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Multiple sclerosis in men: management considerations

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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 scientific 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 influence their long-term quality of life (QOL). When possible, we draw from published sources to underscore our collective clinical and scientific experiences.

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References

  1. Carlson NR, Buskist W, Heth DC, Schmaltz R (eds) (2009) Psychology: the science of behavior, 4th edn. Pearson Education Canada, Toronto

    Google Scholar 

  2. Orton SM, Herrera BM, Yee IM, Valdar W, Ramagopalan SV, Sadovnick AD et al (2006) Sex ratio of multiple sclerosis in Canada: a longitudinal study. Lancet Neurol [Comparative Study Research Support, Non-U.S. Gov’t] 5(11):932–936

    Google Scholar 

  3. Trojano M, Lucchese G, Graziano G, Taylor BV, Simpson S Jr, Lepore V et al (2012) Geographical variations in sex ratio trends over time in multiple sclerosis. PLoS ONE [Research Support, Non-U.S. Gov’t] 7(10):e48078

    CAS  Google Scholar 

  4. Borisow N, Doring A, Pfueller CF, Paul F, Dorr J, Hellwig K (2012) Expert recommendations to personalization of medical approaches in treatment of multiple sclerosis: an overview of family planning and pregnancy. Epma J. 3(1):9

    Article  PubMed  PubMed Central  Google Scholar 

  5. McCombe PA, Greer JM (2013) Female reproductive issues in multiple sclerosis. Mult Scler [Research Support, Non-U.S. Gov’t] 19(4):392–402

    CAS  Google Scholar 

  6. Miller DH, Fazekas F, Montalban X, Reingold SC, Trojano M (2014) Pregnancy, sex and hormonal factors in multiple sclerosis. Mult Scler 20(5):527–536. doi:10.1177/1352458513519840

    Article  CAS  PubMed  Google Scholar 

  7. Bodiguel E, Bensa C, Brassat D, Laplaud D, Le Page E, Ouallet JC et al (2014) Multiple sclerosis and pregnancy. Rev Neurol (Paris) [Research Support, Non-U.S. Gov’t] 170(4):247–265

    Article  CAS  Google Scholar 

  8. Bove R, Chitnis T (2014) The role of gender and sex hormones in determining the onset and outcome of multiple sclerosis. Mult Scler. 20(5):520–526

    Article  CAS  PubMed  Google Scholar 

  9. Bove R, Alwan S, Friedman JM, Hellwig K, Houtchens M, Koren G et al (2014) Management of multiple sclerosis during pregnancy and the reproductive years: a systematic review. Obstet Gynecol [Research Support, Non-U.S. Gov’t Review] 124(6):1157–1168

    CAS  Google Scholar 

  10. Maghzi AH, Ghazavi H, Ahsan M, Etemadifar M, Mousavi S, Khorvash F et al (2010) Increasing female preponderance of multiple sclerosis in Isfahan, Iran: a population-based study. Mult Scler 16(3):359–361

    Article  CAS  PubMed  Google Scholar 

  11. Kingwell E, Zhu F, Marrie RA, Fisk JD, Wolfson C, Warren S et al (2015) High incidence and increasing prevalence of multiple sclerosis in British Columbia, Canada: findings from over two decades (1991–2010). J Neurol 262(10):2352–2363. doi:10.1007/s00415-015-7842-0

    Article  PubMed  PubMed Central  Google Scholar 

  12. Paty DW, Noseworthy JH, Ebers GC (1997) Diagnosis of multiple sclerosis. In: Paty DW, Ebers GC (eds) Multiple sclerosis. FA Davis Company, Philadelphia, pp 48–51

    Google Scholar 

  13. Compston A, Confavreaux C, Lassmann H, McDonald I, Miller D, Noseworthy J, Smith K, Wekerle H (2006) The natural history of multiple sclerosis. In: McAlpine’s multiple sclerosis, 4th edn. Churchill Livingstone Elsevier, pp 183–272

  14. Tremlett H, Zhao Y, Joseph J, Devonshire V (2008) Relapses in multiple sclerosis are age- and time-dependent. J Neurol Neurosurg Psychiatry [Research Support, Non-U.S. Gov’t] 79(12):1368–1374

    Article  CAS  Google Scholar 

  15. van Wijk CM, Kolk AM (1997) Sex differences in physical symptoms: the contribution of symptom perception theory. Soc Sci Med 45(2):231–246

    Article  PubMed  Google Scholar 

  16. Savettieri G, Messina D, Andreoli V, Bonavita S, Caltagirone C, Cittadella R et al (2004) Gender-related effect of clinical and genetic variables on the cognitive impairment in multiple sclerosis. J Neurol [Comparative Study Research Support, Non-U.S. Gov’t] 251(10):1208–1214

