- •There is no difference regarding menstrual characteristics in MS patients before onset of the disease and healthy controls.
- •Irregular menstrual cycle happens more after the disease occurrence.
- •Almost all perimenstrual symptoms are reported more frequently by MS patients.
Menstruation is suggested to affect multiple sclerosis (MS) symptoms, while the effect of MS on menstruation is not studied before. Here, we aimed to compare the pattern of menstrual cycle and its symptoms between MS patients and healthy controls.
This is a cross-sectional study conducted during 2015–2016 in MS clinic of Kashani hospital, Isfahan, Iran. We included female patients > 14 years with diagnosis of relapsing-remitting MS, and healthy subjects as the control group. We collected data regarding menarche age, menstrual characteristics, history of premenstrual syndrome, the amount of menstrual bleeding, and the possible perimenstrual symptoms from all subjects. Also, MS patients were asked to report changes in menstrual characteristics after MS occurrence.
The final study population contained 181 MS patients and 202 healthy subjects. The mean age in MS and control group were 36.04 ± 9.86 and 35.16 ± 11.30, respectively (P-value = 0.426). Menarche age in MS patients and control group were not statistically different (13.59 ± 1.87 and 13.29 ± 1.53, respectively; P-value = 0.087). Changing menstrual characteristics was reported in 70 MS patients (38.7%). Irregular menstrual cycle increased from 21% to 40.3% after occurrence of MS (P-value < 0.001) and was reported 24.7% in the control group. MS patients versus controls reported more symptoms before, during, and after their menstrual period (P-values < 0.001).
We found no difference regarding menstrual characteristics in MS patients before onset of the disease and healthy controls. Irregular menstrual cycle was observed more after the disease occurrence while other menstrual characteristics did not change. Moreover, MS patients reported many more perimenstrual symptoms.
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- Guidelines for Women's Health Care: A Resource Manual. 4th ed. American College of Obstetricians and Gynecologists, Washington, DC2014
- 17β-Estradiol differentially regulates blood-brain barrier permeability in young and aging female rats.Endocrinology. 2004; 145: 5471-5475
- Hypothalamic-Pituitary-Ovarian Axis and Control of the Menstrual Cycle. Clinical Reproductive Medicine and Surgery.Springer, 2013: 31-42
- Hypothalamic dysfunction and multiple sclerosis: implications for fatigue and weight dysregulation.Curr. Neurol. Neurosci. Rep. 2016; 16: 98
- Menstrual symptoms in adolescent girls: association with smoking, depressive symptoms, and anxiety.J. Adolesc. Health. 2009; 44: 237-243
- Multiple sclerosis and depression.Mult. Scler. J. 2011; 17: 1276-1281
- Gender issues in multiple sclerosis.Neurologist. 2002; 8: 351-356
- Hypothalamic-Pituitary-Adrenal Axis Function in Premenstrual Dysphoric Disorder. Adrenal Insufficiency.Endocrine Society, 2015 (p. THR-374-THR-)
- Sex and gender issues in multiple sclerosis.Ther. Adv. Neurol. Disord. 2013; 6: 237-248
- Acute demyelinating disorders of the central nervous system.Curr. Treat. Options Neurol. 2009; 11: 55-63
- Symptoms of multiple sclerosis in women in relation to cyclical hormone changes.Eur. J. Contracept. Reprod. Health Care. 2009; 14: 365-370
- Influence of sex steroid hormones on cerebrovascular function.J. Appl. Physiol. 2006; 101: 1252-1261
- Menstrual pattern in women with multiple sclerosis.Iran. J. Obstet. Gynecol. Infertil. 2017; 19: 42-47
- Effect of combined use of calcium and vitamin B6 on premenstrual syndrome symptoms: a randomized clinical trial.J. Caring Sci. 2016; 5: 67
- Female reproductive issues in multiple sclerosis.Mult. Scler. J. 2013; 19: 392-402
- Functional hypothalamic amenorrhea and its influence on women's health.J. Endocrinol. Investig. 2014; 37: 1049-1056
- Revised diagnostic criteria of multiple sclerosis.Autoimmun. Rev. 2014; 13: 518-524
- Menstrual irregularities and related plasma hormone levels in multiple sclerosis patients treated with beta interferone.Acta Med. Iran. 2010; 48: 36
- Albuquerque APdS, de Araújo RC. Menstruation disturbances: prevalence, characteristics, and effects on the activities of daily living among adolescent girls from Brazil.J. Pediatr. Adolesc. Gynecol. 2013; 26: 148-152
- The validation of visual analogue scales as ratio scale measures for chronic and experimental pain.Pain. 1983; 17: 45-56
- Multiple sclerosis: risk factors, prodromes, and potential causal pathways.Lancet Neurol. 2010; 9: 727-739
- Gender issues in multiple sclerosis.Int. Rev. Neurobiol. 2007; 79: 377-392
- Perimenstrual symptoms and syndromes: guidelines for symptom management and self-care.Adv. Stud. Med. 2005; 5: 228-241
- Sex hormones modulate brain damage in multiple sclerosis: MRI evidence.J. Neurol. Neurosurg. Psychiatry. 2005; 76: 272-275
- Menstrual pain is associated with rapid structural alterations in the brain.PAIN®. 2013; 154: 1718-1724
- Gender issues and multiple sclerosis.Curr. Neurol. Neurosci. Rep. 2002; 2: 277-286
- Reproductive hormones regulate the selective permeability of the blood-brain barrier.Biochim. Biophys. Acta (BBA)-Mol. Basis Dis. 2008; 1782: 401-407
- Prevalence and concurrence of anxiety, depression and fatigue over time in multiple sclerosis.Mult. Scler. J. 2013; 19: 217-224
- Prevalene of perimenstrual symptoms.Am. J. Public Health. 1982; 72: 1257-1264
- Menstrually related worsening of symptoms in multiple sclerosis.J. Neurol. Sci. 1997; 149: 95-97
- The premenstrual period and exacerbations in multiple sclerosis.Eur. Neurol. 2002; 48: 204-206
Published online: February 02, 2018
Accepted: January 21, 2018
Received in revised form: January 5, 2018
Received: November 6, 2017
© 2018 Published by Elsevier B.V.