Sex- and gender-related differences in Parkinson’s disease: a narrative review

This narrative review focuses on sex-and gender-related differences in Parkinson’s disease (PD). Some studies reported differential patterns in epidemiology, disease risk factors, clinical presentation, and treatment response in men and women. Indeed, there is increasing evidence that PD is more frequent in men, although with progression of disease, women seem to develop more therapy-related complications, such as dyskinesias, showing how therapy response may be sex-dependent. Differences in clinical phenotype supported a different pathogenesis of PD between men and women. Several authors showed that genetic and environmental risk factors may be different in men and women. Estrogens could play a key role in the sex differences in PD. Some studies reported that estrogen activity probably has a protective effect on dopamine neurotransmission. Raising awareness of sex-and gender-related differences in PD may help improve PD management.