John: After Alzheimer's disease,
Parkinson's is the second-most
common neurodegenerative
disorder in the United States.
It's a diagnosis nearly 90,000
Americans get every year.
But, as Ali rogin tells us, it
exhibits its symptoms
differently in women than in
men.
Ali: Parkinson's disease damages
or kills nerves in the brain,
causing muscle stiffness,
tremors and other symptoms that
worsen over time.
And while it's more common in
men than women, women are more
often misdiagnosed or diagnosed
late.
And sometimes women experience
symptoms and respond to
treatment differently than men.
Joining me to discuss is Sonia
Mathur, a Parkinson's disease
advocate and family physician.
Dr. Mathur, thank you so much
for joining us.
As you've described it to me,
Parkinson's disease is really
more of a spectrum of neurogenic
neurodegenerative disorders more
than any one ailment.
So with the understanding that
it's not a monolith, can you
describe what some of the most
common symptoms of Parkinson's
disease are?
Dr. Mathur: Parkinson's disease
is um the second most common
neurological disease behind
dementia, but it's the fastest
growing of the neurological
illnesses.
And as you mentioned, is
neurodegenerative, Progressive,
relentless, without a cure.
And the symptoms can sort of be
divided into two groups.
The motor symptoms, those are
things like tremor and slowness
of movement and stiffness and
falls.
Non-motor symptoms can be
anything from head to toe,
including hair and skin changes,
fatigue, sleep issues,
constipation, a variety of
symptoms.
Ali: How is it that men and
women experience these symptoms
differently?
Dr. Mathur: Women are more
tremor dominant.
We have more facial masking and
more restless leg syndrome.
When it comes to non-motor
symptoms, we tend to suffer more
from mood issues such as
anxiety, depression, sleep
disturbances compared to our
male counterparts.
We also experience more fatigue,
pain and urogenital symptoms
such as urinary dysfunction and
incontinence.
And what's even more is that we
know that the severity impact of
these symptoms varies according
to the hormonal status of the
woman, for example, throughout
her menstrual cycle or with
menopause, for example.
We believe that the longer that
you are exposed to estrogen
through your life, that that may
help to prevent or to protect
you from getting something like
Parkinson's disease.
But we just don't have the
answers.
Historically, most research
participants were white, older
gentlemen, so a lot of our
treatment guidelines came from
that research were based on a
result of a small set of
population that's actually
affected by this disease,
because the stereotype is still
there today that it affects
white older gentlemen, as
opposed to the fact that this
disease really knows no
boundaries in terms of age,
gender, race, geographical
borders.
Ali: And you yourself were
diagnosed with what's known as
young onset Parkinson's at age
28.
What was that experience like
for you getting diagnosed and
how did you come to understand
that that's what you had?
Dr. Mathur: I basically noticed
an intermittent tremor in my
right pinky finger, and I just
completed my residency in family
medicine, and was expecting my
first daughter.
And my husband, who's also a
physician, said, I had better go
get it checked out.
And instead of getting the news
that I had hoped, I was instead
diagnosed with young onset
Parkinson's disease at the age
of 28.
And that was almost 24 years
ago.
And the disease continued to
progress.
So much so that I had to
actually stop my clinical
medical practice unfortunately
and instead devoted my life to
words -- advocacy, education and
research in Parkinson's disease.
The impact of this disease is
really extremely disabling.
It affects you, not only
physically, but mentally,
socially, emotionally.
Relationships get affected and
it's pretty unpredictable in
terms of this disability.
Your symptoms and response to
medication can really vary day
by day, hour to hour.
And that's sort of what I'm
experiencing now as well.
Ali: And speaking of that
unpredictability, are there any
symptoms, any changes that women
should look out for if they
think potentially they may be
experiencing Parkinson's disease
symptoms?
Dr. Mathur: The issue with young
onset Parkinson's disease in
general and women in particular
is that we often present with
nonspecific symptoms.
Mine was a little bit unusual in
that I had the tremor right
away.
A lot of women, or men for that
matter, in young onset
Parkinson's, will present with,
you know, shoulder pain or
slowness of movement, not
swinging their arm, loss of
smell, constipation, depression,
what we call our rem sleep
behavior disorder, which is
acting out your dreams and
moving during sleep.
And the other problem with
diagnosing women or men in this
younger age is the fact that not
only is symptoms nonspecific,
but physicians also are not of
the mindset that this happens in
younger people.
They're still on the lookout for
it in older people, and
particularly men.
Ali: To that point, are there
any advancements in the study of
this that give you hope?
Dr. Mathur: It's definitely
improving.
Researchers are much more aware
of the need to include
underrepresented populations in
general in their work.
We need to do research that are
inclusive of women and our
unique genetics, our unique
hormonal status.
The research that is out there
currently is lacking in these
areas.
For example, I mentioned that we
think that there may be a
neuroprotective role for
estrogen.
When it comes to the timing of
estrogen exposure when's the
, best to start something like
hormone replacement therapy?
What type of hormone replacement
therapy for how long?
What about oral contraceptive
pills?
We know that women report that
their Parkinson's symptoms tend
to get worse just prior to
menstruation, sometimes during
it as well.
What is the best way to manage
those fluctuations?
That's something we don't know
yet.
How does pregnancy affect the
trajectory or progression of
your Parkinson's or does it?
There's so many unanswered
questions that affect women
uniquely.
And I want to always stress that
this this type of research is
not only just important for
women, but can benefit the whole
Parkinson's community because it
increases our general
understanding or knowledge of
this disease, which will benefit
everybody.
It's really a win win situation
in that way.
Ali: Dr. Sonia Mathur, family
physician and Parkinson's
disease advocate.
Thank you so much for joining
us.
Dr. Mathur: Thank you so much
for having me.
♪♪
it's John: It's been an exciting