Burcu Zeydan, MD, Mayo Clinic, Rochester, MN, talks about the relationship between sex hormones, multiple sclerosis (MS), and their respective clinical advances. It has been studied that the likes of nulliparity and premature menopause are associated with early onset progressive MS – inferring hormonal imbalances play a role in the development and management of the disease. There is limited data on the impact of sex hormones in MS – however, several small studies portray promising results. Most of these studies are orientated around estrogen administration in females; with results demonstrating improved cognition, fewer enhancing lesions, and clinically lower relapse rates. An ongoing multicenter study (NCT01466114) is also investigating the effects of estriol administration combined with disease modifying treatments (DMTs) – the primary outcome being cognitive function. Dr Zeydan also discusses a pilot study on males, whereby testosterone is given to the patient; initial data indicates improvement in cognition and a reduction in cortical atrophy. Data is still very limited in males. This interview took place at the ACTRIMS Forum 2022 in West Palm Beach, Florida.