Why Men Are More Prone to Developing Parkinson's Disease
Male sex is an independent risk factor for Parkinson's disease, with men having a significantly higher risk of developing this neurodegenerative condition compared to women. 1
Biological Factors Contributing to Male Predominance
Hormonal Influences
- The protective effect of estrogen in women may explain part of the gender disparity
- Testosterone may influence dopaminergic pathways differently than estrogen
- Hormonal differences affect neuroinflammatory responses and oxidative stress mechanisms
Genetic Factors
- Genetic susceptibility appears to play a role in approximately one-third of all Parkinson's disease cases 2
- Some genetic variants may have sex-specific expression patterns
- Mitochondrial dysfunction, which has been implicated in Parkinson's disease, may manifest differently between sexes 2
Environmental Exposure Patterns
- Men may have higher occupational exposure to neurotoxins and pesticides, which are associated with increased Parkinson's disease risk 3, 4
- Rural living and pesticide exposure increase risk of developing Parkinson's disease 2
- Different patterns of exposure to environmental risk factors between men and women may contribute to the disparity
Clinical Manifestations of Gender Differences
Symptom Presentation
- Men with Parkinson's disease are more likely to develop medication-refractory tremor compared to women 5
- A study of deep brain stimulation candidates found that 93.5% of patients who underwent DBS for medication-refractory tremor were men, while patients who had DBS for motor fluctuations more closely approximated the general gender distribution of Parkinson's disease 5
Disease Progression
- The course of disease may differ between men and women
- Men may experience more rapid progression of certain motor symptoms
- Women may have different responses to dopaminergic therapies
Protective Factors
Several factors have been identified that may reduce the risk of developing Parkinson's disease:
- Physical activity - the only currently justifiable intervention for primary prevention 3
- Smoking (nicotine) - consistently identified as having a protective association 3, 4
- Caffeine consumption - associated with reduced risk 3, 4
- Higher serum urate concentrations 3
- Use of ibuprofen and certain other common medications 3
Clinical Implications
Understanding the gender disparity in Parkinson's disease has important implications:
- Earlier screening and monitoring may be warranted in men with risk factors
- Sex-specific approaches to treatment may be beneficial
- Prevention strategies could be tailored differently for men and women
- Research into neuroprotective interventions should consider sex as an important variable
Future Directions
Current research is investigating whether some of the identified protective factors might serve as neuroprotective interventions for individuals with early Parkinson's disease, particularly regarding nicotine, caffeine, and urate 3. As our understanding of the prodromal phase improves, it may become possible to identify Parkinson's disease before motor symptoms appear and implement preventive measures.
Physical activity remains the most evidence-based intervention for primary prevention of Parkinson's disease, with benefits extending to several other chronic diseases as well 3.