Effect of hormone variations and other factors on symptom severity in women with dystonia.
OBJECTIVE
To determine if any relationship exists between the severity of symptoms in women with dystonia and female reproductive hormonal variations.


METHODS
We surveyed 279 women with dystonia seen at Mayo Clinic Scottsdale over a 6-year period (1990-1995), and 204 responded. The women were asked questions regarding their reproductive and menstrual histories and dystonia severity and other questions with an emphasis on possible exacerbating or relieving factors.


RESULTS
Although in the majority of women hormonal influences had no consistent effect on dystonia symptom severity, 26 (41.9%) of 62 premenopausal women noted a change in the severity of their dystonic symptoms in relation to the 3 phases of their menstrual cycle. Other factors that exacerbated dystonia included stress and fatigue, while sleep improved symptoms. Pregnancy, menopause, and hormone replacement therapy had no effect on symptoms.


CONCLUSIONS
Menstrual cycling may result in subjective worsening of dystonia symptoms in some women with dystonia. Further clinical and physiologic evaluation is indicated in such patients, as they may represent an important subgroup of dystonic patients that might yield some clues to the pathophysiology of dystonia and to improved treatment strategies.
Gwinn-Hardy
K A
KA
Department of Neurology, Mayo Clinic Scottsdale, Ariz. 85259, USA.
Adler
C H
CH
Weaver
A L
AL
Fish
N M
NM
Newman
S J
SJ
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001334:Automobile Driving; D004421:Dystonia / Q000097:blood* / Q000503:physiopathology; D015444:Exercise; D005221:Fatigue / Q000097:blood; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008593:Menopause / Q000097:blood; D008597:Menstrual Cycle; D008875:Middle Aged; D011247:Pregnancy / Q000097:blood; D012720:Severity of Illness Index; D012890:Sleep; D013315:Stress, Psychological / Q000097:blood
D012739:Gonadal Steroid Hormones