Parkinson's disease is one of the most devastating illnesses a human can get. The degenerative illness slowly robs the person of their ability to move, care for themselves and even speak — all while their brains remain aware of everything.
With Muhammad Ali's tragic death this past week, many people are again talking about Parkinson's disease — the legendary boxer lived with the illness for 32 years and was a great advocate for research. But while we know much more about the disease than we did three decades ago, there's a lot more that remains unanswered. One of those areas is how Parkinson's disease affects women differently than men.
Parkinson's disease is often thought of as an old man's illness. While that is somewhat true — twice as many men get it as women and the average age of onset is 60 — thousands of women get it every year too. And while there are lots of overlap in symptoms, everything from diagnosis to treatment works differently for women. For instance, simply getting that diagnosis is harder for women. Most men first present with "bradykinesia" or slow, rigid body movements; but women generally have tremors as their dominant symptom, according to a study published in the International Review of Psychiatry. This means women are often diagnosed later, when their symptoms have become more severe. However, people with the tremor-dominant form of PD often live longer and have a higher quality of life.
Once diagnosed, women experience the disease differently than men. Why? One word: hormones. Fluctuations in estrogen and progesterone can make symptoms wax and wane depending on what time of the month it is. Higher progesterone levels seem to increase fatigue and "off times." Women under 50 (about five percent of diagnosed cases) say that PMS makes their Parkinson's symptoms worse and their medications less effective in addition to making their periods heavier, according to research done by the American Parkinson Disease Association. As if we needed another reason to dread PMS! On the other hand, estrogen appears to provide some protection against the disease, according to a study published by the Journal of Neurology, Neurosurgery & Psychiatry, which may somewhat explain why so many more men get it than women.
Other symptoms are different between the genders. Female Parkinson's patients are more likely to experience depression and go on anti-depressant medications than men. They're also more likely to feel upset about the progression of their disease. It's not all bad news though. Women with the illness keep their verbal fluency longer and are less likely to have sleep disturbances.
There's also a gender difference when it comes to treatments for Parkinson's disease. Men are offered surgery more often and at an earlier stage than women, leaving many women suffering longer. And drugs used to treat the disease, like Levodopa, are calibrated for the average man's body. This means that because women generally weigh less, they are inadvertently exposed to a higher concentration of the drug, which can have serious side effects.
While much of Parkinson's disease remains murky, one thing is clear: We need more research into how women are affected by the illness and what treatments work best for their bodies.
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