Multiple sclerosis (MS) affects three times more women than men and this ratio appears to
be increasing. However male patients experience increased disease progression, brain
atrophy, and cognitive impairment. Gonadal hormones may modulate these sex differences.
For example, female puberty heralds an increased risk of MS, and during pregnancy
disease activity is milder, with an increased risk of postpartum relapses. Gonadal hormones
likely have complex and inflammatory and neuroprotective effects, and may interact with …