The verdict on oral contraceptives and their effect on MS is still out. Several case control studies, including a recent analysis of the Swedish Multiple Sclerosis registry, suggest that combined oral contraceptives (progestin and estrogen) use is associated with a later age of onset of MS. One study even suggested less severe disease in patients with longer combined oral contraceptive use. Unfortunately, case control studies are not able to prove causation and there are other possible explanations for these results. There is a randomized control study underway to determine if a pregnancy related estrogen (estriol) is effective at decreasing MS disease activity. Although this will help answer many questions, it will not tell us if oral contraceptives are helpful as these contain different hormones. Stay tuned for more information in the future.