The effect of sex hormones on the course of multiple sclerosis has been an area of interest for researchers.
In the comparable age group between puberty and menopause, there are between two and three women diagnosed with MS for each man with the condition. In the less frequent instances when people are diagnosed after the age of menopause or when children are diagnosed before puberty, the female:male proportion for MS is about one to one.
Similarly, hormone levels are raised during pregnancy and pregnant women with MS usually have less disease activity, particularly during the last three months of the pregnancy.
These observations have led researchers to look at the role of sex hormones as potential treatments for multiple sclerosis, with animal studies suggesting that they may have both an anti-inflammatory and neuroprotective effect.
A team at the University of California in Los Angeles conducted a small trial of oral oestriol (estriol in America) (Trimesta), an oestrogen hormone that is produced towards the end of pregnancy. This suggested that oestriol reduces MRI activity in women with relapsing remitting MS, but not in those with secondary progressive MS.
A larger two-year trial involved 164 women with relapsing remitting MS. Participants received either a combination of oral oestriol and glatiramer acetate (Copaxone) or glatiramer acetate and an inactive placebo. Initial results, reported at a conference in 2014 and published in late 2015, showed that the combination reduced the number of relapses compared to the Copaxone and placebo group, though the effect was less marked in the second year of the trial.
The researchers in California have also conducted a small study of the male hormone testosterone. Ten men with relapsing remitting MS used a skin gel containing testosterone for a year. The results suggested improvements in cognitive function and in slowing brain tissue loss.
- Progress in Brain Research 2009;175:239-251. Full article Estrogen and testosterone therapies in multiple sclerosis.
- Journal of the Neurological Sciences 2009;286(1-2):31-34. Summary Early onset multiple sclerosis: the role of gender.
- Archives of Neurology 2007;64(5):683-688. Summary Testosterone treatment in multiple sclerosis: a pilot study.
- Lancet Neurology 2016;15(1):35-46 Summary Estriol combined with glatiramer acetate for women with relapsing-remitting multiple sclerosis: a randomised, placebo-controlled, phase 2 trial.
Last reviewed: December 2015
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