ECTRIMS 2023 | Pregnancy, multiparity, and MS: neuroprotective implications of hormones

Rhonda Voskuhl, MD, University of California, Los Angeles, CA, explores the intricate relationship between pregnancy and its protective effects on multiple sclerosis (MS) outcomes. It’s well-documented that pregnancy, especially during the last trimester when estradiol levels are elevated, can reduce relapse rates in MS patients by up to 70%. Notably, having multiple pregnancies (multiparity) has been associated with long-term protective effects against disability. Dr Voskuhl postulates that intermittent anti-inflammatory effects from pregnancies alone wouldn’t result in reduced disability over a span of 15 years. Instead, it points to the neuroprotective properties of estrogens, particularly the advantage of targeting Estrogen receptor-β over estrogen receptor-α. European data also highlights the remyelinating properties of progesterone and estrogens, suggesting their joint role in neural protection. The inherent neuroprotective properties of these pregnancy-associated hormones emphasize their potential significance in MS treatment strategies. This interview took place at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress 2023 in Milan, Italy.

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