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Monday, March 4, 2013

Guest Post Katie Brind’Amour: Women and MS Experience

Women and the MS Experience: Different from Men? It’s no secret: women develop Multiple Sclerosis two to three times as often as men. In addition, Harvard Medical School and Healthline agree that women’s MS symptoms are similar to those of men in both frequency and severity. Both men and women seem to respond to cooling therapy and experience depressive symptoms, perceived health, and exercise barriers the same way. So what’s the difference in “the MS experience” between men and women? The well-documented reduction in MS relapses during pregnancy is at least one opportunity for a break in the MS symptom parade—one that men don’t have the option to experience. Despite this brief chance to swap some MS symptoms for the nausea and exhaustion of pregnancy, treatments (in animal studies) based on altering sex hormones still only show limited promise for relieving women’s MS symptoms. In addition, the risk of MS relapse increases again a few months after the baby is born. Women can at least be grateful that having kids does not seem to negatively impact their MS disease progression in the long run. Despite the similarity between men and women in symptoms and disease progression, women don’t have quite the same disease indicators or related disease outcomes. For instance, MSRV, a retrovirus believed to be related to MS, is present at significantly higher levels in the blood of women with MS than in men with MS. This retrovirus is also present at much higher rates in women without MS than in men without the condition, suggesting a potential reason behind the higher rates of MS among women. Even more troubling, women with MS have to worry about the cardiovascular comorbidities associated with their primary illness. Unfortunately, women with MS are more likely than the general population and men with MS to experience cardiovascular problems. These problems include heart failure and stroke, which only adds to the chances that women (and men) with MS will fall prey to the number one killer in the U.S.: heart disease. Is There Any Good News for Women with MS? Although some of the news above doesn’t bode well for the health of women with MS, there is at least a silver lining. One of the best ways to prevent cardiovascular disease is also one of the most successful ways to relieve certain MS symptoms: exercise. An added bonus? Exercise can release hormones and chemicals that also boost mood and energy levels, combatting fatigue and providing some extra oomph in the fight against depression—which is common among both men and women with MS. In addition, regular exercise can improve mobility, endurance, and quality of life for women with MS. Thankfully, exercise can be slowly incorporated into the daily life of women with MS; “all or nothing” and “no pain, no gain” mottos do not apply here. Even if you are currently inactive, incorporating exercise (with your doctor’s knowledge and go-ahead!) may offer you relief from MS symptoms and its life-threatening comorbidities. The ultimate exercise goal for adult women is pretty manageable: 2.5 hours of moderate activity each week (like a half-hour brisk walk five days each week) plus strength or resistance training at least twice each week. Swimming, yoga, cycling, and other gentle exercise programs combine some muscle training with coordination and a bit of aerobic work. Many inactive people with MS are able to begin with stretching exercises and build up to longer, more difficult routines over several weeks. Women who use wheelchairs are no exception to this! Ask your doctor for advice on the best exercise options for you. Opt for a time of day when you have the most energy. If your worst fatigue hits you in the afternoon, try exercising in the morning. Use bottles of water as light weights for simple strength training while you watch TV, and incorporate more work into trips to the grocery store (park further away, carry a basket instead of using a cart, etc.). Work on your weakest muscle groups first; improve balance by working the core and the legs, or increase motor skills by combining stretching exercises with grasping, clutching, and wrist exercises. Your goal should be a combination of cardio and strength exercises each week. This will help protect your heart and fight the progressive nature of MS by restoring some muscle, energy, and balance. All in all, you’ll be fighting MS, depression, cardiovascular disease, diabetes, and many other problems with one prevention technique—and that kind of effective multi-tasking is certainly good news for all women with MS.

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