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Caring for Women with Multiple Sclerosis Across the Lifespan

  • Demyelinating Disorders (J Bernard and M Cameron, Section Editors)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Caring for women with multiple sclerosis (MS), whose first symptoms typically begin during the childbearing years, requires a comprehensive approach to management across a range of reproductive exposures, and beyond through menopause.

Recent Findings

This article summarizes what is known about the disease course in women with MS, how it differs from men, and the current state of knowledge regarding effects of reproductive exposures (menarche, childbearing, menopause) on MS-related inflammation and neurodegeneration. Recent findings regarding pregnancy-associated relapses in the treatment era, protective effects of breastfeeding, and care for women during the menopausal transition are reviewed. Then, updated recommendations to guiding women during childbearing—including pre-conception counseling, discontinuation of MS therapies, and management of postpartum relapses—are provided. Whenever possible, areas of uncertainty and avenues for future research are highlighted.

Summary

From childhood through the postreproductive life stages, gender and hormonal exposures appear to shape an individual’s risk for MS, as well as the experience of living with MS.

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Acknowledgements

RB has received research support from the National Multiple Sclerosis Society, the Hilton Foundation, and the California Initiative to Advance Precision Medicine. RB has served on the advisory boards of Roche Genentech, Genzyme Sanofi, and Novartis.

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  1. Weill Institute for the Neurosciences, Department of Neurology, University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA, USA

    Kelsey Rankin & Riley Bove

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Kelsey Rankin declares no potential conflicts of interest.

Riley Bove is a consultant for Roche Genetech, Novartis, and Genzyme Sanofi.

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This article is part of the Topical Collection on Demyelinating Disorders

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Rankin, K., Bove, R. Caring for Women with Multiple Sclerosis Across the Lifespan. Curr Neurol Neurosci Rep 18, 36 (2018). https://doi.org/10.1007/s11910-018-0846-2

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