Estrogens and Parkinson's disease

There is substantial evidence that estrogens modulate the activity of dopamine in the extrapyramidal system. However, there is conflicting data as to the exact mechanism of estrogen's effects. The majority of clinical reports support an antidopaminergic effect of estrogens on Parkinsonian symptoms. Generally, Parkinsonism worsens with estrogen therapy. We report a case of improvement in Parkinsonian symptoms in a premenopausal patient when placed on leuprolide acetate. The pharmacologic menopause induced by leuprolide acetate leads to a hypoestrogenic state. We hypothesize that the decrease in estrogen improves Parkinson's disease symptoms via the relief of its antidopaminergic effects on the nigrostriatal pathway.