
A spotlight on our women’s health research
Women are two and a half times more likely to get MS than men. And it has different implications for women, including your experience of periods, pregnancy and the menopause.
Yet historically, women’s health wasn’t the focus of much MS research. So there’s lots we don't know about how and why MS affects women differently. We’re funding research to help us better understand why periods worsen MS symptoms, which DMTs are safe to take during pregnancy, and why being pregnant can reduce relapses.
Why do periods worsen MS symptoms?
Many people with MS say symptoms like balance, fatigue and muscle weakness feel worse in the days leading up to and during their period. Levels of the hormones oestrogen and progesterone change during the menstrual cycle, but we don’t know how these changes influence MS.
In previous research, Dr Paul Ansdell and his team looked at these hormones in people without health conditions. They found when hormone levels were higher, the brain could communicate with muscles more easily. But levels of these hormones are low during menstruation. So this might explain why some MS symptoms worsen.
The team are now aiming to identify why some women with MS experience worsening symptoms at certain times in their menstrual cycles, mainly before and during their periods.
We hope to be able to provide patients and clinicians with an idea of when and why these changes occur, so that women with MS can be better supported in managing their symptoms, and ways to alleviate them can be explored.
Read more about Paul’s project
Why can pregnancy protect against MS relapses?
People with relapsing remitting MS often experience reduced relapse rates during pregnancy, especially during the third trimester. And we see similar patterns in other autoimmune conditions too. If we can understand why this occurs naturally in pregnancy, we might be able to replicate the effects to develop better treatments for MS.
Professors Cathy Thornton and Ruth Dobson are both exploring what might cause changes in MS symptoms during pregnancy. They’re both examining blood from pregnant people with MS, compared to pregnant people without MS or non-pregnant people with MS. By collecting blood samples, they can look in detail at how cells in the blood behave.
Debris released from the placenta
Cathy is looking at small bits of debris that are released from the placenta into the mother’s blood. These are known as extracellular vesicles (EVs) and they carry a cargo of molecules. The amount of EVs released increases throughout pregnancy. Cathy’s team think their cargo might reduce inflammation in the brain, which could explain the improvement in symptoms during pregnancy.
Examining DNA packaging
Ruth is looking at DNA. In particularly, how DNA is packaged. She’s exploring whether changes to DNA packaging during pregnancy might affect cells involved in MS immune attacks. By understanding whether and how these changes relate to reduced MS activity, either temporarily or in the longer-term, she hopes to better understand what drives inflammation in MS.
We also previously funded Professor Lars Fugger to look at how immune cells behave during pregnancy in MS. His team are finishing off their analysis at the moment, so we’re looking forward to hearing the results soon.
Read more about Ruth’s project
Read more about Cathy’s project
Read a blog from Lars about his project
What DMTs are safe to take in pregnancy?
Some people with MS who are planning to conceive or are pregnant may be advised to stop taking some DMTs. Because we don’t yet know exactly what the impact is of all DMTs on babies in the womb.
Thanks to other work by Ruth and her colleagues, there are now medical guidelines for pregnancy and MS. We’re also supporting Dr Eleanor Doman to develop computer and mathematical models to work out the possibility of different MS treatments crossing the placenta.
This is important because studying which drugs move through the placenta is tricky. There isn’t a lot of data directly from women who have continued taking drugs during pregnancy. And we need to reduce our use of animals where possible.
Eleanor hopes the results of her project will give people with MS who are planning to get pregnant, as well as policy makers and doctors, better information on the safety of DMTs during pregnancy.
Read an interview with Eleanor about her project
Get involved in pregnancy research
Our UK MS Register hosts the MS Pregnancy Register. People with MS who are pregnant can join the Register and answer questionnaires during and after their pregnancies. This is helping researchers understand what it’s like to be pregnant with MS.
Read Manisha’s blog about how the Pregnancy Register came about
Ultimately, the goal of all these projects is to help improve things for women with MS in the future.