Expert advice for understanding menopause and neurological health risks

Menopause represents a significant milestone in female health, marked by the permanent cessation of menstrual cycles and a sharp decline in estrogen.

This hormonal shift introduces risks for various conditions, ranging from cardiovascular issues to neurodegenerative disorders.

Gynaecologist Dr Lakshmi Aswathaman, senior consultant at MGM Healthcare, explains that women become particularly vulnerable to Parkinson’s disease during this period. Estrogen plays a vital protective role for dopamine-producing neurons.

Consequently, the reduction of this hormone can increase disease risk or exacerbate motor symptoms and fatigue.

A 2021 study highlighted that later menopause correlates with a lower risk of Parkinson’s due to longer natural estrogen exposure.

How does menopause affect Parkinson's disease?

Hormonal shifts directly influence neurological stability. Dr Aswathaman elaborated on the clinical impact:

• Estrogen decline can cause worsening of motor symptoms and increased "off" times.
• Parkinson’s is a progressive disorder where hormonal changes make management increasingly difficult.
• The drop in hormones typically intensifies the severity of pre-existing symptoms.

Does HRT help?

Hormone replacement therapy (HRT) is traditionally used for menopausal symptoms, but it may also offer neuroprotective benefits.

• HRT can address testosterone deficiencies that overlap with non-motor Parkinson's symptoms.
• Bioidentical estrogens like estradiol have a positive effect on alpha-synuclein, a protein that clumps in many neurological diseases.
• Therapy helps reduce fractures, muscular atrophy, and depressed moods.

Generally, individuals over 50 may benefit from hormone therapy to increase energy and exercise tolerance. This suggests HRT could serve a complementary role in managing complex neurological health.