Key takeaways:
Multiple sclerosis (MS) is an autoimmune condition that’s more common in women.
Early symptoms of MS include vision changes, eye pain, fatigue, numbness, difficulty walking, and cognitive difficulties.
Medications can help with symptoms and slow down the condition. It’s best to start treatment early, so don’t delay if you have symptoms.
Multiple sclerosis (MS) is an autoimmune condition that affects the brain and spinal cord. People tend to develop MS in early adulthood. But not everyone is at equal risk for developing MS. Women are about three times more likely to develop MS than men.
Recognizing these symptoms can help you decide if you need to seek medical care. Here’s what to know about MS symptoms in women.
Why does multiple sclerosis affect women more often than men?
Women are more likely to get diagnosed with MS than men. This is especially true for Black and non-Hispanic white women. But it’s not exactly clear why.
Scientists believe the difference may be due to a few factors, like differences in:
Genetics: The X chromosome is linked to autoimmune function. Having two X chromosomes may increase women’s risk of developing autoimmune conditions, including MS.
Hormones: When MS is diagnosed in children, boys and girls are affected equally. But this changes after puberty, suggesting that hormones play a role.
Immunity: There’s evidence linking certain viral infections with development of MS. It’s possible that the immune response toward such an infection is more likely to remain active in women.
So far, these are only theories. More research is needed to know for sure why women are more likely to develop MS than men.
What are the earliest warning signs of multiple sclerosis in women?
Early symptoms of MS in women can be subtle and easy to miss. Here are some early signs and symptoms to be aware of.
1. Vision changes or eye pain
Vision problems are the most common early sign of MS.
Vision changes can include:
Blurred vision
Eye pain
Pain with eye movement
Changes in color perception (colors looking “washed out”)
Trouble seeing in low light conditions
These symptoms are signs of optic neuritis. Optic neuritis develops when the optic nerve, which connects the eye to the brain, gets inflamed. About half of people with MS experience optic neuritis at some point in their lives. For many people, an episode of optic neuritis is what leads to their MS diagnosis.
2. Double vision
MS may affect the muscles that control eye movement. When this happens, the muscles aren’t able to hold the eyeballs in alignment with one another. This can cause double vision. Double vision may make it seem like there are two of something, side by side or on top of each other.
Other, more subtle vision symptoms may be having trouble going down stairs or tilting your head to see better.
3. Fatigue
Many people with MS experience fatigue. People describe this sensation in different ways. They may feel weak, tired, or like they have less energy than normal. Some people describe a feeling of complete exhaustion.
It’s normal to feel tired from time to time. But, with MS, the feeling may be more severe, persist for a long time, or get worse. And, usually, there isn’t a specific reason for it, such as increased stress, illness, or interrupted sleep.
4. Numbness and tingling
Numbness and tingling are common symptoms of early MS. These uncomfortable sensations can occur anywhere, but usually affect the:
Face
Arms
Hands
Legs
Feet
People can experience numbness in different ways:
Some people may notice decreased sensation.
Others may experience changes in sensation, like a tingling, crawling, or itching sensation.
Subtle hand or finger numbness can make it harder to do things, like button clothes, comb your hair, or tie a tie. It may feel like your hands are clumsy.
5. Balance and walking difficulties
MS can cause weakness in one or both of your legs, which can affect how you get around. This, and changes in the brain, can also affect your balance.
Early signs of MS can include:
Tripping or feeling more clumsy than usual
Feeling off-balance or unsteady
Changes in the way you walk
Needing to use walls, furniture, or people for support
6. Memory and cognitive problems
An early symptom of MS in women involves cognition, or how we think and process information. This might feel like:
Forgetting to do things
Difficulty learning new information
Trouble processing instructions
Difficulty concentrating
Thinking more slowly
Struggling to communicate well
Having brain fog
How do MS symptoms differ in women?
The MS symptoms above aren’t specific to women. Both men and women can have any or all of those symptoms. That said, research has uncovered some trends in how men and women experience MS.
Men are more likely to experience:
Motor weakness
Problems with dexterity
Quicker progression of their condition
Whereas women are more likely to have:
Optic neuritis
Fatigue
Symptoms vary during hormonal life stages
Changes in hormones can affect how MS behaves in women. Note that these stages of life don’t affect overall risk of developing MS. Rather, hormonal changes affect how women with MS experience symptoms. This includes:
Pregnancy: During pregnancy, the immune system calms down a bit. So, it’s common for relapse rates to decrease. That said, discontinuing some MS medications during pregnancy can actually increase the risk of relapse during pregnancy.
Postpartum: After childbirth, the immune system tends to ramp back up for those not taking medication. Women with MS can experience an increase in symptoms in the postpartum period. This is less likely if they continue their MS treatment.
Menopause: Women are likely to experience progression of their MS after age 50. But it’s not clear if this is due to age, normal disease activity, or menopause (hormonal changes).
When do women usually develop multiple sclerosis?
Women can develop MS at any point in their lives. But most people are diagnosed between ages 20 and 45. Women tend to get diagnosed with MS at earlier ages than men.
When should you see a doctor?
Having any unexpected symptoms can be unsettling. It’s normal to try to wait things out, to see if they get better on their own. But getting medical attention sooner rather than later is a good idea. Contact your primary care provider first. They can help you get to the bottom of things. If you and your healthcare team are concerned about MS, they may refer you to a nervous system specialist, or a neurologist.
Can multiple sclerosis be cured or prevented?
There’s no cure for MS. And there’s no way to prevent MS from developing, either. But there are several medications that can help people manage MS. There are oral medications, as well as those given by injection or IV.
Medications that treat MS try to stop the autoimmune system from attacking the nervous system. This decreases inflammation and damage to the nervous system. Medications slow down how quickly MS progresses over time. They also prevent how often people experience relapses of MS symptoms, and for how long.
Frequently asked questions
It’s not possible to diagnose yourself with MS. The diagnostic criteria involve imaging and other specific findings. So, it’s best to get professional medical attention. That said, if you’ve noticed any of the symptoms above, that’s the first step in diagnosis. Your healthcare team can help you decide how to move forward.
It’s not possible to diagnose yourself with MS. The diagnostic criteria involve imaging and other specific findings. So, it’s best to get professional medical attention. That said, if you’ve noticed any of the symptoms above, that’s the first step in diagnosis. Your healthcare team can help you decide how to move forward.
Many years ago, the hot bath (or shower) test for MS helped with diagnosis. If someone’s symptoms worsened after a hot bath, it suggested they had MS.
Because heat can worsen symptoms, it’s important for people with MS to stay cool in warm and hot environments.
The bottom line
Multiple sclerosis (MS) affects women more often than men, but scientists aren’t sure why. Symptoms of MS vary from person to person. The most common symptoms of MS in women include vision changes, fatigue, numbness, weakness, and cognitive problems. Seek medical care if you’re experiencing these symptoms. Your healthcare team can determine if MS or another condition is causing your symptoms.
Why trust our experts?
References
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Hall, J. (2024). Keep cool: Multiple sclerosis and heat tolerance. U.S. Department of Veterans Affairs, Multiple Sclerosis Centers of Excellence.
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