Women with EOPD experience unique, gender-specific challenges that affect symptom management and quality of life. Hormonal fluctuations associated with the menstrual cycle may alter symptom severity and treatment response, yet these experiences remain under-studied.

Of 3,315 women who completed the survey, 469 (14.2%) were premenopausal at the time of PD diagnosis and 95 (3.4%) were premenopausal at the time of survey completion. Among premenopausal respondents, 53 (55.8%) reported menstrual cycle-related changes in PD symptoms, most commonly (95.7%) within the week before menstruation. The most frequently worsened motor symptoms were OFF time (71.7%), stiffness (56.6%), tremor (56.6%), slowness (50.9%), and dystonia (45.3%). Commonly worsened non-motor symptoms included fatigue (47.2%), insomnia (43.4%), decreased speed of digestion (34.0%), apathy (32.1%), trouble thinking (30.2%), pain (28.3%) and urinary symptoms (22.6%). Over half (N=48,52.9%) of respondents reported reduced medication effectiveness the week before menstruation, and among those using menstrual hygiene products, 47.6% reported that PD symptoms made their use more difficult. Only 22 (24.2%) had discussed medication adjusts for worsened symptoms during their menstrual cycle with their healthcare provider.

Menstrual cycle-related fluctuations in PD symptoms are common among women with EOPD. These findings underscore the importance of considering hormonal influences when managing PD symptoms in premenopausal women.