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Timothy L. Vollmer, MD
Department of Neurology
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Department of Neurology
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This One Is for the Ladies-Menstruation and MS

Image Source: MANNAPLUS

This one is for the ladies! Men, you’re welcome to read, but I’m not sure if this article will be your cup of tea, per say, ha-ha.

Menstruation and fatigue

It has been shown that MS affects primarily more women than men.  As I’m sure most other women can relate,” that time of the month” is just a really yucky time in general. However, with MS, especially as I’ve gotten older, I’ve noticed that that time seems to affect me even more. I’ve began to really notice lately that the week leading up to my period and often during it as well, that I am dramatically more fatigued than usual. It’s the kind of fatigue where my body and mind both feel like they are just dragging, and struggle to catch up to my busy lifestyle. Weakness and clumsiness also seem to peak during the week before as well. Occasionally I can be more moody before and during that time also, but I honestly attribute that to being so very fatigued and just being a woman on her period. The exhaustion during those 5-7 days can make that one week out of the month seem never-ending at times. During this time I do lack a lot of motivation to get my normal everyday things done, and often times dream of going to bed early throughout the day. Although my fatigue and occasional mood swings before and during my menstrual cycle do seem greater than usual, thankfully it does improve once my period is over. After feeling this way for some time, I decided to do some research and see if there is any correlation between MS and menstruation.

Hormones and MS

According to, they distributed a questionnaire to 149 women to see if there was any relation to neurologic symptoms in women with MS and the menstrual cycle. Their results showed that 70 of the 149 women reported that their symptoms seemed to change at a regular time in their cycle. The site says that, “Most of those that reported a change indicated that the change, usually involving a worsening of their symptoms, occurred within one week of onset of menses. Weakness, fatigue, imbalance, and depression were the symptoms most frequently reported to worsen. Other self-reports have replicated the data.” I also read on another website,, that just before and during a period, the core body temperature rises a little. These temperature changes can sometimes make MS symptoms worsen. And, honestly that makes sense to me. Another small study I found on stated that 16 women who participated reported no difference in symptoms during their menstrual cycles. It also mentioned that another 7 women who were taking a combined oral contraceptive did report significantly higher weakness, numbness and fatigue during the pill free interval compared to the phase in the study where they did take the pill daily. This finding reminded me of another factor that seems to affect MS in women -pregnancy. But, it seems that pregnancy has a positive effect. I know from personal experience that I did feel great during my pregnancy, and was able to stay off my MS medication throughout. The leading causes that may help our MS during pregnancy include estrogens, progesterone, alpha-fetoprotein, and Vitamin D. says that two estrogens, estradiol and estriol, has been shown to be protective in animal models of MS when given in doses equal to or greater than those found in pregnancy. Estradiol is an estrogen associated with our menstrual cycles, and estriol is unique to pregnancy. It looks like future investigations are being done to determine whether estrogens may be more than anti-inflammatory, but actually neuroprotective. It is a huge possibility that one day a drug that sustains pregnancy levels of estrogen may help to protect against disease activity in MS.

Story Source: The above story is based on materials provided by MULTIPLESCLEROSIS.NET
Note: Materials may be edited for content and length

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