Prostate cancer affects the prostate gland, the gland that produces some of the fluid in semen and plays a role in urine control in men.

The prostate gland is located below the bladder and in front of the rectum.

In the United States (U.S.), it is the most common cancer in men, but it is also treatable if found in the early stages.

In 2017, the American Cancer Society predicts that there will be around 161,360 new diagnoses of prostate cancer, and that around 26,730 fatalities will occur because of it.

Regular testing is crucial as the cancer needs to be diagnosed before metastasis.

Fast facts on prostate cancer:

Here are some key points about the prostate cancer. More detail is in the main article.

• The prostate gland is part of the male reproductive system.
• Prostate cancer is the most common cancer in men.
• It is treatable if diagnosed early, before it spreads.
• If symptoms appear, they include problems with urination.
• Regular screening Is the best way to detect it in good time.

Symptoms

There are usually no symptoms during the early stages of prostate cancer. However, if symptoms do appear, they usually involve one or more of the following:

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• frequent urges to urinate, including at night
• difficulty commencing and maintaining urination
• blood in the urine
• painful urination and, less commonly, ejaculation
• difficulty achieving or maintaining an erection may be difficult

Advanced prostate cancer can involve the following symptoms:

• bone pain, often in the spine, femur, pelvis, or ribs
• bone fractures

If the cancer spreads to the spine and compresses the spinal cord, there may be:

• leg weakness
• urinary incontinence
• fecal incontinence

Treatment

Treatment is different for early and advanced prostate cancers.

Early stage prostate cancer

If the cancer is small and localized, it is usually managed by one of the following treatments:

Watchful waiting or monitoring: PSA blood levels are regularly checked, but there is no immediate action. The risk of side-effects sometimes outweighs the need for immediate treatment for this slow-developing cancer.

Radical prostatectomy: The prostate is surgically removed. Traditional surgery requires a hospital stay of up to 10 days, with a recovery time of up to 3 months. Robotic keyhole surgery involves a shorter hospitalization and recovery period, but it can be more expensive. Patients should speak to their insurer about coverage.

Brachytherapy: Radioactive seeds are implanted into the prostate to deliver targeted radiation treatment.

Conformal radiation therapy: Radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ or region that requires treatment. This minimizes healthy tissue exposure to radiation.

Intensity modulated radiation therapy: Beams with variable intensity are used. This is an advanced form of conformal radiation therapy.

In the early stages, patients may receive radiation therapy combined with hormone therapy for 4 to 6 months.

Treatment recommendations depend on individual cases. The patient should discuss all available options with their urologist or oncologist.

Advanced prostate cancer

Advanced cancer is more aggressive and will have spread further throughout the body.

Chemotherapy may be recommended, as it can kill cancer cells around the body.

Androgen deprivation therapy (ADT), or androgen suppression therapy, is a hormone treatment that reduces the effect of androgen. Androgens are male hormones that can stimulate cancer growth. ADT can slow down and even stop cancer growth by reducing androgen levels.

The patient will likely need long-term hormone therapy.

Even if the hormone therapy stops working after a while, there may be other options. Participation in clinical trials is one option that a patient may wish to discuss with the doctor.

Radical prostatectomy is not currently an option for advanced cases, as it does not treat the cancer that has spread to other parts of the body.

Fertility

As the prostate is directly involved with sexual reproduction, removing it affects semen production and fertility.

Radiation therapy affects the prostate tissue and often reduces the ability to father children. The sperm can be damaged and the semen insufficient for transporting sperm.

Non-surgical options, too, can severely inhibit a man’s reproductive capacity.

Options for preserving these functions can include donating to a sperm bank before surgery, or having sperm extracted directly from the testicles for artificial insemination into an egg. However, the success of these options is never guaranteed.

Patients with prostate cancer can speak to a fertility doctor if they still intend to father children.

What causes prostate cancer?

The prostate is a walnut-sized exocrine gland. This means that its fluids and secretions are intended for use outside of the body.

The prostate produces the fluid that nourishes and transports sperm on their journey to fuse with a female ovum, or egg, and produce human life. The prostate contracts and forces these fluids out during orgasm.

