Could hormonal changes worsen my mother’s Parkinson’s symptoms?

Question

Hello doctor,

I hope you are well. I am reaching out regarding my mother, who is 62 and was diagnosed with Parkinson’s disease last year. Recently, her symptoms have been worsening, particularly around her menstrual cycle, which has not yet stopped.

She is currently taking carbidopa-levodopa 25/100 three times daily. However, the tremors in her right hand intensify just before her period begins. Her walking has become very unsteady. She experienced two falls last month and is now fearful of going out alone. Muscle rigidity has also made everyday tasks, like buttoning her clothes or holding a cup, extremely difficult.

Her neurologist recently increased her medication, but this has led to involuntary movements that resemble dancing, which frightens her grandchildren. She is also experiencing prolonged constipation and disrupted sleep, including acting out her dreams at night. Additionally, her blood pressure has been consistently high, around 160/90 mmHg, and I am concerned about potential interactions with her medications.

Could hormonal changes be contributing to the worsening of her Parkinson’s symptoms?
What strategies or adjustments could help her regain more independence and improve her quality of life?

Thank you very much for your guidance.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Changes in estrogen levels can sometimes make Parkinson's symptoms worse in women, especially during their periods. This is because estrogen levels can affect dopamine routes in the brain. The "dancing" moves you described are probably dyskinesias, which can happen when you take more Levodopa.

Some of the most common non-motor symptoms of Parkinson's are constipation, REM sleep behavior disorder (where people act out their thoughts while they sleep), and high blood pressure. Each of these should be treated separately.

Some management methods are:

Changing the timing of meds or adding new Parkinson's drugs can help keep symptoms from changing.
Using bowel routines to get rid of constipation.

How to treat sleep problems

Carefully keeping an eye on and controlling blood pressure, especially if taking a lot of different medicines
Physiotherapy can also help improve your balance and gait, and occupational therapy can make your daily jobs safer and easier. Coordinating her care with her doctor and maybe a gynecologist to deal with changes caused by her periods can help her become more independent and improve her quality of life as a whole.

I hope this helps.

Thank you.