title: Hysterectomy, menopause, and estrogen use preceding Parkinson's disease: an exploratory case-control study.
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 (< or = 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.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Benedetti
authors.forename: D M
authors.initials: DM
authors.lastname: Maraganore
authors.forename: J H
authors.initials: JH
authors.lastname: Bower
authors.forename: S K
authors.initials: SK
authors.lastname: McDonnell
authors.forename: B J
authors.initials: BJ
authors.lastname: Peterson
authors.forename: J E
authors.initials: JE
authors.lastname: Ahlskog
authors.forename: D J
authors.initials: DJ
authors.lastname: Schaid
authors.forename: W A
authors.initials: WA
authors.lastname: Rocca
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000172:deficiency*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008498:Medical Record Linkage; D008594:Menopause, Premature; D008875:Middle Aged; D008910:Minnesota; D010300:Parkinson Disease / Q000209:etiology*; D012307:Risk Factors
chemical_list: D004967:Estrogens