Background: In women of reproductive age with Parkinson's disease (PD), changes in motor symptoms during the menstrual cycle and pregnancy were initially reported in the late 1980s, but subsequent research has been scarce. There are currently no therapeutic guidelines available to support the clinical management of hormone-related PD symptom fluctuations in women.
Objectives: In this study, we aimed to increase knowledge about this understudied topic by exploring the relationship between PD presentation and hormonal stages unique to women of reproductive age.
Methods: We took advantage of a Norwegian longitudinal PD study and conducted cross-sectional structural interviews of 17 female early-onset PD (EOPD) participants aged 21-49 years at motor onset. The interviews investigated PD presentation and treatment during the menstrual cycle, pregnancy, breastfeeding, the postpartum period and transition to menopause.
Results: Menstrual cycle-related deterioration in PD symptoms was reported by nine out of 15 women (60%) prompting specific therapeutic measures in five out of nine (55.6%). Six women experienced a temporal overlap between pregnancy and/or the postpartum period. Among these, four women (66.7%) reported either onset of PD symptoms or worsening of existing PD symptoms during pregnancy, which for some was partially transient.
Conclusions: Changes in PD symptoms during the menstrual cycle, pregnancy and the postpartum period are common in women with EOPD, calling for an increased awareness among both patients and clinicians. Our results highlight the unmet need of evidence-based consensus guidelines and tailored clinical care for this small but vulnerable subgroup of PD patients.
Keywords: Parkinson's disease; menstrual cycle; pregnancy; women's health.
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