Menopause linked to worsening of PD symptoms
Presenter: Willanka Kapelle, MD, Radboud University Medical Centre, Nijmegen, The Netherlands
Women and PD: experienced changes in Parkinson symptoms after menopause. Abstract 1310. Presented August 29, 2023.
Two-thirds of women diagnosed with Parkinson disease (PD) report an increase in severity of symptoms after menopause, according to this survey done in The Netherlands. They reported an increase in symptom severity for both PD-specific and PD-nonspecific symptoms. Unfortunately, few women discuss this change in symptom severity with their healthcare provider.
Although most people are diagnosed with PD later in life, PD also occurs in younger people: up to 10% of all people living with PD are diagnosed before age 50 and almost half of them are women.1
Women with PD often report an increase in symptom severity after menopause, but this increase is rarely addressed by healthcare professionals, according to the investigators, led by Willanka Kapelle, MD, Radboud University Medical Centre, Nijmegen, The Netherlands.
“Research is scarce and gaps in knowledge result in vast shortcomings in providing younger women with PD with the proper care,” they wrote in their poster presentation. “To improve care for women with PD, addressing this topic and exploring interventions is essential.”
Changes in PD symptoms experienced by women after menopause were explored in a substudy that was part of a larger survey study about women-specific issues and the impact of hormonal fluctuations on PD symptoms. The larger study included 110 Dutch-speaking women in The Netherlands aged 21 to 60 years old and diagnosed with PD by a neurologist. The substudy comprised 31 postmenopausal women who had been pre- or postmenopausal at the time of their first PD symptoms. These women answered the question: “Did your PD symptoms change after menopause and how?”
A worsening of symptoms after menopause was reported by 21 (68%) of the women. The symptoms that worsened most frequently were fatigue (45%, n = 14), transpiration (42%, n = 13), and urinary tract issues (42%, n = 13). Increased PD-specific symptoms included bradykinesia (23%, n = 7) and tremor (19%, n = 6). Many women also reported changes in the effectiveness of their medication, as indicated by an increase in the severity of dyskinesias in 35% (n = 11) and efficacy wearing off in 29% (n = 9). Only one of the 21 women reported that a healthcare professional had addressed the topic of possible changes in PD symptoms after menopause.
The authors note that because many symptoms related to menopause are difficult to distinguish from PD symptoms, women may have trouble identifying the reason behind their symptomatology and are reluctant to discuss them with their healthcare professionals.
They offer some suggestions for women-specific care and interventions, including adjustment of treatment, increased engagement of neurologists, and referral to gynecologist to explore hormonal therapy as a therapeutic option. They also emphasized the importance of raising awareness of the link between menopause and PD symptoms among women with PD.
Reference
- American Parkinson Disease Association. What is early onset Parkinson’s disease? https://www.apdaparkinson.org/what-is-parkinsons/early-onset-parkinsons-disease. Accessed August 31, 2023.