UNIVERSITY OF CALGARY

UNIVERSITY OF CALGARY
The role of oral contraceptives in optic neuritis: the story behind the study, initial
experiences, and lessons learned
by
Jessie J. Trufyn
A THESIS
SUBMITTED TO THE FACULTY OF GRADUATE STUDIES
IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE
DEGREE OF MASTER OF SCIENCE
DEPARTMENT OF NEUROSCIENCE
CALGARY, ALBERTA
JULY, 2013
© Jessie J. Trufyn 2013

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Abstract
There is accumulating evidence of sex differences in multiple sclerosis, making hormones
a possible research avenue for therapeutic agents. Oral contraceptives are a source of
synthetic hormones, however, it is unclear whether hormone-based therapies help, hinder,
or have no effect on the disease in women. In an attempt to elucidate the role of sex
hormones, we are currently conducting an observational study of oral contraceptives in
optic neuritis, a condition that often occurs in parallel with multiple sclerosis. The thesis
describes the study rational and supporting evidence for the hypothesis that oral
contraceptive use in our study population will be associated with beneficial outcomes. I
also share experiences with study implementation and preliminary data. The final section
of the thesis offers insight for researchers on the areas of optical coherence tomography,
hormones, and human research.

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Preface
My journey began in Fall 2008 when I started my position at the Calgary Multiple
Sclerosis Clinic as a health research coordinator under the supervision of Ms. Winona Wall
and Dr. Luanne Metz. My experiences there, and interaction with Dr. Fiona Costello and
Dr. Jodie Burton led me on the pursuit of my Masters degree and this thesis.

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Acknowledgements
There are many people I owe thanks to. First, my boyfriend. I met Michael Keough at the
beginning of my graduate school adventure. His hard work has been an inspiration, his
strength a pillar, and his friendship a source of happiness.
My parents for their unconditional support, positive thinking, and for making every trip
home a mini vacation.
The staff at the MS Clinic and Eye Clinic for their smiling faces and smorgasbord of treats.
Dr. Michael Hill for recommending and lending me the book Epidemiology in Medicine.
My supervisory committee, Dr. Gordon Fick, Dr. Bernard Corenblum, and especially Dr. V
Wee Yong, for shaping my project and success. Also, Dr. Bill Fletcher for being my
external examiner.
Above all, Dr. Fiona Costello and Dr. Jodie Burton, my supervisors. Dr. Costello, with her
gumption and fortitude, has kept me moving forward, and instilled in me life lessons and
good energy that I hope to always carry. Dr. Burton, with her commitment, brilliance, and
instrumental feedback, has made this project and my experience something I am proud of.
Merged together, their support has enabled me to grow and and achieve. Jodie and Fiona, I
will forever feel privileged to have worked with you.

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Dedication
This thesis is dedicated to study patients, who selflessly contribute to science during
stressful times of their lives.