Differences in Parkinson's disease manifestation between genders: a scrutiny of gender-based discrepancies in Parkinson's illness.
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Parkinson's disease (PD) is a neurological disorder that affects nearly 1 million Americans, with over 400,000 women currently living with the condition. However, men are 1.5 times more likely to be diagnosed with PD than women, a trend that is expected to persist, with the number of individuals living with PD projected to reach 1.2 million by 2030.
Despite the higher incidence in men, women tend to have faster disease progression, higher mortality, and different symptom profiles compared to men. Women often experience a faster progression and higher mortality, while men have higher prevalence rates. Differences in motor unit behavior have been observed between sexes, suggesting distinct physiological manifestations of PD in men vs. women. Biologically, differential methylation of PD-related genes occurs by gender, with significant differences observed in the MAPT gene in men and the SNCA gene showing gender-specific methylation differences in women.
Women face more barriers accessing care and diagnosis, which can delay recognition and treatment initiation. They are woefully underrepresented in Parkinson's clinical trials and research, a gap that needs to be addressed to better understand the disease in women and improve care. Women may manifest symptoms of PD at an earlier age, and they experience more pain than men and are more susceptible to mental health symptoms like anxiety, depression, and disrupted sleep before experiencing motor symptoms.
The effectiveness of levodopa, a first-line solution for managing PD symptoms, seems to be less for women. Hormonal differences may impact treatment responses and disease pathways differently in men and women, necessitating tailored treatment approaches to better account for these biological and symptomatic differences.
Environmental and occupational exposures, such as those associated with traditionally male-oriented high-impact sports, have been linked to an increased risk of developing Parkinson's. Exposure to toxic substances like polychlorinated biphenyl (PCB) and trichloroethylene, commonly used in industrial occupations, is believed to play a role in the development of Parkinson's.
In the US, paraquat, a highly toxic herbicide, is heavily utilized in agriculture, requiring training and licensing for handling. Paraquat is associated with Parkinson's and is banned in 32 countries, including China and the EU. In 2018, California used 30% of the total quantity of paraquat used in the US and had the highest rate of Parkinson's diagnosis that year. The Environmental Protection Agency (EPA) downplays the potential for paraquat to cause Parkinson's and recently reapproved it until 2035.
Despite these challenges, women are less likely to receive deep brain stimulation surgery, despite reporting better outcomes. More efforts are required to increase the inclusion of women in Parkinson's clinical trials and research to better understand the disease in women and improve care. Improved diagnostic vigilance and therapeutic optimization in females with PD are crucial to address the faster progression and higher mortality rates observed in women.
In conclusion, gender affects Parkinson’s disease through genetic/epigenetic mechanisms, risk factors, clinical manifestations, and treatment responses, necessitating greater attention to sex-specific research and personalized care strategies. Understanding and addressing these gender differences will lead to improved care for all individuals living with Parkinson's disease.
- The medical-conditions associated with Parkinson's disease, such as inflammation, pain, anxiety, depression, and disrupted sleep, can vary significantly between men and women, primarily affecting women in terms of faster disease progression and higher mortality.
- Considering the distinct physiological manifestations of Parkinson's disease in women, the effectiveness of traditional treatments like levodopa might be less for women, highlighting the need for science to explore and develop tailored health-and-wellness solutions that account for these differences.
- With numerous case studies linking exposures to certain toxic substances, such as PCB and trichloroethylene, with an increased risk of developing Parkinson's, and the controversial reapproval of paraquat by the Environmental Protection Agency, initiated discussions about the potential impact of environmental factors on women's health and the importance of wellness research regarding sex-specific risk factors.
