From the Research
Estriol is not a recommended treatment for Relapsing-Remitting Multiple Sclerosis (RRMS) based on the provided evidence, and its use should be approached with caution due to the lack of FDA approval and limited clinical research supporting its efficacy in this context. When considering treatment options for RRMS, it is essential to prioritize therapies with established efficacy and safety profiles. The most recent and highest quality study, a network meta-analysis published in 2024 1, compared the efficacy and safety of various immunomodulators and immunosuppressants for RRMS, but did not include estriol as a treatment option. This study found that natalizumab, cladribine, and alemtuzumab were associated with a significant reduction in relapses and disability progression compared to placebo. In contrast, estriol's potential benefits and risks in RRMS treatment are not well-established, and its use may be associated with side effects such as irregular menstruation, breast tenderness, and headaches.
Key considerations for RRMS treatment include:
- Monitoring for potential side effects and adjusting treatment accordingly
- Supervision by neurologists experienced with MS management, ideally in consultation with endocrinologists
- Regular follow-up with clinical assessments and MRI monitoring to evaluate treatment response and safety
- Prioritizing therapies with established efficacy and safety profiles, such as natalizumab, cladribine, and alemtuzumab, over unapproved treatments like estriol.
It is crucial to weigh the potential benefits and risks of each treatment option and consider the individual patient's needs and medical history when making treatment decisions. The lack of strong evidence supporting estriol's use in RRMS treatment, combined with the availability of more established treatment options, suggests that estriol should not be considered a first-line treatment for RRMS.