The protein excreted by the prostate, prostate-specific antigen (PSA), helps semen retain its liquid state. An excess of this protein in the blood is one of the first signs of prostate cancer.

The urethra is tube through which sperm and urine exit the body. It also passes through the prostate.

As such, the prostate is also responsible for urine control. It can tighten and restrict the flow of urine through the urethra using thousands of tiny muscle fibers.

How does it start?

It usually starts in the glandular cells. This is known as adenocarcinoma. Tiny changes occur in the shape and size of the prostate gland cells, known as prostatic intraepithelial neoplasia (PIN). This tends to happen slowly and does not show symptoms until further into the progression.

Nearly 50 percent of all men over the age of 50 years have PIN. High-grade PIN is considered pre-cancerous, and it requires further investigation. Low-grade PIN is not a cause for concern.

Prostate cancer can be successfully treated if it is diagnosed before metastasis, but if it spreads, it is more dangerous. It most commonly spreads to the bones.

Stages

Staging takes into account the size and extent of the tumor and the scale of the metastasis (whether it has traveled to other organs and tissues).

At Stage 0, the tumor has neither spread from the prostate gland nor invaded deeply into it. At Stage 4, the cancer has spread to distant sites and organs.

Diagnosis

A doctor will carry out a physical examination and enquire about any ongoing medical history. If the patient has symptoms, or if a routine blood test shows abnormally high PSA levels, further examinations may be requested.

Tests may include:

• a digital rectal examination (DRE), in which a doctor will manually check for any abnormalities of the prostate with their finger
• a biomarker test checking the blood, urine, or body tissues of a person with cancer for chemicals unique to individuals with cancer

If these tests show abnormal results, further tests will include:

• a PCA3 test examining the urine for the PCA3 gene only found in prostate cancer cells
• a transrectal ultrasound scan providing imaging of the affected region using a probe that emits sounds
• a biopsy, or the removal of 12 to 14 small pieces of tissue from several areas of the prostate for examination under a microscope

These will help confirm the stage of the cancer, whether it has spread, and what treatment is appropriate.

To track any spread, or metastasis, doctors may use a bone, CT scan, or MRI scan.

Outlook

If the disease is found before it spreads to other organs in a process known as metastasis, the 5-year survival rate is 99 percent. After fifteen years, this decreases to 96 percent. Once the cancer metastasizes, or spreads, the 5-year survival rate is 29 percent.

Regular screening can help detect prostate cancer while it is still treatable.

Risk factors

The exact cause of prostate cancer is unclear, but there are many possible risk factors.

Age

Prostate cancer is rare among men under the age of 45 years, but more common after the age of 50 years.

Geography

Prostate cancer occurs most frequently in North America, northwestern Europe, on the Caribbean islands, and in Australia. The reasons remain unclear.

Genetic factors

Certain genetic and ethnic groups have an increased risk of prostate cancer.

In the U.S., prostate cancer is at least 60 percent more common and 2 to 3 times more deadly among black men than non-Hispanic white men.

A man also has a much higher risk of developing cancer if his identical twin has it, and a man whose brother or father had prostate cancer has twice the risk of developing it compared to other men. Having a brother who has or has had prostate cancer is more of a genetic risk than having a father with the disease.

Diet

Studies have suggested that a diet high in red meat or high-fat dairy products may increase a person’s chances of developing prostate cancer, but the link is neither confirmed nor clear.

Medication

Some research has suggested that non-steroidal anti-inflammatory drug (NSAID) use may reduce the risk of prostate cancer. Others have linked NSAID use with a higher risk of death from the disease. This is a controversial area, and results have not been confirmed.

There has also been some investigation into whether statins might slow the progression of prostate cancer. One 2016 study concluded that results were “weak and inconsistent.”

Obesity

It is often believed that obesity is linked to the development of prostate cancer, but the American Cancer Society maintains that there is no clear link.

Some studies have found that obesity increases the risk of death in advanced cancers. Studies have also concluded that obesity decreases the risk that a cancer will be low-grade if it does occur.

Agent Orange

Exposure to Agent Orange, a chemical weapon used in the Vietnam war, may possibly be linked to the development of more aggressive types of cancer, but the extent of this has not been confirmed.

