Sex Hormones and Multiple Sclerosis

Abstract

Experimental and clinical data about the influence of sex hormones on the course of multiple sclerosis (MS) grow rapidly during the past two decades. Estrogens, progesterone, and androgens have been shown to ameliorate experimental autoimmune encephalomyelitis (EAE) in animals, and pregnancy in women is associated with a dramatic reduction in disease activity. Immunomodulatory and neuroprotective properties of sex hormones are the most probable underlying mechanisms, creating a background for testing similar hormonal treatments in humans. Several pilot studies in this field present promising results, but larger trials are necessary to identify the adverse events and to estimate precisely the place of sex steroids in multiple sclerosis therapeutic strategies.The objective of this chapter is to summarize the recent advances in the research about the effects of sex steroids in EAE and MS and to create a ground for the development of more powerful treatments in the future.

Autonomic Dysregulation in Multiple Sclerosis

“…In women, brain stem, pyramidal lesions and pontile parenchymal atrophy showed associations with SD [ 170 , 180 , 181 ]. Hormonal alterations, such as high levels of prolactin, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were reported in women with MS, which were thought to exist due to peripheral resistance to gonadotropins, abnormal central regulations and immunosuppressive therapy [ 182 , 183 ]. In a recent cross-sectional study, only 10% of MS women had low beta estradiol, 7% had low progesteron plasma concentrations.…”