The Hidden Role of Testosterone in Multiple Sclerosis

Though the female-to-male ratio in multiple sclerosis (MS) diagnoses is close to 3 females for every 1 male, the disparity shrinks in older ages, Clyde Markowitz, MD, said.

Markowitz, director of the MS Center at the University of Pennsylvania, attended the 2017 Consortium of Multiple Sclerosis Centers (CMSC) in New Orleans this week to speak on the state of male-specific issues in MS.

Before his lecture, Markowitz noted that though a limited rate of men are diagnosed with the condition at a young age, the amount of male primary progression MS patients is equal to women patients in older age.

“There’s something hormonal about that,” Markowitz said. “We don’t know exactly what it is, but there have been several different studies that have demonstrated that testosterone plays a role in the susceptibility of getting MS.”

Women with lower levels of testosterone, or even higher levels of estrogen, seem more likely to develop an active form of MS, Markowitz said. This give clinicians curiosity as to whether testosterone serves as a form of protection against MS.

But testosterone treatment could give male MS patients a levy of other issues, such as high blood pressure and cardiac diseases — conditions already prominent in older men, Markowitz said.

That said, Markowitz hasn’t observed any therapeutic differences among genders receiving treatments. But there is question as to whether an increased testosterone level could improve the effects of already-successful MS treatment.