EAN 2026 | What is currently understood about the role of hormonal changes in Parkinson’s disease?
Katarina Rukavina, MD, PhD, Movement Disorders Hospital, Beelitz, Germany, discusses the current understanding of the role of hormonal changes in Parkinson’s disease (PD). Dr Rukavina explains the role of estrogen in PD, highlighting key evidence and clinical implications. This interview took place at the 12th Congress of the European Academy of Neurology (EAN) in Geneva, Switzerland.
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Transcript
First of all, our female sex hormones are actually neuroactive steroids. Our female sex hormones have multiple functions that extend far beyond reproduction, especially estrogen. I will focus on estrogen. Estrogen has multiple functions in the brain, especially in regions of the brain, in striatal regions, for example, that are also affected in Parkinson’s disease. Now speaking about Parkinson’s disease specifically, estrogen does modulate the dopaminergic neurotransmission on multiple levels...
First of all, our female sex hormones are actually neuroactive steroids. Our female sex hormones have multiple functions that extend far beyond reproduction, especially estrogen. I will focus on estrogen. Estrogen has multiple functions in the brain, especially in regions of the brain, in striatal regions, for example, that are also affected in Parkinson’s disease. Now speaking about Parkinson’s disease specifically, estrogen does modulate the dopaminergic neurotransmission on multiple levels. We have data from animal studies showing that estrogen actually enhances the production and release of dopamine while at the same time reduces its uptake and breakdown and that it also modulates the sensitivity of dopaminergic receptors. In women of reproductive age, the levels of striatal dopamine fluctuate in line with the hormonal fluctuations in estrogen during the menstrual cycle. So this is a very important association and there are some signals showing that possibly estrogen might have a kind of protective role even in terms of Parkinson’s disease. And we know this from the epidemiological studies because on one side, Parkinson’s is more prevalent in men than in women. Then, for example, there are several studies showing that women with Parkinson’s have a shorter reproductive lifespan, meaning shorter exposure to endogenous estrogen than women who do not have Parkinson’s. So somehow, it seems that in women, our bodies and brains are used to this role of estrogen, and once we lose it, it increases our vulnerability to Parkinson’s disease. And that is particularly evident when this estrogen drop happens abruptly, which is the case in women who undergo surgical procedures such as oophorectomy or hysterectomy; they do have an increased risk of Parkinson’s disease as well. So it is a really exciting area that we need to explore further.
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