Women with multiple sclerosis (MS) outnumber men with the condition by nearly four to one, and this gender gap is only increasing.
Just yesterday, Tuesday, October 29, actress Teri Garr, 79, known for her roles in Young Frankenstein and Tootsie, passed away from complications due to MS. She battled the disease for more than 25 years and, in more recent years, became an ambassador for the disease and advocate for new research and treatment options.
While doctors still don’t know exactly why MS affects more women than men, studies have shown that hormonal fluctuations can exacerbate symptoms, and women report that MS symptoms often flare up when going through their menstrual cycles and during menopause, when hormones typically are in change.
MS is a condition in which the immune system mistakenly attacks the nervous system, which can lead to a wide range of symptoms.
“I often compare it to faulty wiring—the protective covering around your nerves, like the shielding around a copper wire, gets damaged, and the signals between your brain and body don’t communicate as smoothly,” Dr. Michael Boyd, a neurologist at UChicago Medicine AdventHealth’s Neuroscience Institute, tells Flow Space. “This can cause a variety of symptoms depending on which nerves are being affected at any given time, such that MS can present as fatigue, weakness, numbness, pain, cognitive symptoms and vision problems, among others.”
What’s more, MS can impact mobility, vision, mood and daily life for those suffering from the condition. And for women, the question of reproductive health, family planning and what menopause will bring only adds to the stress about what the future holds.
To understand more about MS, what symptoms can look like, the treatment options available and why it seems women in midlife are being diagnosed more than ever, Flow Space spoke with expert neurologists to learn more.
Why does it seem like MS is affecting midlife women more than others?
The short answer? It doesn’t just seem like it, MS is affecting midlife women more than others. It’s not a misconception.
“MS does tend to impact women more frequently than men, especially during midlife,” Boyd says. “Part of this could be due to the hormonal changes women experience during this time, especially as estrogen levels fluctuate. Hormones play a big role in how our immune system functions, and, for some women, this shift might trigger or worsen autoimmune conditions like MS.”
Midlife can also be a time of heightened stress. Women often juggle a lot during these years—balancing a career, raising children and caring for aging parents—all while possibly having to navigate other health conditions. Stress can affect the immune system, potentially triggering or worsening conditions like MS.
And the average age of MS onset has risen over the years for reasons we do not entirely understand.
“There are more cases of late onset MS, which is when symptoms begin at age 50 or older,” Dr. Jasmin Patel, a neurologist at the New Jersey-based Linda E. Cardinale Multiple Sclerosis Center at CentraState, part of Atlantic Health System, tells Flow Space. “In part, this may be due to better recognition of the disease nowadays. It is possible that cases of MS in middle to older age individuals were previously being missed more often.”
She adds that sometimes symptoms of MS in older women get misattributed to normal aging, menopause or other more common causes.
Can anything be done to reduce the risk of developing MS?
There is no way to fully prevent one’s chances of developing MS, but there are certain lifestyle factors that may help reduce the risk. Eating a healthy diet, particularly a Mediterranean style diet, regular exercise, maintaining a normal weight, drinking enough water throughout the day and avoiding cigarette smoking may decrease the risk, explains Patel.
Keeping your vitamin D levels healthy is also important.
“Because MS is an autoimmune condition where the body’s immune system attacks the covering of the nerve cells, this can affect different functions of the central nervous system depending on where the damage occurs,” Dr. Josef Maxwell Gutman, a clinical associate professor of neurology at NYU Grossman School of Medicine and director of the Comprehensive Multiple Sclerosis Care Center at NYU Langone Hospital—Long Island, tells Flow Space.
Vitamin D acts as a natural protectant and can increase your body’s immunity, so you might consider spending a little more time outdoors in the sun or taking supplements.
What do treatment options for MS look like?
When it comes to treatment, there are several options.
The first step is often selecting a medication to manage the disease itself. These are referred to as disease-modifying therapies, or DMTs. These medications can help reduce the frequency of relapses and slow the progression of MS.
There are currently over 20 different DMTs approved for MS, including oral, injectable and infusion drugs. These can be prescribed or provided on-site by a medical care team.
Beyond that, doctors look at symptom management—whether that’s through physical therapy, lifestyle changes or medications for pain, abnormal sensations, fatigue, attentions and/or mood disturbances.
“Generally when these highly effective medications are started early in the disease process, people with MS can live a long, healthy life without much impact on their day-to-day activities,” Gutman says.
And for women in midlife, the good news is MS doesn’t usually shorten life expectancy, but it can impact quality of life if left untreated. Early diagnosis and staying on top of your care plan can make a huge difference.
Signs to be aware of if you think you might have MS
It is important to remember that the disease can look quite different from person to person, but there are some common signs or symptoms to look out for. Symptoms of MS can sometimes be subtle at first, so it’s important to pay attention to your body.
Unexplained fatigue, vision problems like blurriness or double vision, persistent tingling or numbness sensations, muscle weakness or balance issues that don’t seem to improve could all be signs.
Other symptoms can include: sexual dysfunction, trouble walking, slurred speech, lack of coordination and even depression.
“It’s important to remember that there are so many moving parts in the human body, so a fleeting twitch or tingling can be normal and should not be cause for concerns, but if these symptoms are persistent, recurrent or linger, it’s worth checking in with a doctor,” Boyd says. “Women should also trust their instincts—if something feels off, it’s better to get it looked at early.”
How awareness has improved the visibility around MS
In addition to new research, celebrities who suffer from MS or know someone who does, are helping to spread awareness of the disease, which has encouraged earlier diagnoses and better access to treatment.
The funds raised through campaigns have also helped contribute to research that is helping doctors better understand MS.
“And due in part to celebrity advocacy, there also seems to be a better general understanding that there are many newer and more effective treatments available for the disease,” Patel adds.
For those living with MS, connecting with people who share common life experiences or goals can be helpful. Finding emotional and mental support and building confidence in your ability to cope can go a long way. And strides within the MS community to bring about awareness have only strengthened the hope for those living with the condition.
“I think it’s important to share that I’m not just speaking as a doctor—I’m also someone living with MS,” Boyd says. “I know firsthand what it’s like to receive that diagnosis, and I’m taking medication to prevent the disease from progressing. I expect to have a normal life expectancy, and I fully intend to be there for my family and for my patients for many years to come. MS is a part of my life, but it doesn’t define me. If you’ve been diagnosed or you’re concerned about symptoms, remember—you’re not alone in this. There’s hope, and there are many of us living well with MS.”