a neurologist at Atlantic Health and Medical Director of the Linda E. Cardinale Multiple Sclerosis (MS) Center at Atlantic Health CentraState Medical Center, shares more about this condition and how it affects women.
What is MS?
In MS, the immune system is overactive when it shouldn’t be. This condition damages the myelin, the fatty, protective coating around the nerves, in the central nervous system. Symptoms of MS vary depending on where the nerve damage happens, and often first appear between age 20 and 40.
“MS is more common in women than men, likely because of the role of hormones and the immune system, but sometimes women’s symptoms can be dismissed or attributed to something else,” says Dr. Patel. “It’s extra important to be aware of the symptoms the disease can cause and when to seek care.”
Symptoms of MS in women
MS symptoms can be similar in women and men, but are different from person to person. Symptoms include:
- Cognitive mood issues
- Double vision or vision loss
- Loss of balance and difficulty walking
- Loss of bladder control
- Muscle tightness
- Numbness or tingling
- Severe fatigue
- Sexual dysfunction
- Weakness of the limbs
“The disease itself behaves similarly, but the difference is how external factors impact how women feel or do with certain symptoms,” says Dr. Patel. “For example, bladder control problems may be worsened by multiple pregnancies, and the hormonal transition during menopause can lead to greater sexual dysfunction.”
For women, MS symptoms are often misattributed to premenstrual syndrome, menopause or other causes, especially since it’s normal for women to feel foggy or fatigued a couple of days before their period or have nonspecific symptoms that overlap.
MS symptoms can shift in women over their lives as hormones change, and even within their monthly cycle. For example, MS symptoms:
- Can be more severe just before a woman’s period.
- Ease during pregnancy, but get more intense in the postpartum period.
- May get more severe during perimenopause and menopause (especially brain fog and fatigue).
Treatment options for women with MS
While there is no cure for MS, there are many treatment options to help bring the immune system back into balance and slow disease progression. These disease-modifying therapies don’t vary between men and women.
Therapies and lifestyle modifications can also help patients work through symptoms. This personalized approach includes:
- Exercise to strengthen muscles, improve balance and ease fatigue.
- Medication to ease pain, muscle stiffness, brain fog, overactive bladder and other symptoms.
- Nutrition recommendations.
- Pelvic floor therapy to improve bladder control and sexual health.
- Physical and occupational therapy to recover function from damaged nerves.
- Referrals to ophthalmologists, urologists, gynecologists and other specialists as needed.
“MS is progressive, but the treatments we have work well in halting that progression and easing symptoms,” says Dr. Patel. “The sooner someone gets diagnosed and treated, the better their outcomes since we can prevent further damage to the nervous system.”
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