Multiple sclerosis (MS) is an autoimmune
condition that interferes with the flow of information in the central nervous
system. It causes a variety of symptoms and can affect females differently than
males.
Researchers do not know what
triggers MS. Once it develops, the
condition causes the immune system to destroy a type of tissue called myelin,
which insulates nerve fibers.
Without enough myelin, it is difficult for
the nerves to transmit and receive signals properly.
MS randomly affects nerves in the brain,
spinal cord, and eyes, meaning that it can cause a wide range of unpredictable
physical, mental, and emotional symptoms that vary from person to person.
This article will discuss some of the most common symptoms of MS and explain why females might experience symptoms somewhat differently. It will also cover diagnosis and treatment.
The symptoms of MS in females are similar
to those in males, but they can include additional issues due to hormonal
changes.
MS can also affect sexual health and
bladder function differently.
MS symptoms in females include the
following.
1. Vision problems
For many people, a vision problem is
the first noticeable symptom of MS.
MS can cause
various vision problems, including:
- blurred vision
- poor color vision or contrast vision
- painful eye movements
- blindness
in one eye
- a dark spot in the field of vision
People with MS
develop vision problems either because their optic nerves become inflamed or
because they have nerve damage in the pathways that control visual coordination
and eye movement.
Although
vision problems due to MS can be scary, most either resolve without treatment
or are highly treatable.
2. Numbness
Numbness in
the face, body, arms, or legs is another common symptom of MS, and it is often
one of the earliest symptoms of the condition.
The numbness
can range from mild and barely noticeable to severe enough that it interferes with
everyday activities, such as holding objects and walking.
Most periods
of numbness due to MS resolve without medication and do not become permanently
disabling.
3. Fatigue
About 80% of people with MS experience fatigue or
unexplained exhaustion.
Sometimes, the
cause of fatigue relates to another symptom of MS. For example, people with
bladder dysfunction may sleep poorly because they have to wake throughout the
night to go to the bathroom.
People with MS
who have nocturnal muscle spasms may not sleep well, leaving them feeling tired
during the day. MS can also increase the risk of depression, which
can cause fatigue.
Another type
of fatigue that seems to be unique to MS is called lassitude. A person’s
fatigue may be lassitude if it:
- occurs daily
- worsens as the day goes on
- happens in the morning, even after a good night’s
sleep
- worsens with heat or humidity
- interferes with daily activity
- is unrelated to physical impairments or
depression
4. Bladder
problems
Bladder
problems affect at least 80% of people with MS. These issues occur when scars
on the nerves impair nerve signaling that is necessary for the function of the
urinary sphincters and bladder.
MS can make it difficult for the bladder to hold urine
and may reduce the amount that it can store, causing symptoms such as:
- more frequent or urgent
urination
- hesitancy starting
urination
- frequent
overnight urination
- an inability to
empty the bladder
- an inability to
hold urine, or urine leaks
5. Bowel problems
Many people with MS experience bowel problems, such
as:
- constipation
- diarrhea
- a loss of bowel
control
Bowel problems can make other MS symptoms — especially
bladder problems, muscle stiffness, and involuntary muscle spasms — worse.
Some researchers believe that people with MS have
problems controlling their bowels because of the neurological damage that the
condition causes. Some people with MS may also have trouble controlling their
bowels when they have constipation.
6. Pain
Some research suggests that 55% of people with MS experience clinically
significant pain, while 48% live with chronic pain. Females with MS may be more
likely than males to experience pain as a symptom of this condition.
Acute MS pain seems to be due to problems with the
nerves that help transmit sensations in the central nervous system.
