Hormone levels are raised during pregnancy and pregnant women with MS usually have less disease activity when a hormone called estriol is increased. During the last three months of the pregnancy, relapses decrease by more than 70% when estriol reaches highest concentrations.
A clinical trial involving 164 women with relapsing remitting MS was carried out in the USA to assess whether a combination of oral estriol and glatiramer acetate (Copaxone) reduced MS relapses in women with relapsing remitting MS.
The results were very encouraging. They found that the combination of oral estriol and glatiramer acetate was more effective in reducing relapse rates than glatiramer acetate alone, and treatment was well tolerated over 24 months.
These findings are consistent with the theory that increased concentrations of estriol during pregnancy might be the reason, at least in part, for the protective effect of pregnancy on relapse rates.
These observations have led researchers to look at the role of sex hormones as potential treatments for multiple sclerosis. A phase 3 study of estriol in relapsing remitting MS is needed to test these findings and to explore potential effects on disabilities.
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