    Google Scholar 

  17. Benedict RH, Zivadinov R (2011) Risk factors for and management of cognitive dysfunction in multiple sclerosis. Nat Rev Neurol [Review] 7(6):332–342

    Article  Google Scholar 

  18. Koch M, Kingwell E, Rieckmann P, Tremlett H (2010) The natural history of secondary progressive multiple sclerosis. J Neurol Neurosurg Psychiatry [Research Support, Non-U.S. Gov’t] 81(9):1039–1043

    Article  Google Scholar 

  19. Bove RM, Healy B, Augustine A, Musallam A, Gholipour T, Chitnis T (2012) Effect of gender on late-onset multiple sclerosis. Mult Scler [Research Support, Non-U.S. Gov’t] 18(10):1472–1479

    Google Scholar 

  20. Ribbons KA, McElduff P, Boz C, Trojano M, Izquierdo G, Duquette P et al (2015) Male sex is independently associated with faster disability accumulation in relapse-onset ms but not in primary progressive MS. PLoS ONE 10(6):e0122686

    Article  PubMed  PubMed Central  Google Scholar 

  21. Tremlett H, Paty D, Devonshire V (2006) Disability progression in multiple sclerosis is slower than previously reported. Neurology [Research Support, Non-U.S. Gov’t] 66(2):172–177

    Google Scholar 

  22. Bove R, Musallam A, Healy BC, Houtchens M, Glanz BI, Khoury S et al (2013) No sex-specific difference in disease trajectory in multiple sclerosis patients before and after age 50. BMC Neurol [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t] 13:73

    Google Scholar 

  23. Schoonheim MM, Hulst HE, Landi D, Ciccarelli O, Roosendaal SD, Sanz-Arigita EJ et al (2012) Gender-related differences in functional connectivity in multiple sclerosis. Mult Scler [Comparative Study Research Support, Non-U.S. Gov’t] 18(2):164–173

    Google Scholar 

  24. Schoonheim MM, Popescu V, Rueda Lopes FC, Wiebenga OT, Vrenken H, Douw L et al (2012) Subcortical atrophy and cognition: sex effects in multiple sclerosis. Neurology 79(17):1754–1761

    Article  PubMed  Google Scholar 

  25. Schoonheim MM, Vigeveno RM, Lopes FC, Pouwels PJ, Polman CH, Barkhof F et al (2014) Sex-specific extent and severity of white matter damage in multiple sclerosis: implications for cognitive decline. Hum Brain Mapp 35(5):2348–2358. doi:10.1002/hbm.22332

    Article  PubMed  Google Scholar 

  26. Pozzilli C, Tomassini V, Marinelli F, Paolillo A, Gasperini C, Bastianello S (2003) ‘Gender gap’ in multiple sclerosis: magnetic resonance imaging evidence. Eur J Neurol [Comparative Study] 10(1):95–97

    Article  CAS  Google Scholar 

  27. Kingwell E, van der Kop M, Zhao Y, Shirani A, Zhu F, Oger J et al (2012) Relative mortality and survival in multiple sclerosis: findings from British Columbia. Canada. J Neurol Neurosurg Psychiatry [Research Support, Non-U.S. Gov’t] 83(1):61–66

    Article  CAS  Google Scholar 

  28. Ramagopalan SV, Valdar W, Dyment DA, DeLuca GC, Yee IM, Giovannoni G et al (2009) Association of infectious mononucleosis with multiple sclerosis. A population-based study. Neuroepidemiology. 32(4):257–262

    PubMed  Google Scholar 

  29. Hickey MS, Israel RG, Gardiner SN, Considine RV, McCammon MR, Tyndall GL et al (1996) Gender differences in serum leptin levels in humans. Biochem Mol Med [Research Support, Non-U.S. Gov’t Research Support, U.S. Gov’t, P.H.S.] 59(1):1–6

    CAS  Google Scholar 

  30. Bove RM, Healy B, Augustine A, Musallam A, Gholipour T, Chitnis T (2012) Effect of gender on late-onset multiple sclerosis. Mult Scler 18(10):1472–1479

    Article  PubMed  Google Scholar 

  31. Magyari M, Koch-Henriksen N, Laursen B, Sorensen PS (2014) Gender effects on treatment response to interferon-beta in multiple sclerosis. Acta Neurol Scand 130(6):374–379

    Article  CAS  PubMed  Google Scholar 

  32. Rudick RA, Kappos L, Kinkel R, Clanet M, Phillips JT, Herndon RM et al (2011) Gender effects on intramuscular interferon beta-1a in relapsing-remitting multiple sclerosis: analysis of 1406 patients. Mult Scler 17(3):353–360

