How Multiple Sclerosis Affects Women

Woman in a wheelchair in the park

Chances are you’ve heard of Multiple Sclerosis, but did you know that three times more women than men live with the disease, and most of them were diagnosed during childbearing age? That’s why Capital Women’s Care is marking Multiple Sclerosis Education and Awareness Month by sharing facts–and some hope–about MS.

What Is Multiple Sclerosis (MS)?

MS is an autoimmune disease of the central nervous system (including the eyes) that affects the brain and spinal cord. Those afflicted have brain and spinal cord lesions which damage the surrounding protective myelin sheaths encasing the body’s nerves, causing inefficient transmissions of nerve impulse “messages” between the brain and body.

MS is not fatal; however, there is no single diagnosis test or known cure. Therefore, it’s crucial to recognize its signs and symptoms.  Fortunately, through comprehensive care including treatments and disease-modifying therapies, symptom progressions may be slowed or delayed.

There are four MS forms:

  • Relapse-remitting MS – the most common form, affecting about 80% of those afflicted. It includes periods of symptom experiences (clinical attacks) followed by periods without symptoms (remission.) Triggers for both symptoms and remissions are unknown. 
  • Secondary progressive MS – occurs in those afflicted with relapse-remitting MS usually after 10 years. This form is characterized by no remission reprieve and continually worsening symptoms.
  • Primary progressive MS – the next most common form, affecting about 10 to 20% of those afflicted. This form presents constant symptoms that worsen over time with no clinical attacks or remissions. It typically begins at around age 40, later onset than other forms.
  • Progressive relapsing MS – the rarest form that initially appears like primary progressive MS with constant symptoms. Those afflicted experience clinical attacks of more severe symptoms.

12 Common Symptoms Affecting Women

MS symptoms are great masqueraders that easily disguise themselves as signs of other types of illnesses. What’s more, symptoms differentiate widely among those afflicted, making MS difficult to diagnose.

The most common MS symptoms affecting women include:

  1. Vision problems, including blurred vision, poor color or contrast vision, painful eye movement, blindness in one eye, or dark spot in vision field. Symptoms occur due to optic nerve inflammation or nerve damage in the pathways controlling visual coordination and eye movement. Most MS vision problems resolve without treatment or are highly treatable.
  2. Intermittent numbness, burning or tingly (pins-and-needles) sensations which can affect the face, body, arms, legs, hands or feet. Sensations range from mild to severe and can affect everyday activities like grasping objects and walking. Most MS sensations resolve without medication and are not permanently disabling.
  3. Fatigue or unexplained exhaustion because of wakening due to bladder dysfunction or nocturnal muscle spasms. An MS-specific symptom called lassitude fatigue happens daily, worsens throughout the day (even after sound sleep) and interferes with daily activity. It also worsens with heat or humidity and is unrelated to physical impairments or depression.
  4. Bladder problems occur when nerve lesions impair signals to properly transmit messages to urinary sphincters and bladder, making it difficult to hold urine and reduce amount stored. More frequent or urgent urination, hesitancy initializing urination, frequent nocturnal urination, inability to completely empty bladder or hold urine and bladder leaks are all MS-related symptoms.
  5. Bowel problems such as constipation, diarrhea or loss of bowel control occur due to possible neurological damage. Bowel problems may make other MS symptoms especially worse, including bladder issues, muscle stiffness and involuntary muscle spasms.
  6. Acute pain symptoms may include stabbing face pain (trigeminal neuralgia); electric shock-like sensation moving from back of head down neck and spine usually after bending forward (Lhermitte’s sign); or stabbing, squeezing, painful or burning sensation around torso or in legs, feet or arms (the MS hug.) Chronic MS pain may present as burning, aching, “pins and needles,” or prickling, often in the back and legs. 
  7. Cognitive issues with processing, learning and recalling new information; organizing information and problem-solving; focusing and maintaining attention; compromised perception of surrounding environment; understanding and using language; inability to multitask and do calculations. Symptoms are typically mild to moderate; those afflicted rarely experience disabling cognitive impairments.
  8. Clinical depression is more common in those with MS than those having other chronic health conditions. Lack of interest in everyday activities, change in appetite, sadness, irritability, insomnia/excessive sleep, fatigue, worthlessness and/or guilty feelings, behavior changes and thoughts of death or suicide indicate clinical depression if symptoms persist two weeks minimum. Depression can exacerbate other MS symptoms, including fatigue, pain and changes in cognitive function.
  9. Muscle weakness, stiffness and/or involuntary spasms. Weakness can affect any part of the body. Mobility, especially walking, becomes compromised when weakness affects legs, ankles and feet, causing clumsiness, tripping, stumbling, unsteadiness and falling with no known reason. It occurs due to damage of nerve fibers aiding muscle control or lack of muscle use causing de-conditioned muscles. Stiffness and spasms (spasticity) commonly affect extremities. Spasticity signs:  tightness in or around joints; painful, uncontrollable spasms in legs and arms; lower back pain; hips and knees that may bend and become difficult to straighten or stiffen while close together or crossed.
  10. Dizziness, nausea and (in some instances) vertigo. Symptoms including sensations of lightheadedness, wooziness, weakness or faintness may occur. Vertigo results when nerve damage causes confusion among the body’s motor, sensory and coordination systems that aid maintaining balance in the body. Vertigo symptoms include balance issues, motion sickness, nausea, vomiting, lightheadedness and spinning sensations.
  11. Sexual issues include difficulties with arousal or achieving orgasm, vaginal dryness which can lead to painful intercourse, or abnormal sensations, whether greatly diminished or painfully heightened. 72% of women afflicted with MS have sexual issues. Other MS-related issues affecting sexual intimacy may include muscle spasms and stiffness, changes in mood or self-esteem and fatigue.
  12. Emotional changes include sudden mood swings, bouts of uncontrollable laughing or crying, irritability, grief, worry, fear, anxiety, distress, anger or frustration. More than 60% of those afflicted experience some form of emotional distress. Some medicines used to treat MS symptoms, like corticosteroids, can cause anxiety, irritability, agitation, tearfulness, restlessness and fear. 

