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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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.
Additional information
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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DOI: https://doi.org/10.1007/s00415-015-8005-z