“Neurology and Women”: A book for the management of neurological diseases

2023-11-27 10:14:30

The Spanish Society of Neurology (SEN) has published the book “Neurology and Women” which aims to try to improve the management of neurological diseases in women.

There are anatomical differences between the female and male brains that become plausible in the regulation of body temperature in men and women, hunger and thirst, emotional processing, language skills and executive functions… In addition, The life expectancy of women currently exceeds that of men by five years, making them more susceptible to suffering from neurodegenerative diseases.

“From the Board of Directors of the SEN The creation of a complete work on Neurology and the female sex was devised, until now non-existent in Spain, with the aim of it being a helpful tool in clinical care practice. This book, which represents an update in the management of the most prevalent neurological pathologies, analyzes in detail all the particularities that each of them have in women, emphasizing aspects as important as those related to pregnancy, childbirth, menopause or treatments. hormonal,” explained Dr. José Miguel Láinez, president of the SEN.

In an interview given to EFEsalud, Dr. Susana Arias Rivas, who is part of the editorial committee of the work and is a member of the SEN, tells us about this initiative.

The female and male brains have anatomical differences. EFE/Enric Fontcuberta

“Neurology and women”

The work is divided into chapters according to the typology of each neurological disease. Thus, we find cerebrovascular diseases, migraine, demyelinating diseases, epilepsy, neuromuscular diseases, movement disorders, cognitive impairment, sleep disorders, neuro-oncology and functional neurological disorders.

The doctor emphasizes that there are certain neurological diseases to which women are more prone than men, such as stroke and migraine.

Within each chapter, a few pages are dedicated to treating specific diseases, such as ischemic stroke, cerebrovascular pathology, cerebral venous thrombosis or myopathies.

The great role of hormones

Susana Arias indicates that, although there are certainly physiological differences between the male and female brains, this is not the main cause of there being diseases with more female patients than men.

“We must also know the importance of hormonal conditioning in women, which will make them more prone to certain neurological diseases and in some stages they are more protected. This is due to the role of estrogen and progesterone,” explains the neurologist.

This protection ends when menopause arrives. At this stage, the protective effect of hormones disappears and women are more exposed to cerebrovascular risk factors. It is for this reason that the doctor emphasizes, among other things, how significant migraine attacks are, which decrease exponentially after menopause and become abundant during puberty.

The treatments

As Dr. Susana Arias explains and due to the aforementioned differences, the treatment for a neurological disease for a woman will not be the same as for a man. However, she emphasizes that it is not usually the same for two women.

“There are differences in the clinical course of the disease and its evolution. We have to take into account what the woman’s reproductive desire is. Sometimes we have to use high-impact treatments at the beginning and there we must take into account that gestational desire to delay it or make other decisions,” indicates the doctor.

Regarding the specific management of neurological diseases in female patients, treatment also differs greatly depending on age, the impact of the pathology, lifestyle and reproductive desires.

“In epilepsy we sometimes have to manage it very aggressively at first to reduce the disability. 5% of subjects who suffer from epilepsy are women of childbearing age and estrogens can act by increasing the number of seizures. A bidirectional relationship can occur. That is, the drugs we give for epilepsy can reduce the effect of hormonal contraceptives and contraceptives can reduce the effect of the drugs we give for epilepsy,” she analyzes.

Hormones in the different vital stages of women are key to the management of neurological diseases in women EFE/Zayra Mo

A need for me to change

The truth is that the average life span of women is five years higher than that of men. Aging, as the SEN vowel reminds us, is one of the risk factors for cerebrovascular and neurodegenerative diseases, such as Alzheimer’s.

For this reason, many neurological pathologies are much more prevalent in women than in men.

The SEN spokesperson indicates that, for this reason, it is necessary that there begins to be parity in terms of the number of animals. That is, pharmacological and treatment experiments for these diseases must be carried out in both male and female animals.

“Many times they only use male rat models. This obviously ignores the hormonal effects that mice have when that is precisely what should be well represented. These hormonal changes in the female mice themselves can lead to changes in biomarkers,” explains the doctor.

The entry “Neurology and Women”: A book for the management of neurological diseases was first published in EFE Salud.