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Web End = J Neurol (2016) 263:12631273 DOI 10.1007/s00415-015-8005-z
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Web End = Multiple sclerosis in men: management considerations
Riley Bove1 Allison McHenry2 Kerstin Hellwig3 Maria Houtchens2,4
Neda Razaz5 Penelope Smyth6 Helen Tremlett7 A. D. Sadovnick7,8
D. Rintell2,4
Received: 30 October 2015 / Revised: 16 December 2015 / Accepted: 17 December 2015 / Published online: 2 January 2016 Springer-Verlag Berlin Heidelberg 2015
Abstract Multiple sclerosis (MS) is a lifelong disease typically affecting individuals in young to middle adulthood. There are recognized sex differences in MS onset and clinical course. MS affects approximately three times more women than men, thus resulting in less attention to the male experience (i.e. diagnosis, management, societal dimensions). Here, we review current scientic evidence on sex differences in MS risk and course, highlight potential sources of bias, and suggest avenues of further inquiry. We then describe what is known about male
experiences with MS diagnosis, treatment, and symptom management (particularly mood and sexual function). Finally, we consider ways in which healthcare providers might engage male patients in the broader aspects of living with MS (e.g. familial and societal relationships) to inuence their long-term quality of life (QOL). When possible, we draw from published sources to underscore our collective clinical and scientic experiences.
Keywords Gender Sex difference Depression
Suicide Sexual function Quality of life
Introduction
Both sex (biological category) and gender (sociocultural construct; ones internal representation of being male or female [1]) play important roles in shaping the experience of persons with multiple sclerosis (MS). The reported increasing female preponderance of MS in women relative to men [2, 3] and the need for specialized disease management surrounding pregnancy have led to a strong body of the literature focused on women with MS [47]. By comparison, little has been published about the management of MS in men, despite data suggesting that they tend to have a more rapidly progressive clinical and radiologic disease course [8].
The Multiple Sclerosis Centre of Excellence on Reproduction and Child Health (MS-CERCH) is a virtual international collaborative multidisciplinary research consortium dedicated to providing evidence-based...