Hormonal Changes and MS

Additionally, there is some scientific evidence indicating MS may affect women differently than men due to hormonal changes during:

  • Menstruation -- Some studies indicate women with MS display worse symptoms within one week of beginning their menstrual cycle. Studies utilizing MRI have shown MS disease activity may change according to the different hormonal levels present during menstruation.
  • Pregnancy – May reduce risk of MS symptom flare-ups, especially during the second and third trimesters. Scientists think pregnancy offers a protective effect against MS because it raises levels of compounds which help reduce inflammation and the disease’s effects. Additionally, pregnant women have naturally higher levels of circulating corticosteroids, another immunosuppressant.

Although pregnancy may temporarily reduce some MS symptoms, flare-ups tend to return during the first three to six months postpartum. It is worth noting that in the long term, there is no proven link between pregnancy and higher disability risk. Even though flare-up risk is temporarily reduced, pregnancy puts greater physical stress on the body which may make certain MS symptoms worse.

Some MS medications are not safe to use while pregnant and may cause worsening symptoms. Discuss medications with your doctor should you have MS and are pregnant or planning pregnancy.

MS symptoms often exacerbated during pregnancy include fatigue, gait problems and bladder and bowel problems.

  • Menopause – MS symptoms can worsen after menopause possibly due to declining estrogen levels that adversely affect disease progression. Disease progression may be a natural result of aging or MS condition characteristics. More research is needed to determine the correlation between menopause and MS symptoms.

Other Symptoms

While the symptoms above are the most common, MS affects everyone differently. Less common MS symptoms include:

  • speech problems
  • seizures
  • hearing loss
  • swallowing problems
  • tremor
  • breathing problems
  • itching
  • headaches

Diagnosis and Treatment

It’s important to be aware of any changes within your body and/or mind and keep a list of concerning symptoms. Schedule an appointment with your doctor if unsure or concerned. During your appointment, you will be asked about your and your family’s medical history and have a physical exam.  Your doctor also may suggest having a neurological exam or an MRI, as lesions on the brain and spinal cord, characteristic signs of MS, may be visible.

If diagnosed with MS, your doctor may suggest medication, rehabilitation in the form of either physical or occupational therapies or other therapies and strategies to effectively manage and control symptoms, slow disease progression and live well. You can devise effective MS symptom management through engaging a professional interdisciplinary healthcare team, a key component to a comprehensive MS care and management plan.

Recent Progress

Researchers are tracking down exciting leads and making headway in virtually every field related to MS, according to the National Multiple Sclerosis Society. Here are some recent examples:

  • Researchers are making headway to understand how the body’s gut microbiome may influence MS severity, which could lead to new approaches to stopping MS.
  • Testing is underway of approaches to protecting the nervous system from MS damage, including repurposing therapies already approved for other disorders.
  • Major clinical trials are underway testing novel approaches to treating all forms of MS, including progressive MS.

For more information about multiple sclerosis, its symptoms, diagnosis and treatment options, contact your area Capital Women’s Care team.

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The providers of Capital Women's Care seek the highest quality medical and ethical standard in an environment that nurtures the spirit of caring for every woman.

 

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