Multiple sclerosis gender issues: clinical practices of women neurologists

Mult Scler. 2004 Oct;10(5):582-8. doi: 10.1191/1352458504ms1083oa.


Substantially more women than men develop multiple sclerosis (MS), but information about the effects of MS and gender-specific issues such as pregnancy, breastfeeding, menstruation and hormone use is lacking. A survey study of neurologists' practice patterns was undertaken to elicit information about gender-specific topics and the use of disease-modifying MS therapies (DMT) including the interferons and glatiramer acetate (GA). A total of 147 surveys were returned. Half of respondents require patients to discontinue DMT during pregnancy, while 35% encourage discontinuation. Among those who allow patients to continue therapy, half consider GA to be safer during pregnancy than the interferons. Nearly 86% of respondents do not use DMT in patients who are breastfeeding. Among the 11% who actually prescribe during breastfeeding, most recommend GA. Neurologists generally leave the decision to breastfeed up to patients, and most refer patients to obstetrician/gynaecologists for counselling about contraception or hormone replacement therapy. The survey results described here provide insight into how neurologists manage reproductive health issues among women with MS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding
  • Contraception
  • Estrogen Replacement Therapy
  • Female
  • Health Care Surveys
  • Humans
  • Menstruation Disturbances / therapy
  • Multiple Sclerosis / therapy*
  • Neurology*
  • Physicians, Women*
  • Pregnancy
  • Pregnancy Complications / therapy
  • Professional Practice*
  • Women's Health*