Purpose of review: Multiple sclerosis (MS) disease activity and symptoms are tied to hormonal changes. This review explains the current standard of care in MS at various stages of a woman's reproductive life and helps neurologists answer patients' most common questions surrounding MS care and fertility, pregnancy, and menopause.
Recent findings: Recent work has focused on MS risk and exacerbation with variables related to reproductive health. Management of disease-modifying therapies prenatally and postnatally is also a focus.
Summary: This review is a concise, practical guide for general neurologists caring for women with MS. MS is a disease that requires adaptation of management as a woman moves through reproductive stages. With proper planning and management, pregnancy is safe for women with MS. We describe the current standard of care based on trials, when available, and on expert opinion.
Management strategies for female patients of reproductive potential with multiple sclerosis: An evidence-based review.Mult Scler Relat Disord. 2019 Jul;32:54-63. doi: 10.1016/j.msard.2019.04.003. Epub 2019 Apr 5. Mult Scler Relat Disord. 2019. PMID: 31030020 Review.
Caring for Women with Multiple Sclerosis Across the Lifespan.Curr Neurol Neurosci Rep. 2018 May 23;18(7):36. doi: 10.1007/s11910-018-0846-2. Curr Neurol Neurosci Rep. 2018. PMID: 29789964 Review.
Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management.Eur J Neurol. 2018 May;25(5):739-746. doi: 10.1111/ene.13581. Epub 2018 Feb 28. Eur J Neurol. 2018. PMID: 29356206
Consensus recommendations for family planning and pregnancy in multiple sclerosis in argentina.Mult Scler Relat Disord. 2020 May 4;43:102147. doi: 10.1016/j.msard.2020.102147. Online ahead of print. Mult Scler Relat Disord. 2020. PMID: 32442883 Review.
Reproductive issues in women with multiple sclerosis: ethical considerations.Continuum (Minneap Minn). 2014 Feb;20(1 Neurology of Pregnancy):177-80. doi: 10.1212/01.CON.0000443845.63804.9e. Continuum (Minneap Minn). 2014. PMID: 24492818