    Article  CAS  PubMed  Google Scholar 

  33. Wolinsky JS, Shochat T, Weiss S, Ladkani D (2009) Glatiramer acetate treatment in PPMS: why males appear to respond favorably. J Neurol Sci 286(1–2):92–98

    Article  CAS  PubMed  Google Scholar 

  34. Hutchinson M, Kappos L, Calabresi PA, Confavreux C, Giovannoni G, Galetta SL et al (2009) The efficacy of natalizumab in patients with relapsing multiple sclerosis: subgroup analyses of AFFIRM and SENTINEL. J Neurol 256(3):405–415

    Article  CAS  PubMed  Google Scholar 

  35. Munger KL, Chitnis T, Ascherio A (2009) Body size and risk of MS in two cohorts of US women. Neurology [Comparative Study Research Support, N.I.H., Extramural] 73(19):1543–1550

    Google Scholar 

  36. Kucukali CI, Kurtuncu M, Coban A, Cebi M, Tuzun E (2015) Epigenetics of multiple sclerosis: an updated review. Neuromolecular Med. 17(2):83–96

    Article  CAS  PubMed  Google Scholar 

  37. Hollenbach JA (2015) Oksenberg JR. A comprehensive review. J Autoimmun, The immunogenetics of multiple sclerosis, p 2

    Google Scholar 

  38. Ramagopalan SV, Herrera BM, Bell JT, Dyment DA, Deluca GC, Lincoln MR et al (2008) Parental transmission of HLA-DRB1*15 in multiple sclerosis. Hum Genet 122(6):661–663

    Article  CAS  PubMed  Google Scholar 

  39. Celius EG, Harbo HF, Egeland T, Vartdal F, Vandvik B, Spurkiand A (2000) Sex and age at diagnosis are correlated with the HLA-DR2, DQ6 haplotype in multiple sclerosis. J Neurol Sci 178(2):132–135

    Article  CAS  PubMed  Google Scholar 

  40. Westerlind H, Ramanujam R, Uvehag D, Kuja-Halkola R, Boman M, Bottai M et al (2014) Modest familial risks for multiple sclerosis: a registry-based study of the population of Sweden. Brain. 137(Pt 3):770–778

    Article  PubMed  PubMed Central  Google Scholar 

  41. Ritchie ME, Liu R, Carvalho BS, Irizarry RA (2011) Comparing genotyping algorithms for Illumina’s Infinium whole-genome SNP BeadChips. BMC Bioinformatics [Comparative Study Research Support, Non-U.S. Gov’t] 12:68

    Google Scholar 

  42. Smith-Bouvier DL, Divekar AA, Sasidhar M, Du S, Tiwari-Woodruff SK, King JK et al (2008) A role for sex chromosome complement in the female bias in autoimmune disease. J Exp Med 205(5):1099–1108

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Du S, Itoh N, Askarinam S, Hill H, Arnold AP, Voskuhl RR (2014) XY sex chromosome complement, compared with XX, in the CNS confers greater neurodegeneration during experimental autoimmune encephalomyelitis. Proc Natl Acad Sci U S A. 111(7):2806–2811

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Knudsen GP (2009) Gender bias in autoimmune diseases: X chromosome inactivation in women with multiple sclerosis. J Neurol Sci [Review] 286(1–2):43–46

    Article  CAS  Google Scholar 

  45. Spach KM, Hayes CE (2005) Vitamin D3 confers protection from autoimmune encephalomyelitis only in female mice. J Immunol 175(6):4119–4126

    Article  CAS  PubMed  Google Scholar 

  46. Munger KL, Bentzen J, Laursen B, Stenager E, Koch-Henriksen N, Sorensen TI et al (2013) Childhood body mass index and multiple sclerosis risk: a long-term cohort study. Mult Scler [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t] 19(10):1323–1329

    Google Scholar 

  47. Langer-Gould A, Brara SM, Beaber BE, Koebnick C (2013) Childhood obesity and risk of pediatric multiple sclerosis and clinically isolated syndrome. Neurology [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t] 80(6):548–552

    Google Scholar 

  48. Ragnedda G, Leoni S, Parpinel M, Casetta I, Riise T, Myhr KM et al (2015) Reduced duration of breastfeeding is associated with a higher risk of multiple sclerosis in both Italian and Norwegian adult males: the EnvIMS study. J Neurol 262(5):1271–1277

