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menopause and multiple sclerosis

Marwa Kaisey, Nancy Sicotte, Barbara Giesser
Purpose of review: Multiple sclerosis (MS) disease activity and symptoms are tied to hormonal changes. This review explains the current standard of care in MS at various stages of a woman's reproductive life and helps neurologists answer patients' most common questions surrounding MS care and fertility, pregnancy, and menopause. Recent findings: Recent work has focused on MS risk and exacerbation with variables related to reproductive health. Management of disease-modifying therapies prenatally and postnatally is also a focus...
April 2018: Neurology. Clinical Practice
Keira Byrnes, Ping-Jung Wu, Stephney Whillier
BACKGROUND: Pilates is a system of exercise focusing upon controlled movement, stretching and breathing. Pilates is popular today not only for physical fitness but also for rehabilitation programs. This paper is a review of the literature on the effectiveness of Pilates as a rehabilitation tool in a wide range of conditions in an adult population. METHODS: A systematic literature review was carried out according to the PRISMA guidelines. Electronic databases were searched for cohort studies or randomised controlled trials (RCTs), and inclusion and exclusion criteria were applied...
January 2018: Journal of Bodywork and Movement Therapies
Ülkü Türk Börü, Cansu Köseoğlu Toksoy, Cem Bölük, Adnan Bilgiç, Mustafa Taşdemir
Objectives We aimed to determine whether multiple sclerosis (MS) and methylprednisolone and disease-modifying drugs have an effect on menopausal age. Methods A total of 86 patients and 98 healthy subjects were included in this study. The natural menopausal age of the patients and healthy subjects were compared. The cumulative dosages of methylprednisolone, beta interferons (IFNβs), and glatiramer acetate were calculated. The effects of the Expanded Disability Status Scale (EDSS), duration of the disease, and cumulative dosage of medications on menopausal age were evaluated...
March 2018: Journal of International Medical Research
Ravi Prakash Sasankoti Mohan, Akanksha Gupta, Nagaraju Kamarthi, Sangeeta Malik, Sumit Goel, Swati Gupta
BACKGROUND: Hormonal fluctuations during menopause lead to endocrine changes in women, especially in their sex steroid hormone production. Studies have documented the role of estrogen and progesterone (Pg) on autoimmune disorders such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis. Lichen planus (LP), an autoimmune disorder, seen frequently in perimenopausal women, may also get affected by sex steroid hormones, but no direct relationship has been established yet...
April 2017: Journal of Mid-life Health
Annette Langer-Gould, Jessica B Smith, Kerstin Hellwig, Edlin Gonzales, Samantha Haraszti, Corinna Koebnick, Anny Xiang
OBJECTIVE: To determine whether women who breastfeed their infants longer or have fewer ovulatory years are at lower risk of developing multiple sclerosis (MS). METHODS: We recruited women with newly diagnosed MS or its precursor, clinically isolated syndrome (CIS) (n = 397), and matched controls (n = 433) into the MS Sunshine Study from the membership of Kaiser Permanente Southern California. A structured in-person questionnaire was administered to collect the behavioral (pregnancies, breastfeeding, hormonal contraceptive use) and biological (age at menarche and menopause, amenorrhea) factors to make up ovulatory years...
August 8, 2017: Neurology
Emad S Ali, Cheyenne Mangold, Alan N Peiris
OBJECTIVE: Estriol is the main estrogen in pregnancy, but has received less attention outside gestation. It is well known that pregnancy has an immunosuppressive effect on many autoimmune diseases such as multiple sclerosis, psoriasis, thyroiditis, uveitis, and rheumatoid arthritis. Emerging evidence indicates that estriol has potential immunomodulatory benefits for many disease states including autoimmune, inflammatory, and neurodegenerative conditions. In this review, we discuss emerging roles for estriol in the treatment of menopausal symptoms, osteoporosis, cancer, hyperlipidemia, vascular disease, and multiple sclerosis...
September 2017: Menopause: the Journal of the North American Menopause Society
B Perlman, D Heller, B Cracchiolo
OBJECTIVE: Postmenopausal bleeding must always be evaluated to rule out endometrial carcinoma, although there are many benign etiologies. There have been rare reports of premenopausal bleeding with interferon beta-1b, used to treat multiple sclerosis, but no prior reports in postmenopausal women. METHODS: Literature searches were performed using PubMed and Medline for articles with content related to premenopausal and postmenopausal bleeding while taking interferon beta-1b...