Some of the acute pain symptoms that have an association
with MS include:
- trigeminal
neuralgia, which refers to a stabbing pain in the fact that people may
confuse with dental pain
- Lhermitte’s sign,
which is a short sensation resembling an electric shock that moves from
the back of the head down the neck and spine, usually after bending
forward
- the MS hug, which
describes a stabbing, squeezing, painful, or burning sensation around the
torso or in the legs, feet, or arms
Some of the symptoms that people with chronic MS pain
may report include:
- burning
- aching
- pins and needles
- prickling
Many people with MS also experience chronic pain as a
secondary effect of the condition. For example, it could be due to:
- compensating for
gait changes
- muscle stiffness,
cramps, and spasms
- incorrect use of
mobility aids
- muscle changes
from mobility loss
7. Cognitive changes
More than 50% of people with MS experience changes in cognition,
which means that they may sometimes have difficulty:
- processing new
information
- learning and
remembering new information
- organizing
information and problem-solving
- focusing and
maintaining attention
- properly
perceiving the environment around them
- understanding and
using language
- doing
calculations
The cognitive symptoms of MS are typically mild to
moderate and only affect a few aspects of cognition.
In rare cases, people with MS may experience disabling
cognitive problems.
8. Depression
Clinical depression is one of the most common symptoms
of MS. Depression is more common in people with MS than in people with
other chronic health conditions.
Although almost everyone experiences periods of
sadness or grief, clinical depression refers to depressive symptoms that last
for a minimum of 2 weeks.
Some of the symptoms of clinical depression include:
- a loss of
interest in everyday activities
- an increase in
appetite or appetite loss
- sadness
- irritability
- insomnia or
excessive sleep
- fatigue
- feelings of guilt
and worthlessness
- difficulty
thinking or concentrating
- behavioral
changes
- thoughts of death
or suicide
Clinical depression can also worsen other MS symptoms,
including:
- fatigue
- pain
- cognitive changes
9.
Muscle weakness
Many people
with MS also experience muscle weakness.
This symptom is due to damage to the nerve fibers that help control muscles.
People with MS
may also experience muscle weakness because a lack of use has caused their
muscles to become deconditioned over time.
MS-related
muscle weakness can affect any part of the body. It can be especially
challenging for people with MS to walk and stay mobile when muscle weakness
affects their legs, ankles, and feet.
10. Muscle
stiffness and spasms
MS can cause
spasticity, which refers to muscle stiffness and involuntary muscle spasms in
the extremities, especially the legs.
Some of the
symptoms of spasticity include:
- tightness in or around the joints
- painful, uncontrollable spasms in the arms and
legs
- lower back pain
- hips and knees that bend and become difficult to
straighten
- hips and knees that stiffen while close together
or crossed
11. Dizziness
and vertigo
Some people
with MS experience dizziness and the sensation of being lightheaded, woozy,
weak, or faint. Less commonly, they may experience vertigo, which makes it
feel as though they or their surroundings are spinning.
MS may cause
vertigo by damaging the pathways that coordinate the spatial, visual, and
sensory input that the brain needs to maintain balance in the body.
The symptoms
of vertigo include:
- balance problems
- motion sickness
- nausea and vomiting
- lightheadedness
- a spinning sensation
12. Sexual
problems
People with MS
often experience sexual problems and may find it difficult to become aroused or
have an orgasm.
For example, MS may reduce natural vaginal lubrication, potentially making
sexual intercourse painful for females.
The condition
can also cause sexual problems by damaging nerves in the sexual response
pathways that connect the brain and the sexual organs.
People with MS
may also experience issues with sex as a result of other MS symptoms, such as:
- muscle spasms and stiffness
- mood or self-esteem changes
- fatigue
13. Emotional
changes
MS can cause a
wide range of emotional symptoms and changes, including:
- mood shifts
- periods of uncontrollable laughter or crying
- irritability
- grief
- worry, fear, and anxiety
- distress, anger, or frustration
The condition
is unpredictable, often has fluctuating symptoms, and can become disabling, all
of which can be scary for someone.
MS can also
cause emotional changes by damaging the nerve fibers in the brain. Some of the
medications that people take to manage MS can also cause mood changes.
For example,
corticosteroids can have many emotional side effects, including:
- anxiety
- irritability
- agitation
- tearfulness
- restlessness
- fear
14. Difficulty
walking
People with MS
can develop problems with gait, or how they walk, because of several factors.