    Article  PubMed  Google Scholar 

  49. Gunnarsson M, Udumyan R, Bahmanyar S, Nilsagard Y, Montgomery S (2015) Characteristics in childhood and adolescence associated with future multiple sclerosis risk in men: cohort study. Eur J Neurol 22(7):1131–1137

    Article  CAS  PubMed  Google Scholar 

  50. Bove R, Musallam A, Healy BC, Raghavan K, Glanz BI, Bakshi R et al (2014) Low testosterone is associated with disability in men with multiple sclerosis. Mult Scler. 20(12):1584–1592

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Pakpoor J, Goldacre R, Schmierer K, Giovannoni G, Goldacre MJ (2014) Testicular hypofunction and multiple sclerosis risk: A record-linkage study. Ann Neurol

  52. Pines A (2011) Male menopause: is it a real clinical syndrome? Climacteric. 14(1):15–17

    Article  PubMed  Google Scholar 

  53. Naismith RT, Trinkaus K, Cross AH (2006) Phenotype and prognosis in African-Americans with multiple sclerosis: a retrospective chart review. Mult Scler. 12(6):775–781

    Article  CAS  PubMed  Google Scholar 

  54. Cree BA, Khan O, Bourdette D, Goodin DS, Cohen JA, Marrie RA et al (2004) Clinical characteristics of African Americans vs Caucasian Americans with multiple sclerosis. Neurology. 63(11):2039–2045

    Article  CAS  PubMed  Google Scholar 

  55. Weinstock-Guttman B, Ramanathan M, Hashmi K, Abdelrahman N, Hojnacki D, Dwyer MG et al (2010) Increased tissue damage and lesion volumes in African Americans with multiple sclerosis. Neurology. 74(7):538–544

    Article  CAS  PubMed  Google Scholar 

  56. Rubtsova K, Marrack P, Rubtsov AV (2015) Sexual dimorphism in autoimmunity. J Clin Invest [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t Review] 125(6):2187–2193

    Google Scholar 

  57. McCombe PA, Greer JM, Mackay IR (2009) Sexual dimorphism in autoimmune disease. Curr Mol Med [Review] 9(9):1058–1079

    Article  CAS  Google Scholar 

  58. Ngo ST, Steyn FJ, McCombe PA (2014) Gender differences in autoimmune disease. Front Neuroendocrinol [Review] 35(3):347–369

    Article  CAS  Google Scholar 

  59. Zhang MA, Rego D, Moshkova M, Kebir H, Chruscinski A, Nguyen H et al (2012) Peroxisome proliferator-activated receptor (PPAR)alpha and -gamma regulate IFNgamma and IL-17A production by human T cells in a sex-specific way. Proc Natl Acad Sci USA 109(24):9505–9510

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Pozzilli C, Tomassini V, Marinelli F, Paolillo A, Gasperini C, Bastianello S (2003) ‘Gender gap’ in multiple sclerosis: magnetic resonance imaging evidence. Eur J Neurol 10(1):95–97

    Article  CAS  PubMed  Google Scholar 

  61. Kuhlmann T, Goldschmidt T, Antel J, Wegner C, Konig F, Metz I et al (2009) Gender differences in the histopathology of MS? J Neurol Sci 286(1–2):86–91

    Article  CAS  PubMed  Google Scholar 

  62. Owens GM (2008) Gender differences in health care expenditures, resource utilization, and quality of care. J Manag Care Pharm 14(3 Suppl):2–6

    PubMed  Google Scholar 

  63. Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA (2000) Gender differences in the utilization of health care services. J Fam Pract 49(2):147–152

    CAS  PubMed  Google Scholar 

  64. Tan YC, Sinclair H, Ghoorah K, Teoh X, Mehran R, Kunadian V (2015) Gender differences in outcomes in patients with acute coronary syndrome in the current era: a review. Eur Heart J Acute Cardiovasc Care [Review]

  65. Schwartz L, Kraft GH (1999) The role of spouse responses to disability and family environment in multiple sclerosis. Am J Phys Med Rehabil 78(6):525–532

    Article  CAS  PubMed  Google Scholar 

  66. Why do men die earlier? (2015) http://www.apa.org/monitor/2011/06/men-die.aspx. Accessed 6 July 2015

  67. Wallin MT, Culpepper WJ, Coffman P, Pulaski S, Maloni H, Mahan CM et al (2012) The Gulf War era multiple sclerosis cohort: age and incidence rates by race, sex and service. Brain. 135(Pt 6):1778–1785

    Article  PubMed  Google Scholar 

  68. Marrie RA, Elliott L, Marriott J, Cossoy M, Blanchard J, Leung S et al (2015) Effect of comorbidity on mortality in multiple sclerosis. Neurology [Research Support, Non-U.S. Gov’t] 85(3):240–247

