@article{a320b287404f46d69ee86ea76f8c523d,
title = "Sex effects across the lifespan in women with multiple sclerosis",
abstract = "Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating central nervous system disorder that is more common in women, with onset often during reproductive years. The female:male sex ratio of MS rose in several regions over the last century, suggesting a possible sex by environmental interaction increasing MS risk in women. Since many with MS are in their childbearing years, family planning, including contraceptive and disease-modifying therapy (DMT) counselling, are important aspects of MS care in women. While some DMTs are likely harmful to the developing fetus, others can be used shortly before or until pregnancy is confirmed. Overall, pregnancy decreases risk of MS relapses, whereas relapse risk may increase postpartum, although pregnancy does not appear to be harmful for long-term prognosis of MS. However, ovarian aging may contribute to disability progression in women with MS. Here, we review sex effects across the lifespan in women with MS, including the effect of sex on MS susceptibility, effects of pregnancy on MS disease activity, and management strategies around pregnancy, including risks associated with DMT use before and during pregnancy, and while breastfeeding. We also review reproductive aging and sexual dysfunction in women with MS.",
keywords = "breastfeeding, multiple sclerosis, pregnancy, sex differences, sex hormones, women",
author = "Krysko, {Kristen M.} and Graves, {Jennifer S.} and Ruth Dobson and Ayse Altintas and Amato, {Maria Pia} and Jacqueline Bernard and Simona Bonavita and Riley Bove and Paola Cavalla and Marinella Clerico and Teresa Corona and Anisha Doshi and Yara Fragoso and Dina Jacobs and Vilija Jokubaitis and Doriana Landi and Gloria Llamosa and Longbrake, {Erin E.} and Elisabeth Maillart and Monica Marta and Luciana Midaglia and Suma Shah and Mar Tintore and {van der Walt}, Anneke and Rhonda Voskuhl and Yujie Wang and Zabad, {Rana K.} and Burcu Zeydan and Maria Houtchens and Kerstin Hellwig",
note = "Funding Information: Ruth Dobson works within the PNU, which is funded by Barts Charity. She receives grant support from the UK MS Society, Horne Family Charitable Trust, Biogen, Celgene, and Merck. She has received honoraria for Advisory boards and/or educational actives from Biogen, Teva, Sanofi, Merck, and Roche. Funding Information: Erin E. Longbrake has received honoraria from Genentech, Genzyme, Alexion, Biogen, EMD Serono, and Celgene. She has grant support from NIH K23NS107624 and Race to Erase MS. Funding Information: Paola Cavalla has received recent grants and clinical trial support from Biogen and Sanofi-Genzyme. She has received honoraria from Almirall, Biogen, Merck-Serono, Novartis, Roche, Sanofi-Genzyme, and Teva for non-promotional trainee education events. Funding Information: Vilija Jokubaitis is funded by an MS Research Australia Fellowship (16-0206). She receives project grant support from the National Health and Medical Research Council (NHMRC) of Australia (GNT1156519) and MS Research Australia (18-0424; 19-0665). She has received honoraria from Biogen and Roche for non-promotional educational activities, and conference travel support from Merck and Roche. Funding Information: We would like to thank the Executive Committee and members of the International Women in MS (iWiMS) group. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Kristen M. Krysko is funded by a Sylvia Lawry Physician Fellowship through the National Multiple Sclerosis Society [FP-1605-08753 (Krysko)]. Funding Information: Jennifer S. Graves has received recent grant and clinical trial support from the National MS Society, Race to Erase MS, UCSF CTSI RAP program, Biogen, and Genentech. She has received honoraria from Biogen and Genzyme for non-promotional trainee education events. She has received personal fees from Novartis and Celgene. Funding Information: Burcu Zeydan reports funding from NIH (NIA: U54 AG44170). Funding Information: Maria Houtchens has received grant support from Biogen, Serono, Sanofi Genzyme, and Genentech/Roche. She also received consultant honoraria from Biogen, Serono, Sanofi Genzyme, Roche, and Celgene. Funding Information: Riley Bove is funded by a Harry Weaver Scholarship through the National Multiple Sclerosis Society. She has received recent research support from the National Multiple Sclerosis Society, the California Initiative to Advance Precision Medicine, the Hilton Foundation, the Sherak Foundation, the Weill Innovation Fund, and the UCSF CTSI RAP program. She has received consulting fees from Alexion, Biogen, EMD Serono, Genzyme Sanofi, Novartis, and Roche Genentech. Funding Information: Kristen M. Krysko is funded by a Sylvia Lawry Physician Fellowship through the National Multiple Sclerosis Society [FP-1605-08753 (Krysko)]. She also had fellowship funding through Biogen. Publisher Copyright: {\textcopyright} The Author(s), 2020.",
year = "2020",
doi = "10.1177/1756286420936166",
language = "English (US)",
volume = "13",
journal = "Therapeutic Advances in Neurological Disorders",
issn = "1756-2856",
publisher = "SAGE Publications Ltd",
}