Multiple sclerosis (MS) is a condition that primarily affects the central nervous system, including the brain and spinal cord. The immune system mistakenly attacks the protective covering of nerve fibers, leading to communication problems between the brain and the rest of the body. This can result in a wide range of symptoms, including fatigue, difficulty walking, numbness or tingling, and problems with coordination.
"For women with MS, understanding how the condition may interact with various life stages is crucial," says Diana N. Andino, MD, Neurology at ARC Four Points in Austin. "The impact of MS on the nervous system can influence decisions related to family planning and menopausal management."
Planning for parenthood
"Pregnancy is a time of joy and anticipation for many couples, but for women with MS, it may bring additional concerns and considerations," says Julia M. Voelkl, MD, MPH, Obstetrics/Gynecology at ARC South Ob/Gyn in Austin. "It's essential for those planning to start a family to work closely with their healthcare team, including a neurologist and an obstetrician, to ensure a holistic approach to care."
Common considerations and concerns for expecting mothers
- Medication management during pregnancy is a critical aspect. Some medicines used to manage MS symptoms may need to be adjusted or temporarily discontinued to reduce potential risks to the developing fetus. This should be done under the guidance of a knowledgeable healthcare provider, and alternative strategies for managing MS symptoms may be explored.
- Regular check-ups with both the neurologist and obstetrician become even more important during this period. Monitoring for potential flares and adapting the treatment plan as needed will contribute to the overall well-being of both the mother and the baby.
- Other concerns: While there may be concerns about the impact of MS on the baby's health, studies have shown that with proper management and care, women with MS can have healthy pregnancies and deliver healthy babies. There is no evidence that MS causes infertility, and studies have shown that pregnancy, labor, delivery, and the rate of birth defects are not significantly different in women with MS compared with those without MS.
However, the decision to become pregnant should be well-informed, with open communication between the patient and her healthcare team.
Navigating menopause
As women with MS age, they will eventually face another significant life stage – menopause. Menopause, marked by the cessation of menstruation, brings about hormonal changes that can potentially affect the course of MS.
- Menopause symptoms such as hot flashes and changes in mental health may become more pronounced during menopause. The decline in estrogen levels can impact the nervous system, potentially influencing the frequency and severity of MS symptoms. This is where the expertise of a healthcare provider, possibly specializing in both neurology and women's health, becomes crucial.
- Hormone therapy: Some women may consider hormone replacement therapy (HRT) to manage menopausal symptoms. However, this decision should be made with careful consideration of the potential risks and benefits, especially for women with MS. Consultation with a healthcare professional who is knowledgeable about both MS and menopause is essential to develop an individualized treatment plan.
- Osteoporosis: The risk of developing conditions such as osteoporosis, which involves a reduction in bone density and an elevated susceptibility to fractures, also increases during menopause, adding another layer of consideration for women with MS. Bone health should be monitored, and preventive measures discussed with the healthcare team.
Managing multiple sclerosis across pregnancy and menopause requires a collaborative effort between the patient and her physicians. "Open communication, regular check-ups, and a proactive approach to managing symptoms are key components of ensuring the well-being of both the woman with MS and her baby during pregnancy and beyond, says Dr. Voelkl. "By staying informed and seeking the support of knowledgeable specialists, women with MS can navigate these significant life stages with confidence, paving the way for a healthy and fulfilling life," adds Dr. Andino.
About Dr. Andino
Dr. Andino was recently recognized by the National Multiple Sclerosis Society as a Partner in MS Care for her dedication to providing optimal care and support to people living with MS. She is currently accepting new patients, ages 18 and older, at ARC Four Points in Austin. Learn more about ARC Multiple Sclerosis (MS) Treatment with Dr. Andino.
Make an appointment today with or without a referral
Make an appointment online with Dr. Andino using ARC MyChart or by calling ARC Four Points in Austin at 737-247-7200. Your ARC primary care physician can also give you a referral to Dr. Andino.
Don't miss this!
Dr. Andino is leading the ARC team for the Austin Walk MS 2024 on Saturday, April 13. Join or donate today!