    Google Scholar 

  69. Noyes K, Weinstock-Guttman B (2013) Impact of diagnosis and early treatment on the course of multiple sclerosis. Am J Manag Care [Research Support, Non-U.S. Gov’t Review] 19(17 Suppl):s321–s331

    Google Scholar 

  70. Cohen BA, Coyle PK, Leist T, Oleen-Burkey MA, Schwartz M, Zwibel H (2015) Therapy optimization in multiple sclerosis: a cohort study of therapy adherence and risk of relapse. Mult Scler Relat Disord. 4(1):75–82

    Article  CAS  PubMed  Google Scholar 

  71. Tremlett HL, Oger J (2003) Interrupted therapy: stopping and switching of the beta-interferons prescribed for MS. Neurology 61(4):551–554

    Article  PubMed  Google Scholar 

  72. Fox RJ, Salter AR, Tyry T, Sun J, You X, Laforet G et al (2013) Treatment discontinuation and disease progression with injectable disease-modifying therapies: findings from the north american research committee on multiple sclerosis database. Int J MS Care. 15(4):194–201

    Article  PubMed  PubMed Central  Google Scholar 

  73. Clanet MC, Wolinsky JS, Ashton RJ, Hartung HP, Reingold SC (2014) Risk evaluation and monitoring in multiple sclerosis therapeutics. Mult Scler. 20(10):1306–1311

    Article  PubMed  PubMed Central  Google Scholar 

  74. Caon C, Saunders C, Smrtka J, Baxter N, Shoemaker J (2010) Injectable disease-modifying therapy for relapsing-remitting multiple sclerosis: a review of adherence data. J Neurosci Nurs 42(5 Suppl):S5–S9

    Article  PubMed  Google Scholar 

  75. Jokubaitis VG, Spelman T, Lechner-Scott J, Barnett M, Shaw C, Vucic S et al (2013) The Australian multiple sclerosis (MS) immunotherapy study: a prospective, multicentre study of drug utilisation using the MSBase platform. PLoS ONE [Multicenter Study Research Support, Non-U.S. Gov’t] 8(3):e59694

    CAS  Google Scholar 

  76. Saunders C, Caon C, Smrtka J, Shoemaker J (2010) Factors that influence adherence and strategies to maintain adherence to injected therapies for patients with multiple sclerosis. J Neurosci Nurs 42(5 Suppl):S10–S18

    Article  PubMed  Google Scholar 

  77. Mohr DC, Cox D, Merluzzi N (2005) Self-injection anxiety training: a treatment for patients unable to self-inject injectable medications. Mult Scler. 11(2):182–185

    Article  PubMed  Google Scholar 

  78. Tarrants M, Oleen-Burkey M, Castelli-Haley J, Lage MJ (2011) The impact of comorbid depression on adherence to therapy for multiple sclerosis. Mult Scler Int. 2011:271321

    CAS  PubMed  PubMed Central  Google Scholar 

  79. Dor A, Lage MJ, Tarrants ML, Castelli-Haley J (2010) Cost sharing, benefit design, and adherence: the case of multiple sclerosis. Adv Health Econ Health Serv Res. 22:175–193

    Article  PubMed  Google Scholar 

  80. Grytten N, Aarseth JH, Espeset K, Johnsen GB, Wehus R, Lund C et al (2013) Stoppers and non-starters of disease-modifying treatment in multiple sclerosis. Acta Neurol Scand 127(2):133–140

    Article  CAS  PubMed  Google Scholar 

  81. Minden SL, Feinstein A, Kalb RC, Miller D, Mohr DC, Patten SB et al (2014) Evidence-based guideline: assessment and management of psychiatric disorders in individuals with MS: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 82(2):174–181

    Article  PubMed  PubMed Central  Google Scholar 

  82. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):593–602

    Article  PubMed  Google Scholar 

  83. Dahl OP, Stordal E, Lydersen S, Midgard R (2009) Anxiety and depression in multiple sclerosis. A comparative population-based study in Nord-Trondelag County, Norway. Mult Scler. 15(12):1495–1501

    Article  PubMed  Google Scholar 

  84. Theaudin M, Romero K, Feinstein A (2015) In multiple sclerosis anxiety, not depression, is related to gender. Mult Scler. doi:10.1177/1352458515588582

  85. Beier M, D’Orio V, Spat J, Shuman M, Foley FW (2014) Alcohol and substance use in multiple sclerosis. J Neurol Sci 338(1–2):122–127

