The researchers sought to examine aging-related mechanisms in MS prognosis for a study. They also sought to determine sex-specific elements that influence MS prognosis and explore the link between sex, hormones, and aging in MS prognosis. There were reviews of well-known epidemiological studies, clinical trials, and recent scientific updates on age and sex in MS. In regard to aging in MS, the impact of sex, hormones, ovarian reserve, and periods of significant changes in sex hormone levels in women’s lives, such as menarche, pregnancy, and menopause, were underlined. The most critical factor influencing the transition to the progressive phase of MS was age. Clinical and subclinical activity declines with age, but so does the ability to recover from recurrence. In MS, the efficacy of disease-modifying therapies (DMTs) declines as people get older, and the number of side events associated with DMTs increases. Men enter the progressive phase at a younger age, while women appear to develop handicaps more quickly once they do. Menarche, pregnancy, and menopause were all linked to phenotypic heterogeneity in women with MS. Menarche at an older age may postpone serious impairment. Pregnancy appears to reduce the course of MS and the worsening of disability. Menopause was linked to aging and neurodegeneration, and it was likely to be connected to both progressive MS and deteriorating disability. Adjunctive hormonal therapy research in MS appears to be promising so far. Despite some contradictory findings, most of the study team concluded that sex differences and hormones play a role in MS prognosis across the age spectrum. Finally, the influence of sex and hormones, and aging was crucial in individualizing patient therapy. Sex and hormone status as connected to the aging process should be considered when analyzing natural history research and clinical trial data in MS to support such a personalized treatment approach. In more extensive trials, the role of adjuvant hormone treatments in MS has yet to be determined.