Calories Sedentary lifestyle Not sleeping enough Endocrine disruptors Medications Is obesity self-perpetuating? Obesity gene Takeaway

Obesity is a medical condition that occurs when a person carries excess weight or body fat that might affect their health. A doctor will usually suggest that a person has obesity if they have a high body mass index.

Body mass index (BMI) is a tool that doctors use to assess if a person is at an appropriate weight for their age, sex, and height. The measurement combines height and weight.

A BMI between 25 and 29.9 indicates that a person is carrying excess weight. A BMI of 30 or over suggests that a person may have obesity.

Other factors, such as the ratio of waist-to-hip size (WHR), waist-to-height ratio (WtHR), and the amount and distribution of fat on the body also play a role in determining how healthy a person’s weight and body shape are.

If a person does have obesity and excess weight, this can increase their risk of developing a number of health conditions, including metabolic syndrome, arthritis, and some types of cancer.

Metabolic syndrome involves a collection of issues, such as high blood pressure, type 2 diabetes, and cardiovascular disease.

Maintaining a healthy weight or losing through diet and exercise is one way to prevent or reduce obesity. In some cases, a person may need surgery.

Now read on to find out why obesity happens.

1) Consuming too many calories

When a person consumes more calories than they use as energy, their body will store the extra calories as fat. This can lead to excess weight and obesity.

Also, some types of foods are more likely to lead to weight gain, especially those that are high in fats and sugars.

Foods that tend to increase the risk of weight gain include:

• fast foods
• fried foods, such as french fries
• fatty and processed meats
• many dairy products
• foods with added sugar, such as baked goods, ready-made breakfast cereals, and cookies
• foods containing hidden sugars, such as ketchup and many other canned and packaged food items
• sweetened juices, sodas, and alcoholic drinks
• processed, high-carb foods, such as bread and bagels

Some processed food products contain high-fructose corn syrup as a sweetener, including savory items, such as ketchup.

Eating too much of these foods and doing too little exercise can result in weight gain and obesity.

A person who consumes a diet that consists mainly of fruits, vegetables, whole grains, and water is still at risk of gaining excess weight if they overeat, or if genetic factors, for example, increase their risk.

However, they are more likely to enjoy a varied diet while maintaining a healthy weight. Fresh foods and whole grains contain fiber, which makes a person feel full for longer and encourages healthy digestion.

2) Leading a sedentary lifestyle

Many people lead a much more sedentary lifestyle than their parents and grandparents did.

Examples of sedentary habits include:

• working in an office rather than doing manual labor
• playing games on a computer instead of doing physical activities outside
• going to places by car instead of walking or cycling

The less a person moves around, the fewer calories they burn.

Also, physical activity affects how a person’s hormones work, and hormones have an impact on how the body processes food.

Several studies have shown that physical activity can help to keep insulin levels stable and that unstable insulin levels may lead to weight gain.

Researchers who published a review in BMJ Open Sport and Exercise Medicine in 2017 noted that, while the designs of some studies make it hard to draw exact conclusions, “A lifestyle incorporating regular [physical activity] has been identified as a key factor for maintaining and improving many aspects of health, including insulin sensitivity.”

Physical activity need not be training in the gym. Physical work, walking or cycling, climbing stairs, and household tasks all contribute.

However, the type and intensity of activity may affect the degree to which it benefits the body in the short- and long-term.

3) Not sleeping enough

Research has suggested that missing sleep increases the risk of gaining weight and developing obesity.

Researchers reviewed evidence for over 28,000 children and 15,000 adults in the United Kingdom from 1977 to 2012. In 2012, they concluded that sleep deprivation significantly increased obesity risk in both adults and children.

The changes affected children as young as 5 years of age.

The team suggested that sleep deprivation may lead to obesity because it can lead to hormonal changes that increase the appetite.

When a person does not sleep enough, their body produces ghrelin, a hormone that stimulates appetite. At the same time, a lack of sleep also results in a lower production of leptin, a hormone that suppresses the appetite.

4) Endocrine disruptors

A team from the University of Barcelona published a study in the World Journal of Gastroenterology that provides clues as to how liquid fructose — a type of sugar — in beverages may alter lipid energy metabolism and lead to fatty liver and metabolic syndrome.

