Symptoms of Multiple Sclerosis during use of Combined Hormonal Contraception
2015 (English)In: European Journal of Obstetrics, Gynecology, and Reproductive Biology, ISSN 0301-2115, E-ISSN 1872-7654, Vol. 193Article in journal (Refereed) Published
Objective: Incidence and disease course of Multiple Sclerosis (MS) is influenced by sex steroids and several studies have shown less disease activity during high estrogen states. We have earlier shown variation in symptom experience related to estrogen/progestogen phase in women using combined hormonal contraceptives (CHC) in a small sample. The aim of this study was confirm these results in a larger sample.
Design: Self-assessment of symptoms of MS in relation to CHC cycle or menstrual cycle. Sample: Twenty-three female MS patients using CHC. Control groups were female MS patients without hormonal contraception and healthy women with CHC and without hormonal contraception.
Methods: All women filled out a symptom diary based on a validated instrument for cyclical symptoms.
Main Outcome measures: Mean scores for high and low estrogen/progestogen phases were compared.
Results: The women with MS using combined hormonal contraceptives scored all symptoms higher during the pill-free week than during the CHC-phase and the scores for vertigo, weakness, urinary symptoms and stiffness were significantly higher during the seven days without CHC (p < 0.05). No such relation was found in the group of women with MS not using any hormonal contraception. Women without MS did not report any symptoms at all.
Conclusion: Women with MS report more pronounced symptoms during the lowestrogen/ progestogen phase of CHC use. Future studies should investigate, with a prospective, controlled design, which effects continuous-use regimens of CHC have in women with MS.
Place, publisher, year, edition, pages
Elsevier, 2015. Vol. 193
Multiple Sclerosis, Combined Hormonal Contraceptives, Symptom experience
IdentifiersURN: urn:nbn:se:liu:diva-108886DOI: 10.1016/j.ejogrb.2015.06.030ISI: 000361777400001OAI: oai:DiVA.org:liu-108886DiVA: diva2:733615
Funding: County Council of Ostergotland, Sweden; County Council of Vasternorrland, Sweden2014-07-102014-07-102015-10-19Bibliographically approved