GENDER AND LEVODOPA: WHAT A NEW STUDY SAYS ABOUT “WEARING-OFF” AND DYSKINESIA

In a two-year study of people starting levodopa for the first time, women were more likely than men to experience wearing-off (medication benefit fades before the next dose), and Dyskinesia (involuntary movements). These findings support more gender-informed, individualized treatment planning early in Parkinson’s.

Participants included 216 people with Parkinson’s (139 men, 77 women) across 17 movement-disorder centers in Italy. Participants were followed for two years after starting levodopa.

Wearing-off was more common in women: ~65% of women vs ~53% of men by 24 months. Dyskinesia was more common in women: ~14% of women vs ~5% of men. Female gender was the strongest predictor of both outcomes at two years (even after adjusting for age, dose, and other factors). Older age was linked with lower risk of wearing-off. Baseline motor severity modestly increased dyskinesia risk. Starting levodopa dose did not explain the gender differences.

Why Might This Happen?

Researchers point to possible biological and pharmacologic differences (e.g., how levodopa is absorbed and metabolized), along with potential hormonal and genetic factors. The exact reasons aren’t fully known.

What This Means For People Living With Parkinson’s

Monitor early: In the first 1–2 years on levodopa, keep an eye on symptom return before doses (wearing-off) and any new involuntary movements. Report changes promptly: Small adjustments to dose timing, frequency, or adjunct medications may help smooth control. Ask about individualized plans: Especially for women starting levodopa, discuss closer follow-up and tailored strategies with your clinician. Supportive habits matter, so exercise, sleep, and stress management can complement medication plans.

A Note On Scope

Conducted in Italy; results should be replicated in other populations. Some participants did not complete the full 2 years (pandemic-related disruptions), which can influence outcomes.