Abstract

Many neuro-inflammatory disorders have a predilection for women; even if there is no female predominance, neuro-inflammatory conditions in women pose a management challenge for several reasons. Disease activity of these conditions may change during pregnancy and commonly increases in the postpartum period. Immunomodulating agents that are used to suppress the disease activity may have a negative impact on fertility, pregnancy, and fetal outcomes, and on infants who are breastfed. Adverse effects of immunosuppressants extend beyond the reproductive issues and may include bone loss, increased risk of cancers, and infectious complications. The successful management of women with these disorders not only involves understanding and early recognition of the adverse effects of immunosuppressants but also active prevention of the adverse outcomes through counseling about contraceptive choices, safety monitoring, risk surveillance, and other strategies.

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