Beyond being a medical challenge, multiple sclerosis (MS), which affects nearly three times as many women as men, raises emotional and physical concerns among women. MS is a neurological condition that affects cognitive, emotional, motor, sensory, or visual functions. It is also a chronic autoimmune disease that is caused when a person’s immune system attacks their brain and spinal cord. According to the UK-based MS International Federation, an estimated 2.8 million people live with MS worldwide, with prevalence increasing globally. However, women make up about 75 percent of MS patients globally.However, women are disproportionately affected. The diagnosis gets more emotionally challenging for women as it often appears during early adulthood -- a key period for women building their careers, relationships, and families. Estrogen, genetics and a lack of Vitamin D are major reasons for its increased prevalence in women. Beyond the clinical symptoms, the anxiety, depression, mood changes, and stress, driven by uncertainty about disease progression, impact the daily life of women. Concerns about pregnancy, parenting, work, and long-term independence can further intensify the emotional burden. “MS is significantly more prevalent in women, often striking during their most pivotal years. For many women, the diagnosis goes beyond a medical challenge; it becomes a profound emotional crossroads centered around family planning. They face daunting questions: Can I safely carry a pregnancy? Is breastfeeding possible? Will I have the physical stamina to care for a child? These are not merely clinical concerns; they are deeply personal anxieties about identity, motherhood, and the future,” Dr. Sudhir Kumar, Sr. Consultant Neurologist, Apollo Hospital, Jubilee Hills, Hyderabad, told HealthandMe. “Multiple sclerosis is increasingly recognized as a disproportionate neurological burden among women. Globally, women are affected nearly two to three times more often than men, a pattern believed to arise from a complex interaction of immune system behavior, hormonal influences such as estrogen fluctuations, genetic susceptibility, and environmental triggers, including low Vitamin D levels and viral exposures,” added Dr. Manish Gupta, Director – Neurology, Max Super Specialty Hospital, Noida. Symptoms of multiple sclerosis can be different from person to person. They can come and go or get worse over time. MS can affect any part of the central nervous system. MS symptoms can worsen with heat or during other infections, such as urinary tract or respiratory infections. Common symptoms can include: vision problems difficulty walking or keeping balance difficulty thinking clearly numbness or weakness, especially in the arms and legs muscle stiffness depression problems with sexual function or urination feeling very tired. “No two patients experience MS in the same way. Symptoms depend on the location of demyelinating lesions in the brain or spinal cord, affecting vision, mobility, cognition, balance, or sensation. This biological variability makes early diagnosis and timely, high-efficacy intervention critical. The goal today is no longer just to manage relapses. It is to limit ongoing subclinical inflammation, prevent silent progression, and delay long-term disability,” Dr. Kumar said.Why Treating Multiple Sclerosis Is Difficult MS is an inflammatory condition that results from an autoimmune attack on myelin -- the fatty insulation that surrounds the nerves in the brain and spinal cord. This disrupts the electrical impulses that are sent through the nerves to the rest of the body and results in scars (plaques or sclerosis). “Multiple Sclerosis is one of the most complex neurological disorders we encounter in clinical practice, not because it is untreatable, but because it is unpredictable. MS is an immune-mediated disease characterized by inflammation and demyelination — damage to the protective myelin sheath that insulates nerve fibers in the brain and spinal cord. When this insulation is stripped away, nerve signals slow down or become distorted, producing a wide spectrum of symptoms, varying from fatigue, blurred vision, and dizziness to limb weakness, imbalance, or sensory disturbances,” Dr. Subhash Kaul, Consultant Neurologist at KIMS Hospital, Hyderabad, told HealthandMe. Many of these are invisible, fluctuating, and easily dismissed, both by patients and sometimes even by primary care providers. It is not uncommon for individuals in the early stages of MS to be misdiagnosed. “This delay in recognising the disease is deeply concerning, because MS strikes people in the prime of their lives — when they are building careers, raising families, and contributing economically. If left untreated, the disease does not remain static; inflammation accumulates silently, relapses leave residual deficits, and disability compounds over time. This is precisely why early and appropriate treatment matters,” said Dr. Kaul. Yet, experts stated that early diagnosis remains crucial. Regular neurological evaluation for persistent numbness, vision disturbance, or unexplained fatigue allows timely therapy. Disease-modifying treatments, adequate sunlight exposure, physical activity, and stress management help slow progression and preserve long-term neurological function.“Multiple Sclerosis is not a series of unfortunate episodes; it is a silent, relentless fire. From the moment of onset, MS acts as a chronic, immune-mediated assault on the central nervous system, often causing irreversible damage long before the first visible symptom appears. As one of the leading causes of non-traumatic disability in young adults, we must confront a sobering reality: even when a patient appears clinically stable, “smoldering” inflammation frequently continues beneath the surface, gradually eroding brain volume and neural pathways,” Dr. Kumar said. “By intervening decisively at the outset, we can suppress smoldering inflammation, preserve long-term neurological function, and give women the confidence to pursue the lives and families they envision,” he added.