A Google search for “birth control + multiple sclerosis” features the dangerously deceptive headline, “Birth Control May Lower MS Risk.” The linked article begins, “Women who take birth control pills may be less likely to develop multiple sclerosis (MS) while they’re on the pill, according to a new study.”
The key phrase is ‘while they’re on the pill,’ but we will come back to that in a moment. First, let’s zoom out and look at the broader picture of MS as an autoimmune disease.
Basics of Autoimmune Disease
Dr. Noel Rose, known as the Father of Autoimmune Disease, first hypothesized the idea of the body’s immune system attacking itself in the late 50s. He developed the theory and came up with the name, Autoimmune Disease, while studying Hashimoto’s Thyroiditis in rabbits.
A couple of years ago, I attended a lecture by Dr. Rose. That evening, the amiable, elder statesman explained the basics of autoimmunity. He said we’ve known from the beginning that estrogen probably plays a vital role in autoimmunity because of the role it plays in a woman’s immune system, plus the fact that nearly 80 percent of diagnoses are women.
He explained that patients must be genetically predisposed to contract an autoimmune disease, but stressed that environmental triggers are the real key to activating the disease in a patient.
Finally, he described T cells as soldiers of the immune system. When our body’s natural estrogen attaches to T cell receptors, the soldiers are armed and have their marching orders. The estrogen essentially points out the invader, and triggers the command to attack. But when disruptive agents that mimic natural estrogen enter our body (known as endocrine disruptors), they attach to the receptors. Suddenly, the soldier is armed, but doesn’t know what to attack. This can cause the immune system to battle our body’s healthy tissue, and result in an autoimmune disease.
Dr. Rose’s lecture inspired me to dig deeper into what I saw as the most prolific endocrine disruptor, a chemical literally designed to mimic natural estrogen in the body – hormonal birth control.
Birth Control and Multiple Sclerosis
In the case of Multiple Sclerosis, errant T cells attack the myelin sheath that protects neural pathways of the nervous system. Scientists have identified the cytokine, interleukin-6 (IL-6) as the messenger that triggers T-cells to become pathogenic in MS, and a recent study suggests that “cluster signaling” of IL-6 from the surface of dendritic cells could cause “the T cell to become highly aggressive and efficient in attacking its target antigen.”
Two other unrelated studies established pathways for increased IL-6 production in birth control users. The first study observed increased synthesis of C-Reactive Protein (CRP), which elevated in direct correlation to IL-6. CRP levels in birth control users doubled those of nonusers.
The second study demonstrated lower cortisol production in birth control users, which led to higher levels of IL-6, since cortisol normally regulates IL-6. While neither study proves a definitive link between hormonal contraceptives and MS, they certainly demonstrate how these synthetic hormones make the user’s body more conducive to the disease.
Birth Control Helps My Symptoms
Before examining more evidence, let’s discuss why The Pill seems to relieve MS symptoms in some patients. Hormonal contraceptives flood the body with synthetic estrogen, similar to the body’s natural process during pregnancy. By convincing the body it’s pregnant each month, the contraceptive prevents actual pregnancy.
During pregnancy, the flood of estrogens improves acute MS attacks by 80%, nearly doubling the efficacy of the best drugs on the market. With certain autoimmune diseases like MS, sex hormones appear to promote inflammation when they’re at normal levels, but dampen it at higher levels.
Consequently, the flood of estrogens from hormonal birth control mimics the relief of pregnancy, but with a couple of dramatic pitfalls. First, hormonal contraceptives are synthetic and don’t contain Estriol (E3), a pregnancy-specific hormone that seems to have the most therapeutic benefit. Second, hormonal birth control suppresses ovarian hormone production. In other words, the endocrine system reacts to the influx of synthetic estrogens by decreasing production of natural estrogen. Finally, while birth control provides temporary relief, it actually disrupts the endocrine and immune systems, which creates devastating consequences for MS symptoms in the long run.
Multiple Sclerosis’ Growing Gender Gap
You may wonder how all this talk of T cells and endocrine disruptors translates to actual women. Unfortunately, the results are just as you would suspect. Kaiser Permanente released a study in 2014 disclosing that women who had taken The Pill were 35% more likely to develop Multiple Sclerosis than women who hadn’t. The study also found that women who had used contraceptives but had stopped at least one month before symptoms started were 50 percent more likely to develop MS.
Multiple Sclerosis has always been a discriminatory disease for the reasons outlined by Dr. Rose earlier in this article. However, all indicators point to a dramatic widening of the gender gap since the introduction of birth control pills. According to Gary Cutter PhD., professor of biostatistics at the University of Alabama, in 1940, twice as many women as men had Multiple Sclerosis. By 2000, four out of five MS patients were women. That’s a 50% increase over each decade!
A report published in the Neurology Journal confirmed the increased gender gap as a global trend. After reviewing worldwide epidemiological data, the researchers found that the female-to-male ratio was approximately 1.4 in 1955, and had jumped to 2.3 by the year 2000. Sreeram Ramagopalan, PhD, research fellow at University of Oxford, offered this commentary on the study:
“This intriguing epidemiological phenomenon warrants particular attention because the sex ratio of MS parallels MS incidence, and the increasing frequency of MS among females is a key driver of the increasing prevalence of this devastating disorder worldwide. A change that occurs within a century is too short a time for a genetic cause. This suggests that environmental factor(s) are at work in a sex-specific manner.”
Pardon me for pointing to the elephant in the room, but evidence has already mounted against one particular sex-specific environmental factor that’s been influencing the rise in MS among women over the past 50 years.
Real Risk Study: Birth Control and Blood Clots
Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.
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This article was published originally on January 9, 2017.