Multiple sclerosis: why the disease affects more women – 29/05/2023 – Health

In 2015, when she was just 24 years old, work safety technician Jocilene Emanuele Medina sought an emergency room in Pains, Minas Gerais, where she lives, after having an episode of vomiting, vertigo and imbalance.

After going through a medical consultation and taking some tests, she was referred to an otorhinolaryngologist where she was diagnosed with labyrinthitis.

Even following the indicated treatment, Manu, as she is better known, says that the symptoms did not improve and she began to lose sight on her left side.

Concerned, she sought out an ophthalmologist. “The doctor noticed that I had an inflammation of the optic nerve and decided to hospitalize me immediately. I was scared, I had no idea how serious my case was,” she says.

In the 15 days of hospitalization, even with several tests carried out, the doctors still had not concluded a diagnosis about what was happening to Manu.

It was only after a year and a half of investigation that the diagnosis of multiple sclerosis arrived.

“I was floored when I received the news. I think the initial phase of the diagnosis is the most difficult for the patient. Having ‘easy’ access to information on the internet, for example, makes us even more desperate”, says Manu.

young patients

Multiple sclerosis is a neurological, chronic and autoimmune disease, in which the body’s defense cells attack the central nervous system itself, causing damage to the brain and spinal cord.

May 30 is considered World Multiple Sclerosis Day – a date chosen with the aim of bringing information about the disease to society.

The ABEM (Brazilian Association of Multiple Sclerosis) estimates that about 40,000 Brazilians have the disease, which usually affects young people aged between 20 and 40 years, being more common among women and white people.

The cause of the disease, as well as why it is more common in young women, are still open questions for science.

There are, however, some clues as to why this group represents the majority of diagnoses.

One theory is that fluctuations in sex hormones during the reproductive years could influence the immune response and increase the risk of developing the disease.

Studies suggest that another factor is a genetic component —specific genes would be responsible, in part, for women’s susceptibility to multiple sclerosis.

Furthermore, the generally stronger immune response in women may contribute to greater inflammatory activity in the central nervous system, which increases the risk of developing the disease.

Multiple sclerosis is not a type of dementia

It is important to highlight that multiple sclerosis is not a type of dementia, as many people mistakenly think.

According to the neurologist and medical coordinator of the Center of Excellence in Multiple Sclerosis at Einstein, Rodrigo Thomaz, the word “sclerosis” refers to the “hardening” that occurs in the brain and spinal cord of patients with the condition.

“It is possible to observe the formation of small plaques with scars that are hardened to the touch.”

Multiple sclerosis is characterized by neurological loss. In people who have the disease, immune cells reverse their role – instead of protecting the defense system, they start attacking it, producing inflammation.

These inflammations affect the myelin sheath — a kind of protective cover that covers the neurons responsible for taking impulses from the central nervous system to the body and vice versa, causing the functions coordinated by the brain to be compromised.

In addition to the specific factors that link women to the disease, people with a genetic predisposition to autoimmune diseases and who are exposed to environmental factors such as viral infections, smoking, obesity and reduced levels of vitamin D are also considered to be at higher risk for developing the disease. frame.

“The reduction in the risk of developing multiple sclerosis is questionable, since the disease has a genetic component that increases the risk of alteration in the functioning of the immune system. However, the control of environmental factors can indeed interfere with the chances of presentation of the disease”, says Claudia Vasconcelos, coordinator of the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology.

most common symptoms

• Fatigue (intense and momentarily disabling tiredness)
• Speech-language disorders (slow speech, slurred words and trembling voice)
• Difficulty swallowing liquids, pastes or solids
• Visual disorders (blurry or double vision)
• loss of balance
• Problems with motor coordination
• Instability when walking
• tremors
• vertigo and nausea
• Urinary incontinence or retention
• Spasticity (stiffness of a limb when moving and affects mainly the lower limbs)
• cognitive disorders
• Emotional disorders (depression, anxiety, irritation)
• Erectile dysfunction in men and decreased vaginal lubrication in women

“Symptoms and signs of sclerosis can be transient, last a few minutes and disappear, causing the patient not to give much importance to these signs. to investigate the cause of that sign”, explains Alex Machado Baêta, neurologist at BP – A Beneficência Portuguesa in São Paulo.

Aiming to make multiple sclerosis better known, Manu uses social media to talk openly about the challenges multiple sclerosis patients face on a daily basis.

“Lack of information leads to indirect prejudice. Because it is not a visible disease, society does not see my needs. Sometimes, due to weakness and fatigue, I need to use the preferential queue, and people do not see it with good eyes. When they know reason I get looks of doubt or pity. We need to talk more about the disease”, he adds.

The treatments available

Multiple sclerosis has no cure.

The treatments offered seek to stabilize and interrupt the inflammatory activity over the years so that the patient has an improvement in the quality of life.

According to the World Health Organization, currently, about 20 drugs approved by a regulatory agency, with scientific recognition for the treatment, are available. Most of them exist in Brazil and are available in the SUS (Unified Health System), within the list of the National Supplementary Health Agency.

In addition to drug treatment, according to experts, neurorehabilitation is important to prevent complications such as bone deformities in patients.

“They are drugs that regulate the reactions of the immune system that is facing the attack, and are therefore considered immunosuppressants. In addition to specific treatment to control the disease, drugs and techniques are used to relieve and manage symptoms. procedures are used, such as pulse therapy with corticosteroids or, in aggressive cases, therapeutic plasmapheresis (a process that removes and replaces the patient’s blood plasma)”, explains Thomaz.

“Currently, there is a true revolution in the treatment and prognosis of the disease, with a much lower risk of sequelae and degenerative progression. The current objective is to prevent as much as possible that the brain and spinal cord are “invaded” by the disease, reducing the risk future for people with MS”, adds the neurologist and medical coordinator of the Center of Excellence in Multiple Sclerosis at Einstein.

In the case of Manu, treatment includes follow-up with a rheumatologist to relieve joint and musculoskeletal symptoms, vitamin D replacement and focus on mental health, with follow-up with a psychologist and medication —prescribed by a doctor — to control anxiety.

“I also try to watch my diet, avoiding inflammatory foods, I do low-impact physical activity like swimming and hydrogymnastics”, he says.

“Multiple sclerosis is like a dance partner that I’m always watching so she doesn’t step on my foot. Living with the disease is a box of surprises, each day is a new challenge and I never know which symptom I’ll wake up with.”

This text was originally published here.