Why Multiple Sclerosis Affects More Women Than Men

 

By Rachel Reiff Ellis 

 

Women with MS outnumber men with the condition by nearly 4 to 1. And this gender gap has only widened in the last 50 years. Experts don’t have a clear explanation for the cause of MS in anyone, much less in women specifically. But they have a few theories that might explain the sex differences in MS rates.

Immune System Differences

DID YOU KNOW?

Women with MS outnumber men with the condition by nearly 4 to 1.

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Women’s immune systems work differently from men’s. Specifically, women are more likely to develop autoimmune diseases. In fact, nearly 7 in 10 people with autoimmune diseases are women.

The difference might lie in an immune system protein called interleukin-33 (IL-33). It helps cells within the immune system communicate with each other. This is how they work together to fight off infection.

Current research explores what role IL-33 might play in immune system responses in men and women.

Early studies show that men make more IL-33 than women when they face infections. This may explain why women are more likely to have an autoimmune response than men are.

Nervous System Differences

Men tend to get more nerve damage with MS than women do. Researchers think this may have to do with estrogen levels. Women’s bodies produce more estrogen than men’s. This leads researchers to ask whether estrogen may protect nerves in some way.

 

 

Hormone Changes

One reason that more women develop MS than men could have to do with reproductive hormones. Before puberty hits, boys and girls tend to get MS at about the same rate. But as boys and girls move into adolescence and adulthood, when the male and female bodies make different hormones, women begin to get MS at higher rates than men. This difference pushes researchers to consider a possible link between male and female sex hormones and MS. 

Genetics

Mutations in certain genes called MHC genes may raise the risk for MS. Some research shows that women with MS are more likely to have relevant changes in these genes than men. Daughters are also more likely than sons to inherit those gene changes from their mothers.

But a gene alone likely doesn’t cause MS. Researchers think that other factors in your life, such as diet, smoking, stress, and the amount of sunlight you get, influence how these MS-related genes behave.

Body Fat

Obesity, especially in the form of belly fat, can cause inflammation in your body. And inflammation plays a role in MS. Obesity-related inflammation may arise more often in women than in men. That’s because women tend to carry more body fat than men do, and they are more likely to become obese. Scientists think the rising numbers of women with MS may relate to this higher percentage of body fat.

 https://www.webmd.com/multiple-sclerosis/ms-affects-women-more-than-men?ecd=wnl_mls_040122&ctr=wnl-mls-040122_supportTop_cta_2&mb=q80%2F%40kIeuyYKtyaYzOxdbc6RVoMqf%400VkpmvpK5yEEQ%3D

We Have Come So Far

When Sylvia Lawry started the MS movement in 1946 with the founding of the National MS Society, research into multiple sclerosis was almost non-existent. The disease took years to diagnose, and there were no therapies proven to slow the course of MS.

Things have changed. Decades of research into MS and the basic workings of the immune and nervous systems have built a critical platform of knowledge now serving as a springboard for progress. The Society’s $1.06 billion research investment has fueled many of these advances, and today’s picture looks different for many:

• There are therapies specifically approved for treating and managing MS, and more potential MS therapies in development today than at any other time in history.

• MS is more quickly diagnosed, enabling early and sustained therapy to slow disease activity

• There is much greater awareness of the many symptoms of MS and ways to address them to improve quality of life

• Scientists are making breakthroughs in identifying risk factors that can increase a person’s susceptibility to MS, which will help lead to ways to prevent the disease.

We have made progress but more must be done for those living with forms of progressive MS for which there are limited treatment options.  The hope – and potential - for new, more effective treatments for MS has never been greater. We are part of a global movement of millions of people working toward a world free of MS.