Features of metabolic syndrome include diabetes, cardiovascular disease, and high blood pressure. People with obesity are more likely to have metabolic syndrome.

After feeding rats a 10-percent fructose solution for 14 days, the scientists noted that their metabolism was starting to change.

Scientists believe there is a link between high consumption of fructose and obesity and metabolic syndrome. Authorities have raised concerns about the use of high-fructose corn syrup to sweeten drinks and other food products.

Animal studies have found that when obesity occurs due to fructose consumption, there is also a close link with type 2 diabetes.

In 2018, researchers published the results of investigations involving young rats. They, too experienced metabolic changes, oxidative stress, and inflammation after consuming fructose syrup.

The researchers note that “increased fructose intake may be an important predictor of metabolic risk in young people.”

They call for changes in the diets of young people to prevent these problems.

Avoiding high-fructose corn syrup

Foods that contain high-fructose corn syrup include:

• sodas, energy drinks, and sports drinks
• candy and ice cream
• coffee creamer
• sauces and condiments, including salad dressings, ketchup, and barbecue sauce
• sweetened foods, such as yogurt, juices, and canned foods
• bread and other ready-made baked goods
• breakfast cereal, cereal bars, and “energy” or “nutrition” bars

To reduce your intake of corn syrup and other additives:

• check the labels before you buy
• opt for unsweetened or less processed items where possible
• make salad dressings and bake other products at home

Some foods contain other sweeteners, but these can also have adverse effects.

5) Medications and weight gain

Some medications can also lead to weight gain.

Results of a review and meta-analysis published in The Journal of Clinical Endocrinology and Metabolism in 2015 found that some medicines caused people to gain weight over a period of months.

• atypical antipsychotics, especially olanzapine, quetiapine, and risperidone
• anticonvulsants and mood stabilizers, and specifically gabapentin
• hypoglycemic medications, such as tolbutamide
• glucocorticoids used to treat rheumatoid arthritis
• some antidepressants

However, some medications may lead to weight loss. Anyone who is starting a new medication and is concerned about their weight should ask their doctor whether the drug is likely to have any effect on weight.

6) Is obesity self-perpetuating?

The longer a person is overweight, the harder it may be for them to lose weight.

Findings of a mouse study, published in the journal Nature Communications in 2015, suggested that the more fat a person carries, the less likely the body is to burn fat, because of a protein, or gene, known as sLR11.

It seems that the more fat a person has, the more sLR11 their body will produce. The protein blocks the body’s ability to burn fat, making it harder to shed the extra weight.

7) Obesity gene

A faulty gene called the fat-mass and obesity-associated gene (FTO) is responsible for some cases of obesity.

A study published in 2013 points to a link between this gene and:

• obesity
• behaviors that lead to obesity
• a higher food intake
• a preference for high-calorie foods
• an impaired ability to feel full, known as satiety

The hormone ghrelin plays a crucial role in eating behavior. Ghrelin also affects the release of growth hormones and how the body accumulates fat, among other functions.

The activity of the FTO gene might impact a person’s chances of having obesity because it affects the amounts of ghrelin a person has.

In a study involving 250 people with eating disorders, published in Plos One in 2017, researchers suggested that aspects of FTO might also play a role in conditions, such as binge eating and emotional eating.

Takeaway

Many factors play a role in the development of obesity. Genetic traits can increase the risk in some people.

A healthful diet that contains plenty of fresh food, together with regular exercise, will reduce the risk of obesity in most people.

However, those that have a genetic predisposition may find it harder to maintain a healthy weight.

Effects What is CBD oil? Benefits for pain treatment Other uses Dosage Side effects Other considerations Takeaway

While many people use cannabidiol to relieve pain, more scientific research is needed to be sure it is safe. Understanding cannabidiol can help overcome the stigma associated with it.

Some people experience side effects when taking cannabidiol (CBD) and there are other factors to consider before using CBD oil for pain.

In this article, we look at how CBD oil works and how people can use it to relieve chronic pain.

Effects

CBD is one of more than 120 compounds called cannabinoids.Many plants contain cannabinoids, but people most commonly link them to cannabis.

