Men and women with Parkinson’s — spot the difference
Parkinson’s affects an estimated 10 million men and women worldwide. But are there important differences between the sexes?
Who do you picture when you think of Parkinson’s? If it’s a hunched and shaky elderly white man then you’re not alone. But despite this persistent stereotype we know that the condition is indiscriminate. Anyone can be affected. Men and women, young and old, and of every ethnicity.
So to understand and find solutions to Parkinson’s we need to include everyone across the community in research.
In this blog, we’re going to focus specifically on women.
Parkinson’s affects millions of women across the world but for too long their stories and experiences have been less well represented and researched than their male counterparts.
Thankfully this is changing and we are beginning to understand that the female experience of the condition may differ in a range of ways. These important differences could be vital in developing treatments, care and support that meet the needs of everyone with Parkinson’s.
In this blog, we take a look at what the research so far can tell us about Parkinson’s in men and women.
1. Men are more likely to get Parkinson’s
A recent UK analysis found that men are more than 1.5 times as likely to have the condition compared to women of the same age. This trend seems to hold true in other countries too.
We still don’t fully understand why men are more likely to develop Parkinson’s but there are a number of factors which may play a role:
- The female hormone oestrogen may help to protect the dopamine-producing cells affected in Parkinson’s.
- Traditionally, men may be more likely to be exposed to pesticides, solvents and metals at work, which are known to increase the risk of developing Parkinson’s.
- There may also be crucial differences in how cells deal with problems like inflammation and oxidative stress that are thought to be involved in the loss of brain cells.
2. The symptoms
A recent review of studies done so far suggests that women and men may experience a different blend of symptoms.
Women with Parkinson’s are more likely to:
- have tremor as their first motor symptom.
- have balance problems and experience falls.
- experience more severe non-motor symptoms including fatigue, depression, constipation and pain.
Whereas, men with Parkinson’s are more likely to:
- develop serious posture problems.
- experience ‘freezing’ when walking.
- have more difficulties with memory and thinking.
3. Response to treatment
To date, there has been very little research into whether men and women respond differently to Parkinson’s treatments — including medication and surgical therapies. However, there are some findings worth mentioning:
- Some research suggests women may be more likely to develop dyskinesia (uncontrollable movements) in response to medication but other studies have found no difference between men and women.
- Men are more likely to experience problems such as compulsive gambling, binge eating and hypersexuality which can be triggered by Parkinson’s medication.
- A recent study showed women may be less likely to choose to undergo deep brain stimulation and be missing out on the benefits of this important therapy.
4. Care and support
Another important way in which men and women may experience Parkinson’s differently is in the care, support and services they receive.
Research studies suggest that women may experience longer delays in diagnosis than men. Additionally, women are less likely than men to:
- receive specialist (neurologist) care.
- access physical, occupational, and speech therapy.
- have informal care support from a spouse, family members or friends.
5. Pregnancy, periods and menopause
Finally, how do uniquely female experiences like pregnancy, periods and the menopause influence and impact upon Parkinson’s — and vice versa?
Very little research has been done into pregnancy and Parkinson’s. The impact of pregnancy on the condition is unclear. Some reports suggest symptoms may worsen but that may be because some women stop taking their Parkinson’s medication during pregnancy. On the positive side, there is no evidence that women with Parkinson’s are at higher risk of complications.
There is even less published research into the effect of the female menstrual cycle on Parkinson’s. One very small study found that around the time of their period women’s symptoms often get worse and medication may be less effective. Periods themselves may also become more difficult with women reporting increased pain, fatigue and problems with self-care.
When it comes to the menopause most of the limited research to date has focused on the effects of oestrogen replacement therapy for women with Parkinson’s, with some studies showing that it may improve symptoms. Others have uncovered a possible link between early menopause and an increased risk of Parkinson’s which is likely due to the reduction of natural oestrogen levels. However, there is no published research exploring the personal experiences of women living with Parkinson’s as they go through the menopause.
Overall, much more research is needed to understand how Parkinson’s affects men and women differently. This could be vitally important not just for ensuring that treatment and care are tailored appropriately for both sexes but also for ensuring that new treatments are tested appropriately. If there are fundamental biological differences in men and women with Parkinson’s, new and emerging therapies may have different effects (and side effects) that could affect the outcome of clinical trials.
Whatever your sex there are a number of studies that are looking for participants right now.
If you’d like to find out more about this area of research then this post was inspired by the below research review:
Parkinson's Disease in Women and Men: What's the Difference?
Increasing evidence points to biological sex as an important factor in the development and phenotypical expression of…
You may also be interested to read some women’s stories of their personal experiences of Parkinson’s which is currently the subject of a campaign led by the European Parkinson’s Disease Association: