Restriction lift date: 2026-09-30
Fluctuations in Parkinson's disease symptoms and effectiveness of medications over the menstrual cycle
Loading...
Files
Date
2026-01-31
Authors
Moore, Sarah C.
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
INTRODUCTION: The sex of a person with Parkinson's disease (PD) impacts the degree and features of disability they experience, yet women with PD (WwPD) remain understudied. Published literature on menstruation, pregnancy, and menopause in WwPD suggests a pattern where estrogen decline seems to correlate with worsened PD symptoms or higher disease risk. Current understanding of menstrual-related PD symptom fluctuations is limited, highlighting the need for prospective longitudinal research. AIMS: The primary aim was to compare PD symptoms and medication patterns between menstruating and postmenopausal women, to investigate the effects of HRT and contraceptives on these, and to examine whether PD symptoms fluctuate across menstrual cycle phases, through prospective longitudinal data collection. A secondary aim was to assess the usability and user experience of a mobile application designed for WwPD to track symptoms, medications, and menstrual cycles.
METHODS: Women aged >18 years with PD diagnoses were recruited through PD associations and support groups to complete REDCap surveys capturing demographics, symptoms, and medications. Of n=493 participants completing the initial survey (n=125 menstruating, n=283 postmenopausal), n=131 used the mobile app for longitudinal symptom, medication, and menstrual cycle tracking, with n=40 completing a follow-up survey. Statistical analysis was completed using R version 4.4.1.
RESULTS: Initial survey analysis of menstruating (n=125) and postmenopausal (n=283) women revealed significant differences in symptoms between the groups. For motor symptoms, rigidity was higher (p<0.001), whilst postural instability was lower (p=0.007) in menstruating women. For non-motor symptoms, depression/anxiety (p=0.026), pain (p=0.016), and mood swings (p<0.001) were higher, whilst hyposmia (p=0.003) and constipation (p=0.042) were lower in menstruating women. No differences in medication usage were observed between the groups. HRT users aged 50-54 years had lower tremor prevalence (p=0.006) than those who did not use HRT, and contraceptive users had fewer skin problems than non-users . App tracking data from 48 menstruating and 83 postmenopausal participants showed that dyskinesia was higher in menstruating women (p=0.045). Multiple premenstrual syndrome (PMS) related nonmotor symptoms were higher in menstruating women, for example, irritability (p=0.003), crying spells (p=0.014), hot flushes (p=0.007), pelvic cramps (p=0.001), mood swings (p=0.043), increased appetite (p=0.026), and excessive daytime sleepiness (p=0.026). Analysis of menstrual phase in eight women showed no significant differences in motor and non-motor symptom burden across the cycle phases. 5 Assessment of app usability found that satisfaction that varied somewhat across usability categories, ranging from 4.31 to 5.35 on a seven-point scale.
CONCLUSIONS: This study demonstrates consistent differences in both motor and non-motor symptoms between menstruating and postmenopausal WwPD, suggesting hormonal influences on symptom presentation. There were no significant differences in motor and non-motor symptom burden across the phases of the menstrual cycle.
Description
Keywords
Parkinson's Disease , Women with Parkinson's , My Moves Matter , Motor symptom , Non-motor symptom
Citation
Moore, S. 2026. Fluctuations in Parkinson's disease symptoms and effectiveness of medications over the menstrual cycle. MRes Thesis, University College Cork.