Some MS symptoms that may affect how a person walks include:
- muscle stiffness and spasms
- numbness or other sensory problems in the hips,
legs, ankles, or feet
- fatigue
- muscle weakness
- loss of balance
15. Hormonal
effects
There is some
evidence to suggest that MS can affect females differently than males due to
hormonal changes, including those that occur during the following times of
life.
Menstruation
More research
is necessary to draw firm conclusions, but the National Multiple Sclerosis Society (NMSS) states that
some studies have found that females with MS have worse symptoms within a week
of starting their period.
Studies that
used an MRI scan have also shown that MS
disease activity may change according to the different hormonal levels during
menstruation.
Pregnancy
Pregnancy
can reduce the risk of MS symptom flare-ups, especially
during the second and third trimesters.
Researchers
believe that pregnancy has a protective effect against MS by raising the levels
of compounds that help reduce inflammation and
the effects of the condition.
Pregnant
people also have naturally higher levels of circulating corticosteroids,
another type of immunosuppressant.
Although
pregnancy can temporarily reduce some MS symptoms, flare-ups tend to return in
the first 3–6 months postpartum. However, in the long term, there is no proven
link between pregnancy and a higher risk of disability.
Although being
pregnant can temporarily reduce the risk of flare-ups, pregnancy also puts a
lot of physical stress on the body, which can make certain symptoms of MS
worse.
In addition,
some of the medications that people use for MS are not safe to take during
pregnancy and can worsen symptoms.
Anyone with MS
who is pregnant or planning to become pregnant should discuss their medications
with a doctor.
Some MS
symptoms that pregnancy often exacerbates include:
- fatigue
- gait problems
- bladder and bowel problems
Menopause
MS symptoms
may worsen after menopause, possibly because declining estrogen levels
adversely affect disease progression.
However, it is
difficult to tell whether MS symptoms worsen because of menopause or just as a
natural result of aging or the progression of the condition.
Much more
research is necessary to understand the relationship between menopause and MS
symptoms.
Although the
symptoms above are the most common, MS affects everyone differently. Some less
common symptoms of MS include:
- speech problems
- seizures
- hearing loss
- swallowing problems
- tremor
- breathing problems
- itching
- headaches
Some early symptoms of MS include:
- a temporary loss of vision
- color blindness
- eye pain that worsens with eye movement
- flashes of light with eye movement
- numbness or tingling in different parts of the
body
According to
the NMSS, at least two or three times more females than males receive a
diagnosis of MS.
Overall, MS
seems to affect males and females similarly. However, a doctor cannot predict
which symptoms that someone with MS will experience, the severity of the
symptoms, or the progression of the condition.
The reason for
this is that the condition attacks the myelin randomly, and the nerves that it
affects can differ from person to person.
Although males
and females with MS often experience similar symptoms, certain factors — such
as menstruation, pregnancy, and menopause — may
influence MS symptoms in females.
Why are
females more at risk?
Females may be
more at risk of MS because their bodies suppress the immune system while
pregnant.
Vitamin D
deficiency may also be linked with MS. Some researchers believe
that there is a link between MS and the differences in the ways that male and
female bodies process vitamin D. However, more studies are necessary.
Other
researchers theorize that X chromosomes play a direct
role in autoimmune function. X chromosome inactivation in females may
result in them having more MS susceptibility genes. Again, more research is
necessary.
MS is an
autoimmune condition that randomly affects parts of the central nervous system,
resulting in unpredictable physical, cognitive, and emotional symptoms.
Although MS
tends to affect more females than males, it usually causes similar symptoms.
However, females may experience variations in their symptoms due to hormonal
changes, such as those that take place during menstruation, pregnancy, or
menopause.
Vision
problems and random localized numbness are often the first symptoms of the
condition. Depression, bladder problems, cognitive changes, and pain are also
among the most common symptoms of MS.
There is
currently no cure for MS, but different drugs and complementary therapies can
typically help manage the symptoms or even slow the progression of the
condition.
Anyone who is
experiencing concerning symptoms should contact a doctor for a proper
diagnosis.
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