MS Symptoms in Women: A Harvard Doctor Shares Warning Signs and Why They’re Often Dismissed
Plus learn if the condition is genetic and why women are most at risk
With over 1 million Americans affected by multiple sclerosis (MS), we wanted to learn more about its symptoms, particularly how they manifest in women. Keep reading for everything you need to know about the often-misunderstood condition—and the treatment regimens helping so many not only live with the disease, but thrive.
What is MS?
“MS is a chronic autoimmune condition that affects the central nervous system,” explains neurologist Maria K. Houtchens, MD, Associate Professor of Neurology at Harvard Medical School and Director of Clinical Care at the Brigham MS Center. “The central nervous system has three parts—the brain, spinal cord and optic nerves—and any or all of them can be affected.”
Over time, if MS isn’t controlled, the immune system attacks the myelin sheath, the protective covering around nerve fibers. This leads to neurologic symptoms, Dr. Houtchens explains. Later, the nerve fibers themselves (called axons) can also become disrupted, causing more disability.
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MS is more common than we realize
It may surprise you that MS is considered relatively common. “Most people don’t think of it as such, but we see it a lot in this part of the world—the Northeast, Pacific Northwest and it’s also more common in Northern Europe,” reveals Dr. Houtchens. Indeed, the prevalence of MS increases the farther you get from the equator in either direction, she adds.
“The reasons for this are not 100 percent understood, but we think it could be related to lower vitamin D levels due to reduced sunlight exposure, which could increase the risk of developing MS. Also, the prevalence of certain viral agents, such as [the] Epstein-Barr [virus linked to MS], tends to be more common in colder climates.”
MS affects more women than men
The condition is typically diagnosed between ages 20 and 40, and women are three times more likely than men to develop MS. “That probably has something to do with the interplay between hormones—especially female sex steroids like estrogen—and immune system function,” explains Dr. Houtchens.
A key difference between the sexes when it comes to MS? “Women tend to be more stoic and wait a little bit longer before they seek medical attention,” shares Dr. Houtchens. “I think women are often caregivers and sometimes forget to take care of themselves. That’s the one message I really want to get out: Women need to take time for themselves. They should prioritize their mental and physical health and be kind to themselves—especially if they have this diagnosis.”
Another possible reason women may delay seeking care, Dr. Houtchens adds, is that “the disease often presents in more subtle ways in women. They may experience milder sensory symptoms such as vision changes, while men more often present with motor problems such as walking difficulties—although that’s not exclusive to men.” Women are also more likely to be dismissed when they complain, she adds, and their symptoms attributed to “fatigue” or “stress,” while men’s complaints are often taken more seriously.
3 common MS symptoms in women
While early symptoms tend to vary depending on where the MS lesions form, Dr. Houtchens shares a few major signs of the disease:
Worsening vision in one eye
Known as optic neuritis, this vision problem tends to be painful, but thankfully, it also tends to be reversible, says Dr. Houtchens.
Altered sensations in half the body
“You might feel weakness on one side of the body, either vertically or horizontally, with one arm and one leg affected, or both legs affected,” says Dr. Houtchens of this common symptom of MS.
Decreased sexual function and altered bladder or bowel function
“This [symptom of MS] is crucial for women to know, because they absolutely should speak with their neurologist and their gynecologist to learn what they can do to help these problems [including decreased desire and vaginal dryness],” says Dr. Houtchens.
Other common signs of MS, she adds, include brain fog or trouble thinking, fatigue and balance problems. Dr. Houtchens emphasizes that while not every isolated symptom—such as fatigue—necessarily requires a visit to your healthcare provider, “if you experience weakness in your legs, vision issues, sensory changes or unexpected bladder or balance problems, be sure to check in with your doctor.”
Is MS genetic?
“If you have a first-degree relative affected [mother, father or sibling], there is a slightly increased chance of getting MS,” explains Dr. Houtchens. “But it’s not a typical genetic condition, meaning you’re not going to inherit it like you would some of the other conditions like Huntington’s disease.”
What if two people both have MS and start a family? “In that case, the child has about a 25 percent chance of developing it, so a much higher likelihood. But typically, if one of your parents or siblings has it, your risk is much lower than that.”
There are many treatment options for MS
Fortunately, MS minimally affects life expectancy, says Dr. Houtchens. “People are much more likely to die with the disease than from it,” she reveals. “This is very important for people to know when they receive the diagnosis, because if they applied for life insurance, they may be denied. But I think that is an incorrect assumption on the part of the insurance company.” Just knowing this can help you weigh your options, she adds.
While there is no cure for MS, there are plenty of treatment options. “When I was in medical school, we had only one drug for MS. When I finished medical school and went through residency, we had, I think, three drugs—and now we have 23 medications,” reveals Dr. Houtchens. “There’s been a dramatic explosion in the way we treat this condition, and that’s been wonderful for our patients.”
Such treatments vary widely depending on several factors, including the type of MS: relapsing-remitting, active secondary progressive or primary progressive. Relapsing-remitting multiple sclerosis is much more common and characterized by “flare-ups, and we’re very good at treating this form,” says Dr. Houtchens, while primary progressive MS is more common in men and, unfortunately, has only one FDA-approved treatment.
“Some of our patients, as they get older and have had the condition for a long time, may transition from relapsing MS to the progressive form, known as secondary progressive MS,” she explains. “Because of these variations, there are different treatment approaches and guidelines for each type of the condition.”
Looking ahead to further progress
“Our biggest unmet need is the disability progression,” says Dr. Houtchens, underscoring that while doctors are good at treating relapsing MS, “we’re still trying to do better in terms of treating the disability progression or reversing disability. My hope is that over the next 10 years, we’ll see meaningful advances.”
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