The Role of the Menstrual Cycle in Chronic Disorders of the Nervous System
The role of the menstrual cycle in affecting neurologic function in chronic disorders of the nervous system has received surprisingly little attention. Hormonal fluctuations are known to modify a host of physiologic and psycho-logic parameters in women. The purpose of this chapter is to review and explore the available literature on the effect of the menstrual cycle in patients with spinal cord injury (SCI) and multiple sclerosis (MS) and other autoimmune diseases. Traumatic brain injury (TBI) and stroke are other chronic neurologic conditions in which the menstrual cycle could affect neurologic function, at least on a transient basis. During the menstrual cycle, alterations in the systemic concentrations of hormones can produce direct and indirect effects on neurologic function. When superimposed upon the injured nervous system, these effects can be magnified and can result in changes in the functional abilities of patients and can worsen symptoms such as fatigue and spasticity. This is particularly true in patients suffering from MS. The time when this is most likely to occur is at the end of the cycle, when there is a sudden drop in the serum concentration of estrogen anprogesterone, and menses begins.
KeywordsMultiple Sclerosis Systemic Lupus Erythematosus Traumatic Brain Injury Spinal Cord Injury Luteinizing Hormone
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