Unlike other cannabinoids — such as tetrahydrocannabinol (THC) — CBD does not produce a euphoric “high” or psychoactive effect. This is because CBD does not affect the same receptors as THC.

The human body has an endocannabinoid system (ECS) that receives and translates signals from cannabinoids. It produces some cannabinoids of its own, which are called endocannabinoids. The ECS helps to regulate functions such as sleep, immune-system responses, and pain.

When THC enters the body, it produces a “high” feeling by affecting the brain’s endocannabinoid receptors. This activates the brain’s reward system, producing pleasure chemicals such as dopamine.

Does CBD make you high?

CBD is an entirely different compound from THC, and its effects are very complex. It is not psychoactive, meaning it does not produce a “high” or change a person’s state of mind, but it influences the body to use its own endocannabinoids more effectively.

According to one study posted to Neurotherapeutics, this is because CBD itself does very little to the ECS. Instead, it activates or inhibits other compounds in the endocannabinoid system.

For example, CBD stops the body from absorbing anandamide, a compound associated with regulating pain. So, increased levels of anandamide in the bloodstream may reduce the amount of pain a person feels.

Cannabidiol may also limit inflammation in the brain and nervous system, which may benefit people experiencing pain, insomnia, and certain immune-system responses.

What is CBD oil?

There are different levels of compounds found in the natural hemp or cannabis plant. How people breed the plant affects the CBD levels. Most CBD oil comes from industrial hemp, which usually has a higher CBD content than marijuana.

Makers of CBD oil use different methods to extract the compound. The extract is then added to a carrier oil and called CBD oil.

CBD oil comes in many different strengths, and people use it in various ways. It is best to discuss CBD oil with a doctor before using it.

Benefits

People have used CBD traditionally used for thousands of years to treat various types of pain, but the medical community have only recently begun to study it again.

Here are some of the possible benefits of CBD oil:

Arthritis pain

CBD oil is popular for easing pain associated with arthritis.

A study in the European Journal of Pain used an animal model to see if CBD could help people with arthritis manage their pain. Researchers applied a topical gel containing CBD to rats with arthritis for 4 days.

Their researchers note a significant drop in inflammation and signs of pain, without additional side effects.

People using CBD oil for arthritis may find relief from their pain, but more human studies need to be done to confirm these findings.

Multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disease that affects the entire body through the nerves and brain.

Muscle spasms are one of the most common symptoms of MS. These spasms can be so great they cause constant pain in some people.

One report found that short-term use of CBD oil could reduce the levels of spasticity a person feels. The results are modest, but many people reported a reduction in symptoms. More studies on humans are needed to verify these results.

Chronic pain

The same report studied CBD use for general chronic pain. Researchers compiled the results of multiple systematic reviews covering dozens of trials and studies. Their research concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults.

A separate study in the Journal of Experimental Medicine supports these results. This research suggests that using CBD can reduce pain and inflammation.

The researchers also found that subjects were not likely to build up a tolerance to the effects of CBD, so they would not need to increase their dose continually.

They noted that cannabinoids, such as CBD, could offer helpful new treatments for people with chronic pain.

Other uses

In the United States, CBD oil has varying legality across different states and at a federal level, yet it currently has a range of applications and promising possibilities.

These include:

• smoking cessation and drug withdrawal
• treating seizures and epilepsy
• anxiety treatment
• reducing some of the effects of Alzheimer’s, as shown by initial research
• antipsychotic effects on people with schizophrenia
• future applications in combating acne, type 1 diabetes, and cancer

Although more research is required to confirm some uses of CBD oil, it is shaping up as a potentially promising and versatile treatment.

In June 2018, the U.S. Food and Drug Administration (FDA) approved one form of CBD as a treatment for people with two rare and specific kinds of epilepsy, namely Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS).

The brand name of this drug is Epidiolex.

Dosage

The FDA does not regulate CBD for most conditions. As a result, dosages are currently open to interpretation, and people should treat them with caution.

Anyone who wishes to use CBD should first speak to a doctor about whether it is a good idea, and how much to take.

The FDA recently approved a purified form of CBD for some types of epilepsy, with the brand name Epidiolex. If you are using this medication, be sure to follow the doctor’s advice about doses.

Side effects

Most people tolerate CBD oil well, but there are some possible side effects.

