Research overview
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BackgroundParkinson's disease (PD) affects both sexes, but there are notable differences in its clinical manifestations and management in women.ObjectiveThis study aimed to compare variations in sex and thyroid hormone levels and menstrual factors between postmenopausal women with and without motor complications (PWP-MC and PWP-nMC, respectively) and analyze their correlations with motor complications.MethodsNinety-five Postmenopausal Women with Parkinson's Disease (PWP) provided data on age at menarche, age at menopause, menstrual cycle duration (interval between cycle starts (days)), total years of menstruation (menopausal age - age at menarche), thyroid disease history, and gynecological surgical history. Six sex hormones and seven thyroid function indicators were measured, followed by an analysis of the relationships among sex hormone levels, thyroid function, menstrual factors, clinical characteristics, and disease severity in PWP. The effects of sex hormones and menstrual factors on motor complications in PWP were also investigated.ResultsThe results revealed several key findings: (1) PWP-MC exhibited lower serum prolactin levels than PWP-nMC (p r = -0.208, p = 0.043). (3) There were no statistically significant differences in age at menarche, age at menopause, menstrual cycle duration, menstruation duration (Days of active bleeding per cycle), or total years of menstruation between PWP-MC and PWP-nMC (p > 0.05). (4) In PWP, age at menarche was negatively correlated with Mini-Mental State Examination (MMSE) scale scores (r = -0.264, p = 0.01) and Montreal Cognitive Assessment (MoCA) scale scores (r = -0.297, p = 0.004); total years of menstruation were positively correlated with MoCA scale scores (r = 0.278, p = 0.006); menstrual cycle duration was negatively correlated with Unified Parkinson's Disease Rating Scale, Part III (UPDRS-III) scores (r = -0.246, p = 0.016) and Hoehn-Yahr (H-Y) stages (r = -0.236, p = 0.021); and menstruation duration was positively correlated with HAMA (r = 0.215, p = 0.036) and Non-Motor Symptoms Scale (NMSS) scores (r = 0.214, p = 0.037). (5) In PWP-MC, age at menopause and total years of menstruation were positively correlated with Hamilton Depression Rating Scale (HAMD) scores (r = 0.335, p = 0.043; r = 0.352, p = 0.033, respectively); menstruation duration was negatively correlated with UPDRS-III scores (r = -0.362, p = 0.028) and positively correlated with HAMD (r = 0.329, p = 0.047) and HAMA (r = 0.451, p = 0.005) scores; and menstruation duration was positively correlated with NMSS (r = 0.325, p = 0.050) scores. (6) In PWP-nMC, age at menarche was negatively correlated with MMSE (r = -0.332, p = 0.011) and MoCA (r = -0.296, p = 0.024) scores; total years of menstruation were negatively correlated with UPDRS-III (r = -0.287, p = 0.029) scores and positively correlated with MMSE (r = 0.316, p = 0.016) and MoCA (r = 0.337, p = 0.010) scores. (7) Compared with PWP-nMC, PWP-MC had lower serum triiodothyronine levels (p p r = -0.344, p = 0.037) and H-Y stages (r = -0.445, p = 0.005); free triiodothyronine (FT3) levels were negatively correlated with H-Y stages (r = -0.476, p = 0.003); and free thyroxine (FT4) levels were negatively correlated with UPDRS-III scores (r = -0.422, p = 0.009) and H-Y stages (r = -0.365, p = 0.026).ConclusionThese findings suggest that the occurrence of motor complications in PWP may be correlated with prolactin, T3, and FT3 levels. Additionally, attention should be given to thyroid function and serum T3, T4, FT3, and FT4 levels in PWP, as lower levels may be associated with more severe motor symptoms, higher H-Y stages, and poorer cognitive function. Furthermore, older age at onset was inversely associated with motor complications in PWP, whereas a longer disease duration and higher NMSS score are risk factors.
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