There’s a good chance you know someone who has been diagnosed with Parkinson’s disease. It is very common. It affects about 3% of the population of those age 65 and up to 5% of people over 85. A number of celebrities have been diagnosed with this disease, such as Michael J. Fox, Neil Diamond, Mohammed Ali, and Linda Ronstadt.
More men than women develop Parkinson’s disease. However, after menopause the risk in women increases sharply. This raises the question if there is something about the loss of estrogen that may be causative. And the second question to answer would be: does taking estrogen replacement therapy help. In this blog I will address these issues.
What is Parkinson’s disease?
To begin, let’s describe this disease. Basically
it is a condition where areas in the brain that control our movement become impaired. This causes various symptoms that affect the way our body functions. An early symptom is a slight tremor of the arms that can gradually get worse. Another one is a general slowness and stiffness in movement. The face can also become expressionless. Over time it becomes difficult to walk and do activities, and in more advanced cases it affects other areas such as our mood and mental abilities and can lead to a form of dementia.
It is a difficult disease to treat. Medications which increase the amount of dopamine in the brain are helpful, but over time the disease tends to slowly progress.
What evidence is there that estrogen loss may be a factor?
One very telling observation is that women who go through menopause early, such as women who have their ovaries removed, have an increased risk of developing Parkinson’s. Conversely, women who go through menopause later have a lower chance. In addition, it has been shown that in women who are still menstruating, Parkinson’s symptoms can vary in intensity depending on the time of the month. During the menstrual period, when estrogen levels are the lowest, women have been noted to have a worsening of their symptoms.
We know that estrogen helps the brain make neurotransmitters, which are the chemicals the brain cells use to communicate with each other. One of these is dopamine, and it is a deficiency of dopamine that appears to be a major factor behind Parkinson’s.
In addition, estrogen plays many roles in the brain that help keep it healthy and protect it from damage. This includes its powerful anti-inflammatory and antioxidant effects. These properties would have a significant beneficial effect in protecting the brain from the processes that lead to Parkinson’s. (To learn more about estrogen effects in the brain, see my post: https://yourestrogenquestions.com/hrt/does-estrogen-prevent-alzheimers-disease/.)
Does estrogen therapy help?
Animal studies indicate that estrogen helps retard Parkinson’s. A form of Parkinson’s disease can be induced in rats, and it has been shown that estrogen treatment decreases the symptoms these animals demonstrate. Further studies also demonstrated that estrogen-treated rats had less brain damage in areas involved in movement as well as higher levels of dopamine in these areas.
There is also evidence that estrogen treatment helps humans. Studies comparing women who underwent early menopause due to surgery have shown that those women on HRT had a lower risk of developing Parkinson’s than those not placed on HRT. There have also been small case reports demonstrating that women with Parkinson’s disease had less pronounced symptoms when treated with estrogen.
The big question is, however, does HRT decrease the risk of Parkinson’s in women going through menopause naturally. A recent meta-analysis was performed to address this issue. In this study, the authors analyzed the results of five major observational studies comparing the onset of Parkinson’s in women on HRT vs. women not on HRT. The conclusion was that taking estrogen decreases the risk of Parkinson’s! This is demonstrated in the chart below which takes information from the study. If the dark circles or squares fall in the tinted green area, that indicates that there were fewer women developing Parkinson’s disease.
Is estrogen approved for prevention or treatment of Parkinson’s?
Despite increasingly strong evidence that HRT would be beneficial to prevent Parkinson’s, it is not currently recommended for this purpose. This is because it is felt that we need stronger studies, and there continues to be concern whether the benefits of HRT outweigh the risks. And this concern dates back to the results of the WHI study, which cast doubt on the overall safety of taking HRT for menopausal women. However, as I have repeatedly noted in other blogs, there are a number of shortcomings regarding the application of the WHI results to all menopausal women. (See my article in Linkedin: (61) What is the WHI and Why Women in Menopause Need to Know about it | LinkedIn )
From my perspective it is unfortunate that so little attention has been paid to this subject. As the population of menopausal women grows, so will the number of women who develop Parkinson’s. Even more concerning it that it has been shown that despite its later onset in women, women have a faster progression and higher death rate from Parkinson’s than men. None of the current drugs that we have for Parkinson’s disease are extremely effective for long-term treatment and, on top of that, women tend to have more side effects from these drugs than men.
This is another example where we just haven’t devoted enough time, money and research into exploring how taking estrogen at the time of menopause may help prevent a chronic disease that can severely impact millions of women.
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