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Here we review factors that influence the disease course and the challenges that might be encountered when managing patients with MS. <\/jats:p><jats:p> The majority of diagnosed patients are women of childbearing age, making pregnancy-related issues a key concern. MS typically stabilizes during pregnancy and evidence suggests that the disease has no impact on the risk of complications or outcomes. However, the effect of disease-modifying therapies on outcomes is less clear, and discontinuation of treatment prior to pregnancy or when breastfeeding is recommended. Awareness of genetic risk factors is important for patients planning a family, as several genes increase the risk of MS. <\/jats:p><jats:p> Further aspects that require consideration include infections, vaccinations, environmental factors, surgery and the emergence of osteoporosis. Vaccinations are generally not a risk factor for MS and may be beneficial in terms of protection against infection and reducing the number of relapses. Environmental factors such as vitamin D deficiency, low exposure to sunlight, smoking and Epstein\u2212Barr virus infection can all negatively influence the disease course. Furthermore, osteoporosis is generally higher in patients with MS than the general population, and the risk is increased by the environmental and genetic factors associated with the disease; bone mineral density should be assessed and smoking cessation and correction of serum vitamin D levels are recommended. Finally, as patients with MS are typically young, they are at low risk of surgery-related complications, although they should be carefully monitored postoperatively. Awareness of, and planning around, these factors may minimize the impact of the disease on patients\u2019 lifestyle. <\/jats:p>","DOI":"10.1177\/1756285613501575","type":"journal-article","created":{"date-parts":[[2013,8,28]],"date-time":"2013-08-28T00:15:24Z","timestamp":1377648924000},"page":"137-149","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Specific aspects of modern life for people with multiple sclerosis: considerations for the practitioner"],"prefix":"10.1177","volume":"7","author":[{"given":"Celia","family":"Oreja-Guevara","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital San Carlos, IdISCC, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heinz","family":"Wiendl","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of M\u00fcnster, M\u00fcnster, 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