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Women With Parkinson’s Are Frequently Misdiagnosed

Close to 1 million Americans are affected by Parkinson’s disease (PD), a neurological condition that progressively impacts the brain’s ability to produce dopamine and regulate movement. With an estimated 1.2 million cases by 2030 and an annual rate of 60,000 new diagnoses, medical specialists have increasingly aimed to identify the condition’s root causes and characteristics.    

When analyzing PD’s gender-specific differences, studies found that men have a 1.5 higher rate of diagnoses than women. This evident discrepancy led researchers to more widely consider the implications of gender differentials and how they impact Parkinson’s development in men and women.

How Parkinson’s Affects Women

Despite facing seemingly lower risks, over 400,000 US women are diagnosed with PD. Still, this data is inferred from total Parkinson’s fatalities, which doesn’t account for new cases based on gender and may not always report the precise cause of death. Though research into gender-specific characteristics is fairly limited, the current medical literature provides a few valuable insights regarding PD’s particularities in women. 

Studies have found that the female hormone estrogen likely plays a significant role in neuroprotection, dopamine production, and reducing oxidative stress common in PD. Similarly, longer fertility and later onset of menopause decrease Parkinson’s risks, although women may develop a more benign version of the disease at earlier ages with less pronounced symptoms. 

Conversely, women face distinct social difficulties and tend to downplay the severity of their PD symptoms, leading to psychological distress, delayed or incorrect diagnoses, and later specialist referrals. Due to frequent misdiagnosis, women with Parkinson’s are less likely to benefit from the surgical therapy called deep brain stimulation (DBS), a therapeutic technique that reports better outcomes in women than in men. 

Although Levodopa is the most commonly prescribed Parkinson’s treatment, it’s more suited for male body masses and less effective for women due to their lower body weight and later age of PD onset. In turn, healthcare providers need to tailor female patients’ prescriptions to account for gender differentials.

Man-Made Toxins Are Also at Fault 

Besides known genetic and biological factors, it’s believed that exposure to synthetic toxins also affects Parkinson’s varying expression in men and women. Although many hazardous chemicals like trichloroethylene and polychlorinated biphenyls are heavily restricted, other more widely-used toxic substances face limited to no regulations.    

One such substance is paraquat, a highly toxic herbicide banned in +60 countries due to its connection to Parkinson’s. While facing increasing restrictions internationally, paraquat remains a mainstay in US agricultural practices, with the EPA downplaying the herbicide’s PD risks and even reapproving its use until 2035.

California applied roughly a third of the 4.2 million pounds of paraquat used in the US in 2018 – that same year, it reported 85,100 Parkinson’s diagnoses, the highest number in the country. Moreover, the states with the following highest reported cases of PD, namely Florida (64,000), Texas (52,500), New York (48,000), and Pennsylvania (35,400), also applied large quantities of paraquat.

Nearly 3 million agricultural workers in the US and surrounding farming communities face higher toxic exposure risks due to the overreliance on hazardous pesticides. Men are primarily exposed to paraquat during mixing, application, and cleanup, while women are more prone to exposure during the planting and harvesting phases. Likewise, individuals working with paraquat could inadvertently carry trace amounts indoors on their clothing, footwear, or on their persons.

Awareness of Women-Specific Issues Is Vital for Future Improvements

Due to the mistaken perception of PD as a mainly male-focused risk, similar symptoms are frequently overlooked in women, sometimes taking 61% longer to receive an accurate diagnosis. Additionally, women going through menopause may find that symptoms like anxiety, fatigue, restless sleep, muscle pain, and stiffness overlap with Parkinson’s, increasing the likelihood of misdiagnosis. 

Broader institutional involvement and a higher awareness of gender characteristics are required to improve the condition of women struggling with PD and dispel commonly-held misperceptions that can limit access to treatment. 

Even though PD’s consequences are indiscriminate, women who experience early-to-moderate symptoms also report more pain than men and are more prone to psychological symptoms before any motor dysfunctions become apparent. As such, women that show signs of PD before menopause should monitor their hormonal cycles closely and track the progression of their symptoms.

By also accounting for differing gender variables, healthcare providers need to prescribe more suitable solutions for women dealing with PD’s debilitating effects and offer better access to specialty care or therapeutic options like DBS. Likewise, increasing women-focused research in clinical Parkinson’s studies should be prioritized, as it will allow specialists to uncover further gender-specific risk factors and develop improved treatment options. 

At the same time, the EPA can help lower PD-related risks by applying more scrutiny in their evaluation process and regulating or outright prohibiting the use of toxic pesticides linked to Parkinson’s and other neurological conditions. 

About the Author

Miguel Leyva serves as a Case Manager at Atraxia Law, helping clients injured by hazardous substances gather and organize the information that supports their claims against the liable parties.

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