Unveiling the Role of Sex Hormones and Reproductive Life Factors in Parkinson's Disease

Biological sex shapes the risk, presentation, and progression of Parkinson's disease (PD). Nevertheless, the pathophysiological bases remain poorly understood, and sex-specific and hormonal factors are still insufficiently explored in both research and clinical practice. In the first part of this narrative review, we synthesize the most relevant evidence on sex-specific aspects of PD, including epidemiology, genetic bases, motor and non-motor features, and disease progression. We then explore sex-specific biological underpinnings revealed by translational, neuroimaging, and neurophysiological studies. In the second part, we summarize the roles of sex hormones in PD and of reproductive life factors, from menarche to pregnancy, focusing particularly on women with PD. With this review, we aim to highlight a still underexplored dimension of PD and the importance of systematically considering sex, reproductive life, and sex hormones, from experimental research to clinical care. Recognizing and integrating these factors is essential for achieving more individualized and equitable care.