Sunday, October 6, 2013

Marla Ahlgrimm: Estrogen May Lessen Risk of Parkinson’s Disease

Q: What is Parkinson’s disease?

Marla Ahlgrimm:  Parkinson’s disease is the result of cell degeneration in the brain, which short-circuits control centers that direct movement.

Q: What are the symptoms? 
Marla Ahlgrimm:  Parkinson’s symptoms can include tremors or shaking, rigidity or stiffness, difficulty with balance and slowed movement.

Q: What causes the cell degeneration? 
Marla Ahlgrimm:  It is not known why cells deteriorate.

Q: Is Parkinson’s a common ailment? 
Marla Ahlgrimm:  It is the second most common neurodegenerative disease, after Alzheimer’s. Approximately 1.5 million Americans suffer from Parkinson’s disease.

Q: What age group does it affect? 
Marla Ahlgrimm:  The condition usually presents itself after the age of 60, although approximately 15 percent of people diagnosed are under the age of 60.

Q: Who is most susceptible to the disorder, men or women? 
Marla Ahlgrimm:  More men suffer from Parkinson’s disease than women. Evidence suggests that estrogen may offer some protection against this disorder.

Q: How was that correlation made? 
Marla Ahlgrimm:  A study conducted at the Mayo Clinic found that women who undergo hysterectomies are at a three times increased risk of developing Parkinson’s disease because of estrogen loss.

Q: Did a hysterectomy have an effect on a woman’s risk factor? 
Marla Ahlgrimm:  Women who progressed through menopause naturally and then received estrogen therapy afterward had a 50 percent reduced risk of developing the disease.

Q: Does this mean that women should not have hysterectomies? 
Marla Ahlgrimm:  There was not enough evidence provided by the study to justify making it a major consideration in a woman’s decision about physician-recommended hysterectomy.

Q: When will it become an accepted part of hysterectomy evaluations? 
Marla Ahlgrimm:  Further investigation is needed on the role of estrogen in preventing Parkinson’s disease before it will be deemed reliable enough to be a determining factor in any decisions about hysterectomies.

Q: Hysterectomies aside, where does estrogen fit in the natural progression of a woman’s reproductive years? 
Marla Ahlgrimm:  Studies have shown that women who have more years of fertility—the time from first menstruation to menopause—have a lower risk of developing Parkinson’s disease.

Q: Is there a specific time range associated with those beneficial reproductive years? 
Marla Ahlgrimm:  A recent study found that women who had a fertile lifespan of more than 39 years had an approximately 25 percent less risk of developing Parkinson’s compared to those women whose fertile time was shorter than 33 years.

Q: Did pregnancy have any effect on test results? 
Marla Ahlgrimm:  Data revealed that women who had four or more pregnancies were about 20 percent more likely to develop Parkinson’s disease than women who had three or fewer pregnancies.

Q: Is there an explanation for that discrepancy? 
Marla Ahlgrimm:  One explanation is that the postpartum phase subtracts from a woman’s total fertile lifespan because, typically, estrogen levels are lower during that time.

Q: Does this mean that postmenopausal women should take hormone replacement therapy (HRT) for the rest of their lives? 
Marla Ahlgrimm:  Studies found that women who were taking HRT did not have a lower risk for Parkinson’s, so data does not support exogenous hormone treatment solely to prevent Parkinson’s.

Q: If HRT is a good thing, what would it hurt to continue taking it anyway? 
Marla Ahlgrimm:  Although helpful in many ways, HRT has been shown to increase a person’s risk for both dementia and stroke.

Q: What is the final verdict for HRT—is it good or bad for the brain? 
Marla Ahlgrimm:  More research into estrogen’s effects on the brain is required. A patient and doctor should discuss the pros and cons of HRT before proceeding with treatment.

Q: So, HRT or estrogen replacement is not a cure for Parkinson’s disease? 
Marla Ahlgrimm:  There is currently no cure for Parkinson’s, although medications or surgery can ease symptoms of the disease.