What is it about?

Several endocrine and sexual disturbances have been demonstrated in multiple sclerosis (MS) patients of both sexes. The endocrine profile, hypothalamic–pituitary–testis (HPT) axis and semen quality were evaluated in male patients with MS. A total of 68 male MS patients aged 18 years or older were recruited. Forty-eight age-matched healthy male volunteers served as controls

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Why is it important?

Multiple sclerosis (MS) is one of the most common causes of chronic neurological disability in young and middle-aged adults. It affects more than 2 million people in the world. MS is characterised pathologically by perivascular inflammation, demyelination and axonal loss in the central nervous system (CNS). MS affects women two to three times more than men. However, the clinical progression of MS is more rapid and severe in men. MS patients have significant altered hormonal milieu. Disturbed neuroendocrine function may be involved in the pathogenesis and course of autoimmune diseases including MS. MS patients have reduced levels of growth hormone in the cerebrospinal fluid (3). Demyelinating lesions in the hypothalamus may cause a transient increase of antidiuretic hormone secretion and result in syndrome of inappropriate secretion of antidiuretic hormone.


Factors potentially affecting fertility in MS are: (i) sexual dysfunction; (ii) the endocrine abnormalities as described above; (iii) both lymphocyte-mediated and antibody-mediated immunological factors; and (iv) adverse effects of MS therapies (methylprednisolone, INF, and immunosuppressive drugs) on reproduction. In the present study, none of the patients had been treated with immunosuppressive drugs. In addition, patients had to be free from any medication for at least 6 months prior to enrolment. All of the MS participants had fathered at least one child before the diagnosis of MS. None of the patients with MS had attempted to initiate pregnancy after the diagnosis of MS.

Dr Mohammad Reza Safarinejad
University of Medical Sceices

Read the Original

This page is a summary of: Evaluation of Endocrine Profile, Hypothalamic-Pituitary-Testis Axis and Semen Quality in Multiple Sclerosis, Journal of Neuroendocrinology, October 2008, Wiley,
DOI: 10.1111/j.1365-2826.2008.01791.x.
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