According to a review in Cannabis and Cannabinoid Research, the most common side effects include:

• tiredness
• diarrhea
• changes in appetite
• weight gain or weight loss

In addition, using CBD oil with other medications may make those medications more or less effective.

The review also notes that scientists have yet to study some aspects of CBD, such as its long-term effects on hormones. Further long-term studies will be helpful in determining any side effects CBD has on the body over time.

People who are considering using CBD oil should discuss this with their doctors. Doctors will want to monitor the person for any changes and make adjustments accordingly.

The patient information leaflet for Epidiolex cautions that there is a risk of liver damage, lethargy, and possibly depression and thoughts of suicide, but these are true of other treatments for epilepsy, too.

CBD and other cannabinoids may also put the user at risk for lung problems.

One study in Frontiers in Pharmacology, suggested cannabinoids’ anti-inflammatory effect may reduce inflammation too much.

A large reduction in inflammation could diminish the lungs’ defense system, increasing the risk of infection.

Other considerations

Almost all research on CBD oil and pain comes from adult trials. Experts do not recommend CBD oil for use in children, as there is little research on the effects of CBD oil on a child’s developing brain.

People should consult a doctor if they think a child needs to use CBD oil for seizures.

CBD oil is also not recommended during pregnancy or while breast-feeding.

Takeaway

While many studies have suggested CBD oil is helpful for pain, more research is necessary, especially in long-term studies with human subjects.

However, CBD oil does show a lot of potential for pain relief. Anecdotal evidence suggests that it can be used to help manage chronic pain in many cases.

CBD oil is especially promising due to its lack of intoxicating effects and a possible lower potential for side effects than many other pain medications.

People should discuss CBD oil with their doctor if they are considering using it for the first time.

Multiple sclerosis is an autoimmune condition that interferes with the flow of information in the central nervous system. It causes a variety of symptoms and can affect women differently than men.

Researchers do not know what triggers multiple sclerosis (MS). Once it develops, the disease causes the immune system to destroy a type of tissue called myelin that insulates nerve fibers. Without enough myelin, it is difficult for the nerves to transmit and receive signals properly. MS randomly affects nerves in the brain, spinal cord, and eyes, meaning that it can cause a wide range of unpredictable physical, mental, and emotional symptoms that vary from person to person.

MS in women

According to the National Multiple Sclerosis Society (NMSS), at least two or three times more women than men receive a diagnosis of MS. Overall, MS seems to affect men and women similarly. However, a doctor cannot predict which symptoms someone with MS will get, the severity of the symptoms, or the progression of the disease. The reason for this is that the disease attacks the myelin randomly, and the nerves that it affects can differ from person to person. Although men and women with MS often experience similar symptoms, certain factors, such as menstruation, pregnancy, and , may influence MS symptoms in women.

Symptoms of MS in women

The symptoms of MS in women are similar to those in men, but they can include additional issues due to hormonal changes.

MS can also affect female sexual health and bladder function differently.

MS symptoms in women include:

1. Vision problems

For many people, a vision problem is the first noticeable symptom of MS.

MS can cause various vision problems, which include:

• blurred vision
• poor color vision or contrast vision
• painful eye movement
• blindness in one eye
• a dark spot in the field of vision

People with MS develop vision problems either because their optic nerves become inflamed or because they have nerve damage in the pathways that control visual coordination and eye movement.

While vision problems due to MS can be scary, most either resolve without treatment or are highly treatable.

2. Numbness

Numbness in the face, body, arms, or legs is another common symptom of MS, and it is often one of the earliest symptoms of the condition.

The numbness can range from mild and barely noticeable to severe enough that it interferes with everyday activities, such as holding objects and walking.

Most periods of numbness from MS resolve without medication and do not become permanently disabling.

3. Fatigue

Fatigue is a common symptom of MS.

About 80 percent of people with MS experience fatigue or unexplained exhaustion.

Sometimes, the cause of fatigue relates to another symptom of MS. For example, people with bladder dysfunction may sleep poorly because they have to wake throughout the night to go to the bathroom.

People with MS who have nocturnal muscle spasms may not sleep well, leaving them feeling tired during the day. MS can also increase the risk of depression, which can cause fatigue.

