Lifetime exposure to estrogen and progressive supranuclear palsy: Environmental and Genetic PSP study

Mov Disord. 2018 Mar;33(3):468-472. doi: 10.1002/mds.27336. Epub 2018 Feb 20.


Background: Studies suggesting a protective effect of estrogen in neurodegenerative diseases prompted us to investigate this relationship in progressive supranuclear palsy (PSP).

Methods: This case-control study evaluated the self-reported reproductive characteristics and estrogen of 150 women with PSP and 150 age-matched female controls who participated in the Environmental Genetic-PSP study. Conditional logistic regression models were generated to examine associations of PSP with estrogen.

Results: There was no association between years of estrogen exposure duration and PSP. There was a suggestion of an inverse association between composite estrogen score and PSP that did not reach statistical significance (P = .06). Any exposure to estrogen replacement therapy halved the risk of PSP (odds ratio = 0.52; 95% confidence interval = 0.30-0.92; P = .03). Among PSP cases, earlier age at menarche was associated with better performance on Hoehn and Yahr stage (β = -0.60; SE = 0.26; P = .02) and Unified Parkinson's Disease Rating Scale II score (β = -5.19; SE = 2.48; P = .04) at clinical examination.

Conclusions: This case-control study suggests a protective role of lifetime estrogen exposure in PSP. Future studies will be needed to confirm this association. © 2018 International Parkinson and Movement Disorder Society.

Keywords: case-control study; estrogen; estrogen replacement therapy; parkinsonism; progressive supranuclear palsy.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Case-Control Studies
  • Estrogens / adverse effects*
  • Female
  • Gene-Environment Interaction*
  • Humans
  • Logistic Models
  • Middle Aged
  • North America
  • Self Report
  • Supranuclear Palsy, Progressive / chemically induced*
  • Supranuclear Palsy, Progressive / epidemiology
  • Supranuclear Palsy, Progressive / genetics*
  • Surveys and Questionnaires


  • Estrogens