Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's Hospital, Brookline, MA 02445, USA; Harvard Medical School, Boston, MA 02115, USA; Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA; University of California San Francisco Department of Neurology, San Francisco, CA 94158, USA.
PatientsLikeMe, Inc., Cambridge, MA, USA.
Mult Scler Relat Disord. 2016 Sep;9:56-9. doi: 10.1016/j.msard.2016.06.015. Epub 2016 Jul 1.
Many women with multiple sclerosis (MS) are postmenopausal. Previously reported findings from an online MS cohort suggested that earlier, surgical menopause may be associated with higher patient-reported MS severity scores.
To explore experiences of menopause in a series of MS women responding to a reproductive survey from an online research platform, PatientsLikeMe (PLM).
The free-text responses from a detailed reproductive history survey deployed to PLM members were analyzed using grounded theory approach.
Of the 208 free text responses, 127 responses related to menopause. Five themes emerged: (1) perimenopausal onset of MS symptoms, (2) overlap of MS and menopausal symptoms, (3) MS exacerbations and pseudo-exacerbations triggered by hot flashes, (4) escalation of disease course after menopause, including increasing fatigue, cognitive disturbance, and other symptoms; and (5) effect of HRT on MS symptoms. Some women reported no effects of menopause or HRT.
Given an aging population and a median age of individuals currently living with MS very close to menopausal age in many cohorts, there is a pressing need to understand the impact of menopause on MS course. Qualitative responses in this study illustrated several specific themes that require quantitative testing in clinic-based cohorts.
许多多发性硬化症(MS)患者已绝经。先前来自在线 MS 队列的研究结果表明,手术绝经时间较早可能与患者报告的 MS 严重程度评分较高有关。
通过对在线研究平台 PatientsLikeMe(PLM)的一项生殖调查做出回应的一系列 MS 女性,探讨其绝经经历。
使用扎根理论方法对从 PLM 成员中部署的详细生殖史调查的自由文本回复进行分析。
在 208 份自由文本回复中,有 127 份与绝经相关。出现了五个主题:(1)MS 症状的围绝经期发作;(2)MS 和绝经症状的重叠;(3)潮热引发的 MS 恶化和假性恶化;(4)绝经后疾病进程的加剧,包括疲劳、认知障碍和其他症状的增加;以及(5)HRT 对 MS 症状的影响。一些女性报告绝经或 HRT 没有影响。
鉴于人口老龄化以及目前许多队列中 MS 患者的中位年龄非常接近绝经年龄,迫切需要了解绝经对 MS 病程的影响。本研究中的定性回复说明了几个需要在基于临床的队列中进行定量测试的具体主题。