    Article  PubMed  Google Scholar 

  86. Kirzinger SS, Jones J, Siegwald A, Crush AB (2013) Relationship between disease-modifying therapy and depression in multiple sclerosis. Int J MS Care 15(3):107–112

    Article  PubMed  PubMed Central  Google Scholar 

  87. Kim S, Foley FW, Picone MA, Halper J, Zemon V (2012) Depression levels and interferon treatment in people with multiple sclerosis. Int J MS Care 14(1):10–16

    Article  PubMed  PubMed Central  Google Scholar 

  88. Patti F, Amato MP, Trojano M, Bastianello S, Tola MR, Picconi O et al (2011) Quality of life, depression and fatigue in mildly disabled patients with relapsing-remitting multiple sclerosis receiving subcutaneous interferon beta-1a: 3-year results from the COGIMUS (Cognitive Impairment in Multiple Sclerosis) study. Mult Scler. 17(8):991–1001

    Article  CAS  PubMed  Google Scholar 

  89. Antypa N, Souery D, Tomasini M, Albani D, Fusco F, Mendlewicz J et al (2015) Clinical and genetic factors associated with suicide in mood disorder patients. Eur Arch Psychiatry Clin Neurosci [Epub ahead of print]

  90. Sadovnick AD, Eisen K, Ebers GC, Paty DW (1991) Cause of death in patients attending multiple sclerosis clinics. Neurology [Research Support, Non-U.S. Gov’t] 41(8):1193–1196

    CAS  Google Scholar 

  91. Manouchehrinia A, Tanasescu R, Tench CR, Constantinescu CS (2015) Mortality in multiple sclerosis: meta-analysis of standardised mortality ratios. J Neurol Neurosurg Psychiatry. doi:10.1136/jnnp-2015-310361

  92. Scalfari A, Knappertz V, Cutter G, Goodin DS, Ashton R, Ebers GC (2013) Mortality in patients with multiple sclerosis. Neurology [Research Support, Non-U.S. Gov’t Review] 81(2):184–192

    Google Scholar 

  93. Pompili M, Forte A, Palermo M, Stefani H, Lamis DA, Serafini G et al (2012) Suicide risk in multiple sclerosis: a systematic review of current literature. J Psychosom Res 73(6):411–417

    Article  PubMed  Google Scholar 

  94. Stenager EN, Stenager E, Koch-Henriksen N, Bronnum-Hansen H, Hyllested K, Jensen K et al (1992) Suicide and multiple sclerosis: an epidemiological investigation. J Neurol Neurosurg Psychiatry 55(7):542–545

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Dickstein LP, Viguera AC, Nowacki AS, Thompson NR, Griffith SD, Baldessarini RJ et al (2015) Thoughts of death and self-harm in patients with epilepsy or multiple sclerosis in a tertiary care center. Psychosomatics 56(1):44–51

    Article  PubMed  Google Scholar 

  96. Bronnum-Hansen H, Stenager E, Nylev Stenager E, Koch-Henriksen N (2005) Suicide among Danes with multiple sclerosis. J Neurol Neurosurg Psychiatry 76(10):1457–1459

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  97. McCabe MP (2002) Relationship functioning and sexuality among people with multiple sclerosis. J Sex Res 39(4):302–309

    Article  PubMed  Google Scholar 

  98. Schairer LC, Foley FW, Zemon V, Tyry T, Campagnolo D, Marrie RA et al (2014) The impact of sexual dysfunction on health-related quality of life in people with multiple sclerosis. Mult Scler 20(5):610–616

    Article  PubMed  Google Scholar 

  99. Jaracz K, Pawlak M, Gorna K, Kolcz B, Woloszyn D, Kozubski W (2010) Quality of life and social support in patients with multiple sclerosis. Neurol Neurochir Pol 44(4):358–365

    PubMed  Google Scholar 

  100. McCabe MP (2004) Exacerbation of symptoms among people with multiple sclerosis: impact on sexuality and relationships over time. Arch Sex Behav 33(6):593–601

    Article  PubMed  Google Scholar 

  101. Foley FW (2011) Assessment and treatment of sexual dysfunction in multiple sclerosis. In: Giesser BS (ed) Primer on multiple sclerosis. Oxford University Press, New York, pp 211–220

    Google Scholar 

  102. Bove R, Musallam A, Healy BC, Raghavan K, Glanz BI, Bakshi R et al (2014) Low testosterone is associated with disability in men with multiple sclerosis. Mult Scler [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t] 20(12):1584–1592

    CAS  Google Scholar 

  103. Bhasin S, Basaria S (2011) Diagnosis and treatment of hypogonadism in men. Best Pract Res Clin Endocrinol Metab [Review] 25(2):251–270

