The study by Hawkins and McDonnell1 found that in multiple sclerosis, women were more likely than men to have a benign course and that young subjects had a more benign course than older subjects with multiple sclerosis. These findings prompt the question: Do postmenopausal women with multiple sclerosis on estrogen replacement therapy do better than those not taking such therapy? Axonal damage is now recognised to be an important determinant of disability in multiple sclerosis (reviewed in …