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International Women’s Day

Mar. 05, 2021

In recognition of International Women’s Day on 8 March, we highlight some of the research that is looking at the differences in Parkinson’s in men and women and how our own sex-hormone, estrogen, may have a bearing.

The incidence of Parkinson’s is lower in women than men, however there are many women living with Parkinson’s and their experience is often very different to that of men.

Some studies have indicated women experience tremor and painful early morning muscle contractions than men. Others have found women are more likely to have depression and report problems with daily living and fatigue. Not to mention issues some women report around menstruation and menopause.

In 2019, a review published in the Journal of Parkinson’s Disease found there was growing evidence that Parkinson’s affects women and men differently, with the significance of estrogens highlighted. 

The scientists, from the Mondino National Institute of Neurology Foundation in Pavia, Italy, reviewed different clinical features, risk factors, responses to treatments, and mechanisms underlying the disease pathophysiology of Parkinson’s disease in women and men.

The review “meticulously examined” the most recent knowledge concerning differences between women and men with Parkinson’s including:

• motor and non-motor symptoms
• quality of life
• genetic and environmental risk factors
• pharmacological therapy of motor and non-motor symptoms
• surgical procedures
• Parkinson’s and steroids
• impact of biological sex on pathophysiology.

Research reviewed showed that motor symptoms emerge later in women, with tremor a common first presenting symptom, more severe pain syndromes, a higher propensity to develop postural instability and elevated risk for levodopa-related motor complications.

The review reported that non-motor symptoms had been the subject of a study of over 950 people with Parkinson’s, which concluded that symptoms such as fatigue, depression, restless legs, constipation, pain, loss of taste or smell, weight change and excessive sweating are more common and severe in women.

The authors noted that the distinctive clinical features, as well as the contribution of different risk factors support the idea that Parkinson’s development might involve distinct pathogenetic mechanisms (or the same mechanism but in a different way) in women and men.

They highlighted the significance of estrogen. Research has pointed to estrogen having multiple effects on dopamine, including the amount of dopamine absorbed into the nerve cells.

The role of estrogen was subject to a project in 2019 when researchers from Harvard University injected male mice under with the hormone therapy DHED, which is designed to activate estrogen in the brain.

The motor performance and brain health of the male and female mice were compared along with whether DHED affected the progression of Parkinson’s-like symptoms in males.

Results showed the male mice showed improvements in all the motor functions tested. They also showed significant improvements in the brain, including healthier dopamine neurons and lower amounts of alpha-synuclein at risk for clumping.

While it is early days in terms of research on the differences between Parkinson’s in men and women, discussions around women and Parkinson’s is growing internationally.

The European Parkinson’s Disease Association (EDPA) has created information specific to women and Parkinson’s. 

If you are experiencing any issues, or just have a question, the Parkinson’s Victoria health team is available to help. Call us on 1800 644 189 for a confidential chat.

 

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