    Article  CAS  Google Scholar 

  104. Sicotte NL, Giesser BS, Tandon V, Klutch R, Steiner B, Drain AE et al (2007) Testosterone treatment in multiple sclerosis: a pilot study. Arch Neurol [Clinical Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t] 64(5):683–688

    Google Scholar 

  105. Basaria S, Coviello AD, Travison TG, Storer TW, Farwell WR, Jette AM et al (2010) Adverse events associated with testosterone administration. N Engl J Med [Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, U.S. Gov’t, Non-P.H.S.] 363(2):109–122

    CAS  Google Scholar 

  106. Lu E, Zhu F, Zhao Y, van der Kop M, Synnes A, Dahlgren L et al (2014) Birth outcomes in newborns fathered by men with multiple sclerosis exposed to disease-modifying drugs. CNS Drugs 28(5):475–482

    PubMed  Google Scholar 

  107. Pecori C, Giannini M, Portaccio E, Ghezzi A, Hakiki B, Pasto L et al (2014) Paternal therapy with disease modifying drugs in multiple sclerosis and pregnancy outcomes: a prospective observational multicentric study. BMC Neurol 14:114

    Article  PubMed  PubMed Central  Google Scholar 

  108. Hellwig K, Haghikia A, Gold R (2010) Parenthood and immunomodulation in patients with multiple sclerosis. J Neurol 257(4):580–583

    Article  CAS  PubMed  Google Scholar 

  109. Kieseier BC, Benamor M (2014) Pregnancy outcomes following maternal and paternal exposure to teriflunomide during treatment for relapsing-remitting multiple sclerosis. Neurol Ther. 3(2):133–138

    Article  PubMed  PubMed Central  Google Scholar 

  110. Cavalla P, Rovei V, Masera S, Vercellino M, Massobrio M, Mutani R et al (2006) Fertility in patients with multiple sclerosis: current knowledge and future perspectives. Neurol Sci. 27(4):231–239

    Article  CAS  PubMed  Google Scholar 

  111. McCabe MP, Stokes M, McDonald E (2009) Changes in quality of life and coping among people with multiple sclerosis over a 2 year period. Psychol Health Med. 14(1):86–96

    Article  PubMed  Google Scholar 

  112. Miller A, Dishon S (2006) Health-related quality of life in multiple sclerosis: the impact of disability, gender and employment status. Qual Life Res 15(2):259–271

    Article  PubMed  Google Scholar 

  113. Janzen W, Turpin KV, Warren SA, Marrie RA, Warren KG (2013) Change in the health-related quality of life of multiple sclerosis patients over 5 years. Int J MS Care 15(1):46–53

    Article  PubMed  PubMed Central  Google Scholar 

  114. van Houtum L, Rijken M, Groenewegen P (2015) Do everyday problems of people with chronic illness interfere with their disease management? BMC Public Health. 15(1):1000

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  115. Rosendale N, Josephson SA (2015) The importance of lesbian, gay, bisexual, and transgender health in neurology: what’s in a name? JAMA Neurol 72(8):855–856

    Article  PubMed  Google Scholar 

  116. Jensen MP, Smith AE, Bombardier CH, Yorkston KM, Miro J, Molton IR (2014) Social support, depression, and physical disability: age and diagnostic group effects. Disabil Health J 7(2):164–172

    Article  PubMed  Google Scholar 

  117. Reeves D, Blickem C, Vassilev I, Brooks H, Kennedy A, Richardson G et al (2014) The contribution of social networks to the health and self-management of patients with long-term conditions: a longitudinal study. PLoS ONE [Research Support, Non-U.S. Gov’t] 9(6):e98340

    Google Scholar 

  118. Kawachi I, Berkman LF (2001) Social ties and mental health. J Urban Health [Research Support, Non-U.S. Gov’t Review] 78(3):458–467

    CAS  Google Scholar 

  119. Glymour MM, Weuve J, Fay ME, Glass T, Berkman LF (2008) Social ties and cognitive recovery after stroke: does social integration promote cognitive resilience? Neuroepidemiology [Comparative Study Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t] 31(1):10–20

    Google Scholar 

  120. Loucks EB, Berkman LF, Gruenewald TL, Seeman TE (2006) Relation of social integration to inflammatory marker concentrations in men and women 70 to 79 years. Am J Cardiol [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t] 97(7):1010–1016

    CAS  Google Scholar 

  121. Starks H, Morris MA, Yorkston KM, Gray RF, Johnson KL (2010) Being in- or out-of-sync: couples’ adaptation to change in multiple sclerosis. Disabil Rehabil [Research Support, N.I.H., Extramural] 32(3):196–206