Critical Milestones

1981 - First MRI pictures of a brain affected by MS are produced, revolutionizing MS diagnosis
1984 - First modern documentation of cognitive problems in MS
1988 - First demonstration, using MRI, of significant lesion activity in MS, even when the disease seems quiet
1993 - First disease-modifying therapy for relapsing MS approved
1996 - First proof that aerobic exercise improves physical and psychological well-being in MS
1999 - Society grantees first to isolate immature cells in the adult brain capable of developing into replacements for myelin-making cells destroyed by MS
2003 - Italian researchers transplant cells to enhance nerve tissue repair in mice with MS
2004 - Pivotal study by Society Fellow shows that African-Americans tend to have a more aggressive course of MS than Caucasians
2005, 2010, 2018 - “McDonald Criteria” for diagnosing MS updated by Society Task Force, speeding time to diagnosis for many
2007 - With support from Society to International MS Genetics Consortium, two genes are confirmed to be linked to MS risk; many more uncovered since
2007 - First large-scale trial of sex hormone estriol gets underway in women with MS, a result of the Society’s targeting of gender differences
2010 - First oral disease-modifying therapy approved for relapsing MS
2012 - Launch of Progressive MS Alliance to speed the development of therapies
2013 - Studies hint that exercise and rehabilitation can improve many functions and even help rewire the brain
2014 - First large, phase 2 clinical trials of myelin repair strategy for MS are launched
2015 - A phase 2 clinical trial co-funded by the Society suggests a pill used to treat epilepsy (phenytoin) has the potential to slow the accumulation of disability in people with MS
2015 - Results of phase 2 trial of anti-LINGO suggests it has potential as myelin repair strategy 
2015 - Society co-hosts international conference on cell-based therapies to forge next steps for cell therapy in MS
2015 - Society funding helps launch MS Microbiome Consortium to promote research on role of gut bacteria in MS progression and treatment
2015-16 - Two large-scale clinical trials break through long-standing barrier by showing benefit in primary progressive and secondary progressive MS
2016 - Positive results announces from two studies of bone marrow-derived stem cells (HSCT) in people with aggressive, relapsing MS; more research focuses on who might benefit and how to reduce risks
2016 - Society-funded International Consortium of MS Genetics identifies 200 genetic variations linked to MS, offering new leads to how genes and other factors that make people susceptible to developing MS
2016 - Society launches two new studies testing the ability of dietary approaches to treat MS symptoms and improve quality of life  
2016-17 - International Progressive MS Alliance awards three large-scale Collaborative Network Awards to promote solutions for people with progressive MS
2017 - FDA approves Ocrevus (ocrelizumab) as first disease-modifying therapy for primary progressive MS, and also as a therapy for relapsing MS
2017 - International team co-sponsored by the Society revised MS diagnostic criteria to speed diagnostic process and reduce incidence of misdiagnosis
2018 - FDA approves expansion of the use of Gilenya to include children and adolescents 10 years of age or older with relapsing MS, the first therapy specifically approved to treat pediatric MS
2018 - A Phase 2 trial showed that ibudilast could reduce brain atrophy in progressive MS. The trial was funded collaboratively by the National MS Society, the NINDS, its NeuroNext trials network, with support by MediciNova, the supplier of ibudilast 
2018-19 - Results announced from several studies of bone marrow-derived stem cells in people with aggressive, relapsing MS. More research is focused on who might benefit and how to reduce risks
2019 - Study sponsored by the National MS Society conducted by leading experts estimates that nearly 1 million adults are living with MS in the United States. This is more than twice the previously reported number
2019 - FDA approves oral Mavenclad (cladribine) for adults with relapsing forms of MS, and also approves oral Mayzent (siponimod) for adults with clinically isolated syndrome (an initial neurological episode) and relapsing forms of MS
2019 - FDA approved Vumerity™ (diroximel fumarate, Biogen and Alkermes plc) for relapsing MS
2020 - National MS Society releases recommendations for aHSCT-bone marrow transplant for MS
2020 - FDA approves generic form of Tecfidera for relapsing MS
2020 - FDA approves Kesimpta® (ofatumumab) for relapsing MS
2020 - Society-supported Wellness Research Group publishes exercise and physical activity recommendations for ALL people with MS
2020 -  National MS Society, Consortium of MS Centers, and others establish the North American MS COVID-19 Clinical Database
2020 - FDA approves Oral Bafiertam™ (Monomethyl Fumarate) for relapsing MS
2020 - FDA approves Oral Zeposia® (Ozanimod) for relapsing MS

Download a Timeline of MS Research Progress (.pdf).

 

Can Vitamin D Help MS?

 By Stephanie Watson

You might have heard that vitamin D helps to lower the risk for multiple sclerosis (MS). Or that it helps lessen symptoms in people who already have the disease. Evidence suggests that getting enough of this vitamin might protect against MS by holding back your immune system from attacking your own nerve cells.

But the link between vitamin D and MS isn't proven yet.

The MS-Vitamin D Link

This fat-soluble vitamin acts like a hormone in your body. Vitamin D also helps your immune system work better and to tamp down inflammation.

Those protective actions are important in autoimmune diseases like MS where your body turns against itself. In MS, cells of your immune system attack the coating around nerve fibers, called myelin, and leads to such hallmark symptoms as numbness, weakness, and blurry vision.

Research finds that vitamin D might help repair myelin and guards your nerves from damage.

Can Vitamin D Prevent or Slow MS?

Researchers aren’t sure if vitamin D can keep you from getting MS in the first place. Your body makes most of the vitamin D it needs from sunlight on your skin. People in northern climates like Scotland and Scandinavia are more likely to have MS compared with those who live in much sunnier climates. Studies show that people who get more sunlight and more vitamin D in their diets have a lower risk for MS overall.

There's some evidence that vitamin D might slow MS and make the disease less severe. Studies have found a link between higher vitamin D levels in the blood and less active disease, fewer lesions in their brain and spinal cord, and fewer relapses of symptoms.

In other studies, people with MS who had higher vitamin D levels had less severe disease and disability.

Do I Need More Vitamin D?

It's common for people with MS to be low on this vitamin. It may be hard for you to get outside to get sun often enough. Low vitamin D can also be a side effect of corticosteroids and other MS medications.

Your doctor can run a blood test to check your vitamin D level. You might be able to make up the difference by eating more fatty fish, eggs, and other foods that are high in vitamin D. Or, your doctor might suggest you take a supplement.

It's not clear whether taking a daily vitamin D supplement protects people from getting MS, or slows the disease in those who already have it. Studies suggest it might help, but this hasn't been proven. But since supplements are usually safe to take, it may not hurt to try them.

What Dosage Is Best?

Experts can’t say how much vitamin D is needed to prevent or slow MS. Different medical groups disagree on the ideal amount.

Official recommendations for adults is 400 to 600 international units (IUs) of vitamin D daily.

Ask your doctor what’s right for you. Be careful not to overdo it. Vitamin D helps your body absorb calcium, and you might end up with too much of that mineral. High calcium levels can weaken bones, damage the heart, and increase the risk for kidney stones.

If you already have MS, your doctor can check whether your vitamin D levels are too low. If so, it might make sense for you to take a supplement.