Differences in Parkinson's Symptomatology Between Genders: Women's Experiences Compared to Men's
Current research reveals significant gender differences in Parkinson's disease (PD), shedding light on the need for tailored diagnostic, therapeutic, and supportive strategies for women living with the condition.
- Diagnosis and Symptom Differences:
Women with PD tend to present with tremor-dominant symptoms and experience greater motor complications than their male counterparts. Men, on the other hand, are more likely to exhibit severe cognitive decline and a higher prevalence of PD in certain populations. Non-motor symptoms such as depression, anxiety, sleep disturbances, fatigue, and pain are reported more commonly in women with PD.
- Treatment Patterns and Outcomes:
Prescription patterns of anti-Parkinson drugs, like levodopa, show gender-based differences. Women may require more tailored treatment strategies due to factors such as lower average body weight, inappropriate dosage, and age of onset, which seem to make levodopa less effective for women with PD. Women also have increased motor complications and distinct responses to medications compared to men, necessitating more personalized management approaches, especially among elderly female patients.
Despite reporting better outcomes, women are less likely to receive deep brain stimulation (DBS) surgery for PD. This is attributed to factors including reduced patient preference, higher rates of depression, less clinician referral, and importantly, reduced social support before surgery. Women undergoing DBS often report a reduced quality of life and greater mood-related issues like anxiety and depression.
- Ongoing Research Directions:
Researchers are focusing on elucidating the biological and social reasons behind these gender differences, including differences in motor unit behavior, pharmacological response, and neuropsychiatric impact. This research emphasises the importance of incorporating gender as a key factor in designing PD treatment plans, improving referral practices for therapies like DBS, and addressing barriers to care and support for women living with PD.
- Prevalence and Risk Factors:
Approximately 60,000 new cases of PD are diagnosed each year, and PD affects nearly 1 million Americans and is expected to affect 1.2 million by 2030. Long-term exposure to toxic substances in industrial occupations, such as trichloroethylene and polychlorinated biphenyl, can increase the risk of PD. The EPA can help reduce the risk of Parkinson's by increasing the regulation of toxic herbicides associated with its onset and development.
In 2018, California used 30% of the total paraquat used in the US and had the highest rate of Parkinson's diagnosis that year. Paraquat, a highly toxic herbicide, is associated with Parkinson's and is banned in 32 countries, but is heavily used in US agriculture. Traumatic head injuries have been associated with an increased risk of developing PD, most common in traditionally male-oriented high-impact sports.
- Addressing Gender Inequities:
Women with PD often face disadvantages in the quality of care, such as attending appointments alone and resorting to healthcare at home or living in a nursing facility. Women are underrepresented in Parkinson's clinical trials and research, which can lead to discrepancies in treatment and care. Healthcare providers should account for gender differences and customise treatment for women's lower body weight and specific drug metabolism.
Over 400,000 women in the US live with Parkinson's disease. Researchers advocate for more patient-centered, gender-sensitive approaches to improve outcomes and quality of life, including better recognition of non-motor symptoms and mood disorders prevalent in women.
In summary, women with Parkinson’s disease differ from men in clinical presentation, experience more motor and non-motor complications, respond differently to medications, and face distinct barriers to advanced treatments. Current research highlights the critical need for gender-specific diagnostic, therapeutic, and supportive strategies to optimise care outcomes.
- In the realm of health and wellness, new evidence suggests that women with Parkinson's disease may exhibit unique health-and-wellness implications, such as higher rates of inflammation and non-motor symptoms like depression, anxiety, sleep disturbances, fatigue, and pain.
- On the subject of treatment patterns, women with Parkinson's disease might require tailored therapeutic strategies due to factors such as lower body weight, different drug metabolism, and higher rates of certain medical-conditions, like depression, which could affect the efficacy of medications like levodopa.
- To address these gender-based differences in PD, ongoing research is focusing on women's health, exploring various factors such as differences in motor unit behavior, pharmacological response, and neuropsychiatric impact, with the ultimate goal of developing more gender-specific wellness plans and addressing social support barriers to care and treatment.