    Article  Google Scholar 

  122. Simmons RD, Tribe KL, McDonald EA (2010) Living with multiple sclerosis: longitudinal changes in employment and the importance of symptom management. J Neurol [Research Support, Non-U.S. Gov’t] 257(6):926–936

    Google Scholar 

  123. Busche KD, Fisk JD, Murray TJ, Metz LM (2003) Short term predictors of unemployment in multiple sclerosis patients. Can J Neurol Sci 30(2):137–142

    CAS  PubMed  Google Scholar 

  124. Anaf J, Baum F, Newman L, Ziersch A, Jolley G (2013) The interplay between structure and agency in shaping the mental health consequences of job loss. BMC Public Health [Research Support, Non-U.S. Gov’t] 13:110

    Article  Google Scholar 

  125. Bjorklund O, Soderlund M, Nystrom L, Haggstrom E (2015) Unemployment and health: experiences narrated by young Finnish men. Am J Mens Health. 9(1):76–85

    Article  PubMed  Google Scholar 

  126. Razaz N, Tremlett H, Boyce WT, Guhn M, Joseph KS, Marrie RA (2015) Impact of parental multiple sclerosis on early childhood development: a retrospective cohort study. Mult Scler. 21(9):1172–1183

    Article  PubMed  Google Scholar 

  127. Beardslee WR, Versage EM, Gladstone TR (1998) Children of affectively ill parents: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 37(11):1134–1141

    Article  CAS  PubMed  Google Scholar 

  128. Razaz N, Joseph KS, Boyce WT, Guhn M, Forer B, Carruthers R, Marrie RA, Tremlett H (2015) Relationship between parental multiple sclerosis and childhood developmental health. Mult Scler [Epub ahead of print]

  129. Stoeckel M, Weissbrod C (2015) Growing up with an ill parent: an examination of family characteristics and parental illness features. Fam Syst Health 33(4):356–362. doi:10.1037/fsh0000140

    Article  PubMed  Google Scholar 

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Correspondence to Riley Bove.

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Conflicts of interest

Dr. Bove reports no conflict of interest. Ms. McHenry reports no conflict of interest. Dr. Hellwig received research support and speaker honoraria from Bayer Healthcare, Biogen Idec, Genzyme, Merck Serono, Novartis Pharma and Teva Pharma. She has also received research support from the German Research Foundation. Dr. Houtchens has served as a consultant for Biogen, Teva, Novartis, and Genzyme Sanofi. Ms. Razaz reports no conflict of interest and has received research funding from the Multiple Sclerosis Society of Canada. Dr. Smyth reports no conflict of interest and has received research funding from the National MS Society and the MS Society of Canada as well as Arnold P. Gold Foundation and University of Alberta Teaching and Learning Enhancement Fund. Dr. Tremlett is the Canada Research Chair for Neuroepidemiology and Multiple Sclerosis. She has received research support from the National Multiple Sclerosis Society, the Canadian Institutes of Health Research, the Multiple Sclerosis Society of Canada (Don Paty Career Development Award); the Michael Smith Foundation for Health Research (Scholar Award) and the UK MS Trust; speaker honoraria and/or travel expenses to attend conferences from the Consortium of MS Centres (2013), the National MS Society (2012, 2014), Bayer Pharmaceuticals (2010), Teva Pharmaceuticals (2011), ECTRIMS (2011, 2012, 2013, 2014), UK MS Trust (2011), the Chesapeake Health Education Program, US Veterans Affairs (2012), Novartis Canada (2012), Biogen Idec (2014), American Academy of Neurology (2013, 2014, 2015). All speaker honoraria are either declined or donated to an MS charity or to an unrestricted grant for use by her research group. Dr. Sadovnick reports no conflict of interest. She has received research support from the National MS Society, BiogenIdec, Novartis, Teva Neurosciences and Genzyme. Dr. Rintell reports no conflict of interest. He has received research support from the National MS Society, and has consulted to Novartis Pharmaceuticals.

Funding

The launch of MS-CERCH was funded by the Canadian Institutes of Health Research, Teva Neurosciences and BiogenIdec, which together funded a 2-day workshop in February 2013. Dr. Bove has received research support from the National Multiple Sclerosis Society and the National Institutes of Health K12 BIRWCH Program.

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On behalf of the Multiple Sclerosis Centre of Excellence in Reproduction and Child Health (MS-CERCH).

R. Bove and A. McHenry are the co-first authors.

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Bove, R., McHenry, A., Hellwig, K. et al. Multiple sclerosis in men: management considerations. J Neurol 263, 1263–1273 (2016). https://doi.org/10.1007/s00415-015-8005-z

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