Another type of fatigue that seems to be unique to MS is called lassitude. A person’s fatigue may be lassitude if it:

• occurs daily
• worsens as the day goes on
• happens in the morning, even after a good sleep
• worsens with heat or humidity
• interferes with daily activity
• is unrelated to physical impairments or depression

4. Bladder problems

Bladder problems affect at least 80 percent of people with MS. These issues occur when scars on the nerves impair nerve signaling that is necessary for the function of the urinary sphincters and bladder.

MS can make it difficult for the bladder to hold urine and may reduce the amount that it can store, causing symptoms such as:

• more frequent or urgent urination
• hesitancy starting urination
• frequent overnight urination
• being unable to empty the bladder
• being unable to hold urine or having urine leaks

5. Bowel problems

Many people with MS experience bowel problems, such as:

• constipation
• diarrhea
• loss of bowel control

Bowel problems can make other MS symptoms worse, especially bladder problems, muscle stiffness, and involuntary muscle spasms.

Researchers think that people with MS have problems controlling their bowels because of the neurological damage that the condition causes. Some people with MS may also have trouble controlling their bowels when they are constipated.

6. Pain

Some research suggests that 55 percent of people with MS experience clinically significant pain, while 48 percent live with chronic pain. Women with MS may be more likely than men to experience pain as a symptom of this condition.

Acute MS pain seems to be due to problems with the nerves that help transmit sensations in the central nervous system.

Some of the acute pain symptoms that have an association with MS include:

• Trigeminal neuralgia, a stabbing pain in the face that people may confuse with dental pain.
• Lhermitte’s sign, a short sensation resembling an electric shock that moves from the back of the head down the neck and spine, usually after bending forward.
• The MS hug, a stabbing, squeezing, painful, or burning sensation around the torso or in the legs, feet, or arms.

Some of the symptoms that people with chronic MS pain may report include:

• burning
• aching
• pins and needles
• prickling

Many people with MS also experience chronic pain as a secondary effect of the condition. For example, it could be due to:

• compensating for gait changes
• muscle stiffness, cramps, and spasms
• incorrect use of mobility aids
• muscle changes from mobility loss

7. Cognitive changes

More than 50 percent of people with MS experience changes in cognition, which means that they may sometimes have trouble:

• processing new information
• learning and remembering new information
• organizing information and problem-solving
• focusing and maintaining attention
• properly perceiving the environment around them
• understanding and using language
• doing calculations

The cognitive symptoms of MS are typically mild to moderate and only affect a few aspects of cognition.

In rare cases, people with MS may experience disabling cognitive problems.

8. Depression

For people with MS, clinical depression is a common symptom.

Clinical depression is one of the most common symptoms of MS. Depression is more common in people with MS than in people with other chronic health conditions.

While almost everyone experiences periods of sadness or grief, clinical depression refers to depressive symptoms that last for a minimum of 2 weeks.

Some of the symptoms of clinical depression include:

• loss of interest in everyday activities
• increase in appetite or appetite loss
• sadness
• irritability
• insomnia or excessive sleep
• fatigue
• feelings of guilt and worthlessness
• difficulty thinking or concentrating
• behavioral changes
• thoughts of death or suicide

Clinical depression can also worsen other MS symptoms, including:

• fatigue
• pain
• cognitive changes

9. Muscle weakness

Many people with MS experience muscle weakness. This symptom is due to damage to the nerve fibers that help control muscles.

People with MS may also experience muscle weakness because a lack of use has led their muscles to become deconditioned over time.

MS-related muscle weakness can affect any part of the body. It can be especially challenging for people with MS to walk and stay mobile when muscle weakness affects their legs, ankles, and feet.

10. Muscle stiffness and spasms

MS can cause spasticity, which is muscle stiffness and involuntary muscle spasms in the extremities, especially the legs.

Some of the signs and symptoms of spasticity include:

• tightness in or around the joints
• painful, uncontrollable spasms in the arms and legs
• lower back pain
• hips and knees that bend and become difficult to straighten
• hips and knees that stiffen while close together or crossed

11. Dizziness and vertigo

Some people with MS experience dizziness and the sensation of being lightheaded, woozy, weak, or faint.

