Association Between Menopausal Hormone Therapy and Risk for Parkinson’s Disease

Abstract

Background: The relationship between menopausal hormone therapy (MHT) and risk of Parkinson’s disease (PD) remains controversial. Objective: This nationwide population-based cohort study investigated the association between MHT and PD development. Methods: Data from the National Health Insurance System of South Korea from 2007 to 2020 were used. The MHT group included women who underwent MHT for the first time between 2011–2014, while the non-MHT group included women who visited a healthcare provider for menopause during the same period but never received hormonal therapy. We used propensity score matching (1 : 1) to adjust for potential confounders, and Cox regression models to assess the association between MHT and PD. Results: We selected 303,260 female participants (n = 151,630 per MHT and non-MHT groups). The median age of the participants was 50 (48–54) years, and the follow-up period lasted 7.9 (6.9–8.9) years. Cox regression analysis revealed an increased risk of PD with MHT (hazard ratio [HR] 1.377, 95% confidence interval [CI] 1.184–1.602), particularly with tibolone (HR 1.554, 95% CI 1.297–1.861) and estrogen alone (HR 1.465, 95% CI 1.054–2.036). Tibolone and estrogen alone were linked to PD within three years; however, no association was observed after three years. In contrast, the use of combined estrogen-progesterone was linked to a higher risk of PD, which increased with the duration of MHT (HR 1.885, 95% CI 1.218–2.918 for over five years). Conclusions: This study demonstrated that the MHT is closely associated with the risk of PD in a regimen- and duration-specific manner.