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The effect of estrogen replacement on early Parkinson's disease.

OBJECTIVE: To determine the effect of estrogen in postmenopausal women with
early PD.

BACKGROUND: The role of estrogen in PD is highly disputed, with some
studies suggesting a prodopaminergic effect and others suggesting an
antidopaminergic effect.

Owing to controversy and the small sample sizes of prior studies, further
investigation is warranted.

METHODS: A retrospective chart review was carried out from a computerized
database of patients at Columbia-Presbyterian, including only women who had
symptoms of presumed PD for less than 5 years and who had not yet been on
L-dopa at their first visit.

Multiple regression was performed to assess the effects of estrogen on
disease, measured by total Unified Parkinson's Disease Rating Scale (UPDRS)
score, as a function of symptom duration, age at onset, education, smoking,
dopamine agonist, and deprenyl use.

RESULTS: Of the women who were not on L-dopa and had PD for less than 5
years at their first visit, 34 were found to have received estrogen at some
time and 104 had never received estrogen.

Excluding the women who had taken dopamine agonists, analysis yielded a
multiple regression coefficient of 0.52 (p < 0.001).

Estrogen use was negatively correlated with UPDRS score; age at onset and
symptom duration were positively correlated (p < 0.05).

CONCLUSIONS: We found a positive association between estrogen use and lower
symptom severity in women with early PD not yet taking L-dopa.

These results indicate that estrogen therapy should not be avoided and may
be beneficial in early PD, at least prior to the initiation of L-dopa.


Neurology 1999 Apr 22;52(7):1417-21
Saunders-Pullman R, Gordon-Elliott J, Parides M, Fahn S, Saunders HR,
Bressman S
Department of Neurology, Beth Israel Medical Center, New York, NY 10003, USA.
PMID: 10227628, UI: 99242167
http://www.ncbi.nlm.nih.gov/

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janet paterson   52 now 41 dx 37 onset  [log in to unmask]
613-256-8340   PO Box 171  Almonte  Ontario  K0A 1A0  Canada
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