INTRODUCTION: It has been reported that estrogen may affect T helper (Th) 1 and Th-2 lymphocytes and the ratio of Th-1 to Th-2, which play an essential role in the immunopathogenesis of multiple sclerosis (MS). Therefore, hormonal changes during transitional periods, such as pregnancy and menopause, may affect the activity of the disease at different phases of the menstrual cycle. This study aimed to determine the association of MS in women with variables, such as menarche age, menstrual order, menopausal age, and disease-related factors, such as disability level and the number of relapses.
METHODS: This descriptive study enrolled 281 women with MS. The participants were evaluated using a simple and short survey by the researchers. A neurologist evaluated the Expanded Disability Status Scale (EDSS) score, the number of attacks, and disease duration.
RESULTS: Sixty-seven (23.8%) of 281 patients had entered menopause. There was no significant difference in the EDSS score of women with MS with or without menopause (p>0.05). Sixty patients (21.4%) had children after MS. There was no significant difference between the number of relapses before (1.87±1.46) and after having a child (3.15±3.59) (p>0.05). Additionally, the last EDSS score (2.46±2.07) was not different from the EDSS score after having a child (2.35±1.81) (p>0.05). It was found that 80.4% of the patients had a regular menstrual cycle, whereas 19.6% of them had an irregular cycle. The EDSS score was significantly higher in women with irregular menstrual cycles than in women with regular menstrual cycles (p<0.05). The age at menarche in the study group (13.07) was found to be earlier than the average age at menarche in Turkey (13.3) (p<0.05).
DISCUSSION AND CONCLUSION: This study suggested that menopause and childbearing may not affect disability level or the number of attacks in women with MS. Additionally, women with MS have an earlier age at menarche compared with the general population. Future studies should investigate earlier age at menarche as a possible risk factor in MS.