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    Is Multiple Sclerosis Different in Women?

    By Ilene Raymond Rush
    WebMD Feature
    Reviewed by Neil Lava, MD

    Anyone can get multiple sclerosis. But the disease has a gender gap that baffles experts.

    Two to three times as many women get MS at ages 20-40 as men the same ages do. Doctors don’t know why that is, though they have some theories.

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    Lhermitte’s Sign: What Is It? How Do You Treat It?

    It lasts just a few seconds, but it can be startling: An intense burst of pain like an electric shock that runs down your back into your arms and legs when you move your neck. It’s called Lhermitte’s sign, or barber chair sign, and it’s often one of the symptoms that people mention when they’re first diagnosed with multiple sclerosis. The problem can be painful, but it’s not life-threatening. With time or with treatment, some people stop having Lhermitte’s sign.

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    Hormones may be part of it, says Joseph Berger, MD, chief of the multiple sclerosis division at the University of Pennsylvania’s Perelman School of Medicine. “But we’re not yet sure.”

    On the plus side, when young women get MS they are more likely than men to get a milder form of the disease.

    Shared Symptoms

    Both sexes have the same symptoms, which include problems with:

    “If there are differences between male and female symptoms, they are probably trivial,” Berger says.

    Yet there are a few differences in how men and women experience the disease.

    Urinary Tract Infections (UTIs)

    It’s a matter of simple anatomy: Women tend to get more UTIs than men, Berger says.

    “Bacterial and viral infections can make symptoms worse and spur relapses, he says. “UTIs tend to worsen clinical symptoms that people already have.”

    Menstruation

    For some women with MS, ovulation and menstrual cycles can temporarily worsen their MS symptoms, says Thomas Leist, MD, director of the Comprehensive Multiple Sclerosis Center at Thomas Jefferson University Hospital in Philadelphia.

    It doesn’t mean you’re having a relapse. It usually gets better within 24 hours.

    If it happens, those women may feel fatigue, depression, problems with balance, and weakness. Before and during a period, a woman’s core body temperature can rise a bit, and heat is known to worsen MS.

    You may not have that problem. “I’ve seen thousands of patients,” Berger says. “And have not seen much evidence of this, so it must not be terribly frequent.”

    Pregnancy

    A woman with MS who wants to become pregnant should talk to her doctor about what her treatment plan will be, since none of the MS medicines are approved for use during pregnancy or while breastfeeding.

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