Carlos Singer, MD, University of Miami
Carlos Singer, MD, University of Miami
As Parkinson’s disease (PD) progresses over time, managing movement symptoms with standard medications can become more challenging. When this happens, people often explore other treatment options. These include deep brain stimulation (DBS), pump medications and procedures such as focused ultrasound.
This guide explains how these treatments work, why they are used and what to know before or after starting them. It aims to answer common questions and support informed conversations with your care team.
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Carlos Singer, MD, University of Miami
If managing your Parkinson’s has become more challenging than it used to be, the book Managing Parkinson’s Mid-Stride: A Treatment Guide to Parkinson’s is for you. This audiobook explains why symptoms may get better and worse throughout the day and how to treat and cope with them. Find answers and learn tips and stories that can help.
About 75 percent of people with PD experience changes in speech and voice at some time during the course of the disease. These changes usually come on gradually and can vary from mild to severe.
Problems communicating can lead to feelings of frustration, depression and withdrawal. Learning how PD affects communication and what you can do about it can help you better cope with problems that you might experience.
Many of these problem areas can be improved with PD-specific exercise programs, devices that help communication and strategies/techniques that can help you and your conversation partners to communicate more effectively and efficiently.
This book is only available digitally to view, download or print. It is also available in Kindle and audiobook formats.
Consider this your practical guide for achieving good sleep health. This book addresses healthy sleep, sleep changes due to aging and sleep problems due to Parkinson’s, as well as diagnosis, treatment and coping strategies.
This book is only available digitally to view, download or print. It is also available in Kindle and audiobook formats.
La siguiente lista de preguntas le puede ayudar a prepararse para su pr6xima consulta. Piense con anticipaci6n en lo que le gustaria preguntarle a su medico de acuerdo a sus prioridades personales.
Parkinson’s disease (PD) affects an estimated 10 million men and women worldwide. Women have been shown to have a lower risk of developing PD, and research suggests that there are differences in the way that men and women experience Parkinson’s. Studies indicate that women diagnosed with PD report different symptoms, more often report side effects and changes in their symptoms throughout the day (“fluctuations”) and receive lower quality healthcare than men.
What explains these differences? Based on the evidence so far, researchers can make some educated guesses. Some differences may have to do with biology—the way men’s and women’s bodies react to the disease or to therapies. Others may be due to lack of access to healthcare or to unintended differences in the way women are treated for PD compared to men.
Studies conducted around the world, and across race, ethnic and age groups, support the finding that women overall have a lower risk of developing PD than men, but we still don’t know why. Environmental factors could explain this lower risk. It may be that women are less likely than men to be exposed to pesticides or heavy metals, or to sustain a head injury—all of which may increase a person’s PD risk.
Biological differences between women and men may also play a role. Estrogen, the female sex hormone, may protect the brain against PD, but little is known about its influence. If estrogen is preventative, it may only be helpful at certain levels or for a specific time.
Parkinson’s symptoms vary enormously from person to person. PD symptoms include motor symptoms, like tremor and stiffness, and nonmotor symptoms, like depression and fatigue.
Although women report experiencing some symptoms (including depression) more often than men, research to date has not conclusively shown whether symptoms affect women and men differently. This may be because symptoms vary as much among women as between women and men.
All current treatment options (including medications, surgical options and exercise) address PD symptoms, but they do not slow down or stop the progression of PD. Levodopa, often prescribed as Sinemet, is considered the gold standard therapy for Parkinson’s movement symptoms. However, many people with PD experience changes in the effectiveness of the drug as the disease progresses. And some studies suggest that women are more likely than men to report these fluctuations earlier in the disease course and more frequently overall.
In particular, it seems that women are more likely to have involuntary movements called dyskinesias that occur when levodopa levels are highest in the blood. There are several factors that could be contributing to dyskinesia, including dosage, body weight and age of onset. Lower body weight can affect how medications build up in someone’s system. Lighter people sometimes need a smaller dose of medication to feel its effect. On average, women weigh less than men. If women and men are receiving similar doses, this may explain how levodopa levels are causing dyskinesias.
Physicians have also suggested that they find it harder to fine-tune Parkinson’s medications for women than for men. Women more often experience large swings in symptoms from even small changes in medications or schedules.
Deep brain stimulation (DBS) is an accepted surgical therapy for both men and women whose symptom fluctuations are difficult to control. Yet, even though women are reported to have greater improvement in quality of life after DBS, studies have shown that they are less likely than men to receive this therapy.
Women with PD may face more barriers to quality healthcare and social support than men. Women are less likely than men to be cared for by a Parkinson’s specialist, such as a neurologist or movement disorder specialist, and are also less likely to have a care partner. On the other hand, women with Parkinson’s are more likely to do the following:
All these factors mean that women may not have access to adequate Parkinson’s care.
Research to date on women’s experience of PD underscores the need to focus more on this important part of the Parkinson’s community. Compared to men, women are diagnosed with PD less often, respond differently to current therapies, have less access to and lower use of expert care and are less socially supported. These combine so that women with PD have poorer quality of life than men. Studies that specifically address these issues are needed to improve the lives of all people affected by Parkinson’s.
Una persona recién diagnosticada puede sentirse abrumada. Tómese el tiempo para entender la enfermedad y cómo podrán manejar usted y su familia los cambios físicos y emocionales. ¡No está solo! ¡La Parkinson’s Foundation está aquí para apoyarle!