December 2016: Climacteric: the Journal of the International Menopause Society
R Bove, T Vaughan, T Chitnis, P Wicks, P L De Jager
BACKGROUND: Many women with multiple sclerosis (MS) are postmenopausal. Previously reported findings from an online MS cohort suggested that earlier, surgical menopause may be associated with higher patient-reported MS severity scores. OBJECTIVE: To explore experiences of menopause in a series of MS women responding to a reproductive survey from an online research platform, PatientsLikeMe (PLM). METHODS: The free-text responses from a detailed reproductive history survey deployed to PLM members were analyzed using grounded theory approach...
September 2016: Multiple Sclerosis and related Disorders
Riley Bove, Charles C White, Kathryn C Fitzgerald, Tanuja Chitnis, Lori Chibnik, Alberto Ascherio, Kassandra L Munger
OBJECTIVE: To determine the association between hormone therapy (HT) and physical quality of life (QOL) in postmenopausal women with multiple sclerosis (MS). METHODS: We included female participants from the prospective Nurses' Health Study, with a diagnosis of definite or probable MS, who had completed a physical functioning assessment (PF10; subscale of the 36-Item Short-Form Health Survey QOL survey) at a time point between 3 and 10 years after their final menstrual period (early postmenopause)...
October 4, 2016: Neurology
Rhonda Voskuhl, Francesco Patti
No abstract text is available yet for this article.
October 4, 2016: Neurology
Juan Ignacio Rojas, Francisco Sánchez, Liliana Patrucco, Jimena Miguez, Jorge Funes, Edgardo Cristiano
BACKGROUND: Male sex is associated with worsening disability and a more rapid progression of multiple sclerosis (MS). This study analysed structural sex differences in magnetic resonance images of the brain, comparing women whose disease started before and after the menopause with a control group of men. METHODS: This was a case control study in which female patients whose MS started before (Group 1) and after (Group 2) the menopause were included. The control group was matched by age, disease duration, Expanded Disability Status Scale and disease-modifying treatment...
October 2016: Neuroradiology Journal
Riley Bove
Multiple sclerosis (MS) typically affects 3 times more women than men during the reproductive years. The author describes what is known about the effects of various reproductive exposures on MS course, including menarche, childbearing, and menopause. Then, the management of childbearing is reviewed. Topics include preconception counseling, prenatal care, discontinuation of MS therapies, and management of postpartum relapses. Overall, most women with MS can be encouraged to become pregnant and breastfeed their children, should they choose to do so...
April 2016: Seminars in Neurology
Riley Bove, Brian C Healy, Alexander Musallam, Bonnie I Glanz, Philip L De Jager, Tanuja Chitnis
BACKGROUND: Onset of multiple sclerosis (MS) is typically in early adulthood. The impact, if any, of menopause on the MS course is unknown. Our objective was to determine whether menopause is associated with changes in MS severity in a longitudinal clinical cohort. METHODS: Responses from an ongoing reproductive questionnaire deployed in all active female CLIMB observational study participants with a diagnosis of clinically isolated syndrome (CIS) or MS were analyzed when the response rate was 60%...
June 2016: Multiple Sclerosis: Clinical and Laboratory Research
Chrissa Sioka, Andreas Fotopoulos, Stilianos Papakonstantinou, Athanasia Georgiou, Sygliti-Henrietta Pelidou, Athanasios P Kyritsis, John A Kalef-Ezra
Although pregnancy and breast-feeding do not have any deleterious effect on disease activity in female multiple sclerosis (MS) patients, their role on bone mineral density (BMD) and osteoporosis risk is unknown. We investigated the role of age at menarche, parity and lactation on BMD expressed as percentage of the mean BMD (%BMD) in 46 pre-menopausal ambulatory female MS patients using dual-energy X-ray absorptiometry (DXA) scans in lumbar spine (LS) and hip. MS female patients with age at menarche ≥13 years old had reduced %BMD compared to those with menarche age <13 years (95...
