EAN 2026 | Practical considerations for managing menopause in women with Parkinson’s disease

So, although estrogen has a clear role in Parkinson’s disease and there are relevant interactions between estrogen and dopamine, we do not understand those interactions enough yet. So there are no specific recommendations for the treatment of menopause and postmenopause in women with Parkinson’s disease. In general, the European Society of Endocrinology recommends that, in women after the menopause, in the first 10 years following the natural menopause, the treatment of symptoms is approached holistically, not with a focus solely on menopausal hormonal therapy, but including those in women for whom it is indicated. So the general recommendation is to use menopausal hormonal therapy in women to treat symptoms such as some vasomotor symptoms, for example. It is important to do this in dialogue with our patients. It is our duty to fully inform our patients about all the positive and also the possible negative effects of hormonal therapy. It is also important to inform them that, for example, what might have a high relevance for Parkinson’s disease, woman with Parkinson’s have a heightened risk of osteoporosis, and we do have data that menopausal hormonal therapy is beneficial for osteoporosis prevention. So I think this point is very important because a recent study from the PPMI cohort has shown that women with Parkinson’s have significantly more fall-related injuries, which are due to osteoporosis. So I think that’s an important point in treatment. It is also important to know that, although we don’t have any reliable evidence on menopausal hormonal therapy in women with Parkinson’s, we do not have any evidence that would be showing that it is doing any harm. So I think, in general, the general recommendations of the European Society of Endocrinology can be followed also in women with Parkinson’s disease.

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