Preguntas importantes sobre la Esclerosis Múltiple
Of the nearly 1 million people living with multiple sclerosis (MS) in the United States, 74% are women. However, women still lack knowledge of how MS affects the body.
To find out more, we spoke to Aliza Ben-Zacharia, PhD, MS specialist, researcher, and associate professor at Hunter College in New York City.
The interview has been edited for clarity and length.
Healthy women: What is Multiple Sclerosis (MS)?
Aliza Ben-Zacharias: MS is a disease in which myelin, the protective covering that surrounds most of the nerve fibers, deteriorates. MS damages or destroys the myelin and underlying nerves in the brain, spinal cord, and optic nerves.
Healthy women: What are the Different Types of MS?
Aliza Ben-Zacharias: There are four types of MS. Isolated clinical syndrome (ACS) is the first episode of MS. The second type, relapsing-remitting multiple sclerosis (RRMS), involves at least two episodes that are at least 30 days apart. Around 85% of patients with multiple sclerosis have RRMS.
The other two types are known as secondary progressive multiple sclerosis (SPMS) and primary progressive multiple sclerosis (PPMS). EMSP starts out as RRMS, but then the time between relapses decreases and there is more symptom progression between relapses. Not all people with RRMS develop SPMS.
With PPMS, patients typically experience mild progression over many years and can have long plateau periods. For example, a person may have trouble walking so they start using a stick, then switch to a stroller, and finally use a wheelchair.
Healthy women: What Are Some of the Early Symptoms of MS?
Aliza Ben-Zacharias: MS affects every system in the body and no two people have the same experience. One person may have sensory symptoms such as numbness and tingling, while another person may have blurred vision. Symptoms can also include poor balance and coordination, difficulty walking, cognitive impairment, or sexual dysfunction.
Healthy women: How is MS treated?
Aliza Ben-Zacharias: It really depends on the type of MS and symptoms. There are several types of drugs for MS, including intravenous drugs, pills, and injectable drugs. Some patients want to be aggressive with their treatment while others want to be more conservative.
Healthy women: With so many treatment options for MS, how do you determine which is best for each patient?
Aliza Ben-Zacharias: It’s about identifying the type, the symptoms and analyzing tests like the MRI. Managing MS symptoms is important as they affect a patient’s quality of life. Most of the women I see have RRMS, and many can treat it with a modifying drug that will treat their specific symptoms.
Healthy women: Are some women more likely to develop MS than others? If so, how can they receive medical care?
Aliza Ben-Zacharias: Some minorities living in the United States, such as African American and Latina women, are more likely to develop MS than those same non-population groups. These populations are often underrepresented in clinical trials, making it difficult to assess treatment demographically.
To improve access to care for all women with MS, providers can learn how to deliver culturally literate health care. And patients have the legal right to request a medical interpreter to guide them through all treatment options.
Healthy women: Does MS Impair Reproductive Health? What should a woman with MS consider when planning a pregnancy?
Aliza Ben-Zacharias: Women with multiple sclerosis trying to get pregnant should speak to their health care team as we weigh the risks and benefits when considering how to change the treatment and management of symptoms for a woman with MS before, during, and after treatment can pregnancy. It is important to understand the patient’s (and, if applicable, partner’s) treatment plan so that we can make the necessary changes.
Healthy women: What are some of the other diseases that women with MS are at risk of developing?
Aliza Ben-Zacharias: Comorbidities (when a person has more than one health problem) really affect the way we treat MS patients. Some of my patients have autoimmune diseases such as Hashimoto’s arthritis, psoriasis, and thyroiditis.
The prevalence of depression in people with MS is very high, and I also see many postmenopausal women with osteoporosis. The cause of the symptoms should also be considered. For example, is a patient’s fatigue caused by MS or anemia? Or if a patient is in pain, should we assume that it is MS related? It is important to consider these other diseases when deciding how to treat MS.
Healthy women: What about complementary and alternative therapies for people with MS?
Aliza Ben-Zacharias: Complementary and comprehensive treatments can be very useful. I have often recommended acupuncture for trigeminal neuralgia, which is a severe facial pain that can occur in MS. Yoga and massages can also contribute to well-being and promote relaxation. Supplements can also help, but you should check with your MS care team before taking any medications or supplements.
Healthy women: Can Lifestyle Changes Improve MS Symptoms?
Aliza Ben-Zacharias: It is very important to stay active with MS. Activities like cycling and swimming can help patients feel stronger and more energetic. Physical activity can also help MS patients manage their comorbidities. For example, if a patient with MS has diabetes, exercise can treat both diseases.
Mental health is just as important as physical health. Therefore, it is important that MS patients address their emotional problems. Dealing with stress is also crucial, as stress can make MS symptoms worse.
Choosing a healthy lifestyle is really a big part of MS treatment. Being socially active, spending time with friends and family (even if only virtually), volunteering, and continuing to work when possible can help you stay integrated into the world. This integration is the key to a good life with MS.
For more information, visit the HealthyWomen Multiple Sclerosis Platform and the National Multiple Sclerosis Society.
Sources for Spanish translation:
Bilingual information sheet from the National MS Society
Merck Manual – Spanish Edition
GAEM MS Research from the Barcelona Foundation
This resource was created with the assistance of Biogen.