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Dr. Girishkumar Soni

The Hidden Differences: How Parkinson’s Affects Women Vs. Men

Parkinson’s disease is characterized by slowness of daily activities, rigidity, and tremors with gait issues, commonly seen after the age of 45-50 years. 

It is two times more common in men than women, though clinical features, response to the treatment, and prognosis are different in women as compared to men. From subtle early signs to how the condition develops over time, gender can shape the Parkinson’s journey in important ways.

Women usually experience Parkinson’s disease at a later age, but with faster progression of symptoms as compared to men. There is a need for more research in this space; however, we will try to shed light on these differences in Parkinson's trajectories in men and women based on available evidence.

<h2>Why Is Parkinson’s Less Common In Women?</h2>

Estrogen, a group of primary female sex hormones, is neuroprotective and protects dopaminergic neurons in women; women also have a higher baseline reserve of dopaminergic neurons. Hence, Parkinsonism is less common in women. 

In the post-menopausal period, once this estrogen-related neuroprotective effect disappears, Parkinson’s symptoms progress rapidly. Motor symptoms emerge later in women with tremors, rigidity, and gait disturbances being more common and severe. Freezing of gait and postural instability with falls are more common in women.

<h2>Differences In Motor vs Non-Motor Symptoms</h2>

Non-motor symptoms like pain, fatigue, autonomic disturbances, sleep disorders, constipation, and mood disorders, including depression and anxiety, are more common and severe in women. Men with Parkinson’s disease have worse general cognitive abilities; however, women have worse visuospatial abilities.

Women with Parkinson’s receive less social support, lower quality care, attend medical appointments alone, and report more psychological stress. Women have a lower body mass index and higher bioavailability of <span>levodopa</span>, which makes them more susceptible to the side effects of levodopa, such as motor fluctuations and <span>dyskinesia</span>, which entail involuntary movements like fidgeting and writhing.

<h2>Why Personalized Treatment Matters</h2>

There is a clear need for personalized and tailored treatment. The different and distinctive clinical features in women, like later onset, higher tremors and rigidity, higher dyskinesia and motor fluctuations from drugs, and worse non-motor symptoms, require tailored, sex-specific treatment strategies rather than a “one-size-fits-all” approach.

Clinicians must give importance to the screening and management of non-motor symptoms in women, which are the main factors of their decreased quality of life. Women with this ailment go through longer delays in diagnosis and less access to specialists, highlighting a need for better healthcare access for women.

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Parkinson’s disease is characterized by slowness of daily activities, rigidity, and tremors with gait issues, commonly seen after the age of 45-50 years. It is two times more common in men than women, though clinical features, response to the treatment, and prognosis are different in women as compared to men. From subtle early signs to how the condition develops over time, gender can shape the Parkinson’s journey in important ways. Women usually experience Parkinson’s disease at a later age, but with faster progression of symptoms as compared to men. There is a need for more research in this space; however, we will try to shed light on these differences in Parkinson's trajectories in men and women based on available evidence. Why Is Parkinson’s Less Common In Women?Estrogen, a group of primary female sex hormones, is neuroprotective and protects dopaminergic neurons in women; women also have a higher baseline reserve of dopaminergic neurons. Hence, Parkinsonism is less common in women. In the post-menopausal period, once this estrogen-related neuroprotective effect disappears, Parkinson’s symptoms progress rapidly. Motor symptoms emerge later in women with tremors, rigidity, and gait disturbances being more common and severe. Freezing of gait and postural instability with falls are more common in women. Differences In Motor vs Non-Motor SymptomsNon-motor symptoms like pain, fatigue, autonomic disturbances, sleep disorders, constipation, and mood disorders, including depression and anxiety, are more common and severe in women. Men with Parkinson’s disease have worse general cognitive abilities; however, women have worse visuospatial abilities.Women with Parkinson’s receive less social support, lower quality care, attend medical appointments alone, and report more psychological stress. Women have a lower body mass index and higher bioavailability of levodopa, which makes them more susceptible to the side effects of levodopa, such as motor fluctuations and dyskinesia, which entail involuntary movements like fidgeting and writhing. Why Personalized Treatment MattersThere is a clear need for personalized and tailored treatment. The different and distinctive clinical features in women, like later onset, higher tremors and rigidity, higher dyskinesia and motor fluctuations from drugs, and worse non-motor symptoms, require tailored, sex-specific treatment strategies rather than a “one-size-fits-all” approach. Clinicians must give importance to the screening and management of non-motor symptoms in women, which are the main factors of their decreased quality of life. Women with this ailment go through longer delays in diagnosis and less access to specialists, highlighting a need for better healthcare access for women.

the hidden differences: how parkinson’s affects women vs. men

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