How does MS affect my period or vice versa?
We know that something about hormones changes MS risk, which is not unusual for autoimmune diseases, but we don’t fully understand it. We also know the MS rate for women begins to rise around puberty, when girls’ periods start, and more women than men have MS. But MS doesn’t make periods heavier or more painful or affect the period itself in other ways.
Is it safe to use hormonal contraceptives with MS?
Using hormonal birth control is fine for women with MS. No research has shown that they cause more MS symptoms or brain lesions. We have seen MS symptoms worsen with fertility treatments in some small studies, but not with hormonal birth control.
Does MS affect my ability to get pregnant?
The great news is that MS doesn't affect fertility. Decades ago, there was a notion that pregnancy could worsen MS, but we now know that pregnancy doesn't change the course of MS. Hormones change during pregnancy, and as a result, the immune system settles down. So MS tends to be quieter—even more so as the trimesters go on. But that changes after delivery: In the nine months postpartum, there’s a higher risk of MS relapse or new symptoms.
Should I stop taking MS meds during pregnancy?
For women with MS, it’s very important to have a planned pregnancy. We recommend that you discontinue disease-modifying treatments before and during pregnancy. The maker of each drug recommends a different timeline for when you should stop taking that drug before you get pregnant, depending on how long-lasting the medication’s effects are. We have many disease-modifying meds now, and some last for six months after they’re taken. The risk of being on one of these medications during pregnancy ranges from very dangerous to less dangerous but still potentially problematic. The concern is that any of these medications could lead to birth defects, small birth size for gestational age, or pregnancy loss.
How does menopause affect MS?
Menopause is a challenging time for all women, including those with MS. A lot of women with MS report more symptoms—such as cognitive or memory problems, bladder problems, fatigue, or sleep disturbances—during the menopausal transition. But it’s a little hard to sort out whether those things are due to MS or menopause. Depending on your family history of various female cancers or vascular risk factors, you may be able to take hormone replacement therapy along with your MS medications. Alternatively, over-the-counter supplements may help with some of these symptoms. It’s best to talk to your gynecologist about both.
What else should I know about MS and my reproductive health?
One very important thing: We can’t start you on MS meds unless you are on effective birth control because of the risks to a potential fetus. Effective birth control is not just condoms by themselves. To find a contraceptive method that will work well for you, talk over your needs with your gynecologist. Adding a gynecology visit to your to-do list may be annoying, but it’s a key piece of your MS care.