Less commonly, they experience vertigo, which makes it feel as though a person or their surroundings are spinning.

MS may cause vertigo by damaging the pathways that coordinate the spatial, visual, and sensory input that the brain needs to maintain balance in the body.

The symptoms of vertigo include:

• balance problems
• motion sickness
• nausea and vomiting
• being lightheaded
• a spinning sensation

12. Sexual problems

People with MS often experience sexual problems and may find it difficult to get aroused or have an orgasm.

MS may reduce natural vaginal lubrication, potentially making sexual intercourse painful for women.

The disease can also cause sexual problems by damaging nerves in the sexual response pathways that connect the brain and the sexual organs.

People with MS can also experience issues with sex as a result of other MS symptoms, such as:

• muscle spasms and stiffness
• mood or self-esteem changes
• fatigue

13. Emotional changes

MS can cause a wide range of emotional symptoms and changes, including:

• mood swings
• periods of uncontrollable laughter or crying
• irritability
• grief
• worry, fear, and anxiety
• distress, anger, or frustration

The condition is unpredictable, often has fluctuating symptoms, and can become disabling, all of which can be scary for someone.

MS can also cause emotional changes by damaging the nerve fibers in the brain. Some of the medications that people take to manage MS can cause mood changes too.

For example, corticosteroids can have many emotional side effects, including:

• anxiety
• irritability
• agitation
• tearfulness
• restlessness
• fear

14. Difficulty walking

People with MS can develop problems with gait, or how they walk, because of several factors. MS symptoms that affect how a person walks include:

• muscle stiffness and spasms
• numbness or other sensory problems in the hips, legs, ankles, or feet
• fatigue
• muscle weakness
• loss of balance

15. Hormonal effects

There is some evidence to suggest that MS can affect women differently than men due to hormonal changes, including those that occur during:

Menstruation

More research is necessary to draw firm conclusions, but the NMSS state that some studies have found that women with MS have worse symptoms within a week of starting their period. Studies that used an MRI have also shown that MS disease activity may change according to the different hormonal levels during menstruation. 

Pregnancy

Pregnancy can reduce the risk of MS symptom flare-ups, especially during the second and third trimesters. Researchers think that pregnancy has a protective effect against MS by raising the levels of compounds that help reduce inflammation and the effects of the disease. Women who are pregnant also have naturally higher levels of circulating corticosteroids, another type of immunosuppressant.

Although pregnancy can temporarily reduce some MS symptoms, flare-ups tend to return in the first 3 to 6 months postpartum. However, in the long term, there is no proven link between pregnancy and a higher risk of disability.

While being pregnant can temporarily reduce the risk of flare-ups, pregnancy also puts a lot of physical stress on the body, which can make certain symptoms of MS worse.

In addition, some of the medications that people use for MS are not safe to take during pregnancy and can worsen symptoms.

Anyone with MS who is pregnant or planning to become pregnant should discuss their medications with their doctor.

Some MS symptoms that pregnancy often exacerbates include:

• fatigue
• gait problems
• bladder and bowel problems

Menopause

MS symptoms may worsen after menopause, possibly because declining estrogen levels adversely affect disease progression. However, it is difficult to tell whether MS symptoms worsen because of menopause or just as a natural result of aging or the progression of the condition. Much more research is necessary to understand the relationship between menopause and MS symptoms.

Rarer symptoms

While the symptoms above are the most common, MS affects everyone differently. Less common symptoms of MS include:

• speech problems
• seizures
• hearing loss
• swallowing problems
• tremor
• breathing problems
• itching
• headaches

Outlook

MS is an autoimmune disease that randomly affects parts of the central nervous system, resulting in unpredictable physical, cognitive, and emotional symptoms.

Although MS tends to affect more women than men, it usually causes similar symptoms. However, women may experience variations in their symptoms due to hormonal changes, such as those that take place during menstruation or menopause.

Vision problems and random localized numbness are often the first symptoms of the condition. Depression, bladder problems, cognitive changes, and pain are also among the most common symptoms of MS.

There is no cure for MS, but different drugs and complementary therapies can typically help manage symptoms or even slow the progression of the condition.

Anyone experiencing concerning symptoms should see a doctor for a proper diagnosis.