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Hysterectomy, menopause, and estrogen use preceding Parkinson's disease: An exploratory case-control study

Authors

  • Maria D. Benedetti MD, MSc,

    1. Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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    • Dr. Benedetti conducted this study while on leave from the Department of Neurology, University of Verona, Italy.

  • Demetrius M. Maraganore MD,

    1. Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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  • James H. Bower MD,

    1. Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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  • Shannon K. McDonnell MS,

    1. Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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  • Brett J. Peterson BS,

    1. Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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  • J. Eric Ahlskog PhD, MD,

    1. Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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  • Daniel J. Schaid PhD,

    1. Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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  • Walter A. Rocca MD, MPH

    Corresponding author
    1. Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
    2. Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
    • Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905

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  • Presented in part at the 5th International Congress of Parkinson's Disease and Movement Disorders; New York, NY, October 1998.

Abstract

We studied the association of Parkinson's disease (PD) with type of menopause (natural or surgical), age at menopause, and postmenopausal estrogen replacement therapy using a case-control design. We used the medical records-linkage system of the Rochester Epidemiology Project to identify 72 women who developed PD in Olmsted County, MN, during the twenty years 1976–1995. Each incident case was matched by age (± 1 year) to a general population control subject. We collected exposure data through review of the complete medical records of cases and control subjects in the system. PD cases had undergone hysterectomy (with or without unilateral oophorectomy) significantly more often than control subjects (odds ratio [OR] = 3.36; 95% confidence interval [CI] = 1.05–10.77). In addition, PD cases had experienced early menopause (≤ 46 years) more commonly than control subjects (OR = 2.18; 95% CI = 0.88–5.39). Finally, PD cases had used estrogens orally or parenterally for at least 6 months after menopause less frequently (8%) than control subjects (14%; OR = 0.47; 95% CI = 0.12–1.85). However, the findings for early menopause and estrogen replacement therapy were not statistically significant. Despite the limited sample size of this exploratory study, we hypothesize that there is an increased risk of PD in conditions causing an early reduction in endogenous estrogen. This hypothesis needs to be confirmed in a larger study. © 2001 Movement Disorder Society.

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