Men's MS: Signs, risk factors, remedies, and prognosis
Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system (CNS). The disease course and treatment of MS differ between males and females in several key ways.
Disease Prevalence and Severity
MS is approximately three times more common in females than males. Females tend to experience more frequent relapses and a generally more active inflammatory disease course. Men with MS often have a comparatively slower disease progression and less inflammatory activity.
Hormonal fluctuations play a significant role in these differences. For example, pregnancy reduces relapse risk by up to 70% in the second and third trimesters, while relapse risk is higher postpartum when hormone levels readjust. On the other hand, testosterone may protect against autoimmune activity and inflammation in males, potentially slowing the progression of the disease.
Treatment and Management Differences
While standard therapies like corticosteroids for acute relapses and disease-modifying therapies (DMTs) are used similarly between sexes, hormonal factors in women influence treatment considerations. For instance, hormone replacement therapy (HRT) during menopause may help improve MS symptoms such as fatigue and cognitive impairment.
However, there is a lack of sex-specific treatment guidelines partly because of historic male-centric research bias—women have been underrepresented in clinical trials, contributing to less optimized treatment protocols tailored to females. Some treatments might need adjustment considering pregnancy, breastfeeding, or menopausal status in women, which is not a concern in male patients.
Recommended Treatments and Therapies
Rehabilitation programs can help a person improve or maintain their ability to carry out their normal functions at home and at work. These programs may include physical therapy, occupational therapy, speech and language therapy, and cognitive rehabilitation.
A heart-healthy diet that is high in fiber and low in fat is recommended for people with MS, although there is no identified diet that can modify the course of MS. Complementary therapies that may benefit people with MS include diet, exercise, stress management, acupuncture, meditation, mindfulness, yoga, tai chi, and talking therapy.
People with MS may benefit from a combination of aerobic activities and stretching exercises. Aerobic exercises may help improve strength, bladder and bowel function, fatigue, mood, and pain. Stretching exercises may help reduce stiffness and improve strength and mobility.
Importance of Early Diagnosis and Treatment
The outlook for males with MS is generally less positive for people who seek treatment later in the course of the disease. It is vital to consult a doctor as soon as possible if symptoms of MS occur.
Males may prefer to seek help from therapists with experience in treating males with chronic illnesses. They may also wish to look for support groups specifically for males.
Summary
The differences in MS disease activity and response to treatment between males and females are influenced by sex hormones. Continued research is needed to optimize sex-specific therapies and to reduce the current knowledge gap due to male-centric MS research.
References [1][2][3][4][5]
- Males are more likely to receive a diagnosis of MS after 50 years of age, suggesting that hormonal changes during menopause reduce the effects of estrogen on MS.
- Males are more likely to delay seeking medical attention for MS symptoms.
- Occupational therapy provides tools, devices, and modifications to simplify everyday tasks in the home and the workplace.
- Speech and language therapy involves diagnosing and treating issues with speaking or swallowing.
- Physical therapy focuses on improving strength, balance, posture, walking, mobility, fatigue, pain, and bladder and bowel function.
- Depression, anxiety, and mood changes are common among people with MS. A person may benefit from emotional support in the form of psychotherapy or support groups for people living with MS.
- Multiple sclerosis (MS) is three times more prevalent in females than males, and females tend to experience more frequent relapses and a more active inflammatory disease course.
- Hormonal fluctuations, such as during pregnancy, can significantly affect the disease course in females, reducing relapse risk in the second and third trimesters but increasing it postpartum.
- Hormone replacement therapy during menopause may improve symptoms like fatigue and cognitive impairment in females living with MS.
- The treatment of MS in males often involves a comparatively slower disease progression and less inflammatory activity.
- Testosterone may protect against autoimmune activity in males, potentially slowing the progression of MS.
- Sex-specific treatment guidelines for MS are lacking due to a historic male-centric bias in research, and some treatments might require adjustments considering pregnancy, breastfeeding, or menopausal status in women.