July 2015: Multiple Sclerosis and related Disorders
R Bove, B C Healy, E Secor, T Vaughan, B Katic, T Chitnis, P Wicks, P L De Jager
BACKGROUND: Many women with multiple sclerosis (MS) are postmenopausal, yet the impact of menopause on MS symptoms is unknown. OBJECTIVE: To investigate patient-reported impact of menopause in a large online research platform, PatientsLikeMe (PLM). METHODS: A detailed reproductive history survey was deployed to PLM members, and responses were linked to PLM׳s prospectively collected patient-reported severity score (MS Rating Scale, MSRS). The MSRS has previously shown good correlation with physician-derived EDSS scores...
January 2015: Multiple Sclerosis and related Disorders
Mindy S Christianson, Virginia A Mensah, Wen Shen
Multiple sclerosis (MS) is an autoimmune demyelinating and neurodegenerative condition of the central nervous system that preferentially afflicts women more than men. Low estrogen states such as menopause and the postpartum period favor exacerbations of multiple sclerosis in women with the disease. Existing and emerging evidence suggests a role for estrogen in the alleviation of symptoms and reversal of pathology associated with MS. While clinical evidence is sparse regarding the benefit of estrogen therapy for women at risk for MS exacerbations, scientific data demonstrates that estrogen potentiates numerous neuroprotective effects on the central nervous system (CNS)...
February 2015: Maturitas
A N Begum, C Cunha, H Sidhu, T Alkam, J Scolnick, E R Rosario, D W Ethell
Adaptive immunity to self-antigens causes autoimmune disorders, such as multiple sclerosis, psoriasis and type 1 diabetes; paradoxically, T- and B-cell responses to amyloid-β (Aβ) reduce Alzheimer's disease (AD)-associated pathology and cognitive impairment in mouse models of the disease. The manipulation of adaptive immunity has been a promising therapeutic approach for the treatment of AD, although vaccine and anti-Aβ antibody approaches have proven difficult in patients, thus far. CD4(+) T cells have a central role in regulating adaptive immune responses to antigens, and Aβ-specific CD4(+) T cells have been shown to reduce AD pathology in mouse models...
2014: Translational Psychiatry
Rachel Jawahar, Unsong Oh, Charles Eaton, Nicole Wright, Hilary Tindle, Kate L Lapane
Background. In multiple sclerosis (MS), symptom management and improved health-related quality of life (HrQOL) may be modified by smoking. Objective. To evaluate the extent to which smoking is associated with worsened health outcomes and HrQOL for postmenopausal women with MS. Methods. We identified 251 Women's Health Initiative Observational Study participants with a self-reported MS diagnosis. Using a linear model, we estimated changes from baseline to 3 years for activities of daily living, total metabolic equivalent tasks (MET) hours per week, mental and physical component scales (MCS, PCS) of the SF-36, and menopausal symptoms adjusting for years since menopause and other confounders...
2014: Multiple Sclerosis International
Magnus K Gislason, Sylvie Coupaud, Keisuke Sasagawa, Yuji Tanabe, Mariel Purcell, David B Allan, K Elizabeth Tanner
The disuse-related bone loss that results from immobilisation following injury shares characteristics with osteoporosis in post-menopausal women and the aged, with decreases in bone mineral density leading to weakening of the bone and increased risk of fracture. The aim of this study was to use the finite element method to: (i) calculate the mechanical response of the tibia under mechanical load and (ii) estimate of the risk of fracture; comparing between two groups, an able-bodied group and spinal cord injury patients group suffering from varying degrees of bone loss...
February 2014: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Yifei Zhong, Anna Kinio, Maya Saleh
Nucleotide-binding and oligomerization domain NOD-like receptors (NLRs) are highly conserved cytosolic pattern recognition receptors that perform critical functions in surveying the intracellular environment for the presence of infection, noxious substances, and metabolic perturbations. Sensing of these danger signals by NLRs leads to their oligomerization into large macromolecular scaffolds and the rapid deployment of effector signaling cascades to restore homeostasis. While some NLRs operate by recruiting and activating inflammatory caspases into inflammasomes, others trigger inflammation via alternative routes including the nuclear factor-κB, mitogen-activated protein kinase, and regulatory factor pathways...
2013: Frontiers in Immunology
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