Soon after I turned 50, I began experiencing sudden and dramatic episodes of chills followed by severe sweating. Puzzled, I wondered if these symptoms were related to my Parkinson’s disease, a medication effect, migraine changes, or if it was the start of menopause. After several months of dealing with these symptoms, I finally sought a doctor’s opinion.

My physician agreed that I was probably menopausal and prescribed an estrogen patch. When I asked if we should consider the other factors in my history, he was dismissive.

When things didn’t improve—the patch only made my episodes longer and more frequent—I followed up with my physician and insisted on having bloodwork to see if something else was causing my problems. My symptoms were different from the sweating and chills associated with menopause. I would have severe chills even in 90-degree weather and despite heavy clothing. The sweating would follow, mostly in my head and face and my temperature would slowly creep up for up to an hour or two.

After a full exam and reviewing my bloodwork, including my hormone levels, and finding no clear cause of my symptoms, my physician suggested I discontinue a new medication I had started taking recently. I had mentioned that my sweating and chills coincided with the new drug. Once we discontinued the medication, my symptoms resolved.

My experience got me thinking about how often symptoms of Parkinson’s and other neurologic disorders might be misdiagnosed as perimenopause or menopause in women of a certain age. For instance, many patients with Alzheimer’s disease are anxious, depressed, and irritable, and have poor concentration and memory. People with epilepsy may experience menopause-like symptoms such as fatigue, memory problems, and mood changes due to an accumulated medication effect or poorly controlled seizures. In Parkinson’s patients who have sleep difficulties, poor concentration, severe night sweats, and mood changes, it may be more difficult to know when menopause is underway, especially if patients have had a hysterectomy and can’t rely on menstrual flow as an indicator of hormonal changes.

Women who develop Parkinson’s symptoms such as sleep disturbances, anxiety, and fatigue around the time of menopause may have a delayed diagnosis of the disease.

Here are some ways to avoid being misdiagnosed and improperly treated:

Be aware.

It’s important to understand how similar the symptoms of Parkinson’s disease (and other neurologic conditions) and menopause can be.

Don’t make assumptions.

Instead of concluding you have menopause, seek your doctor’s opinion early on. Have a thorough physical exam and share your list of medications. Your doctor should consider your age, your stage of disease, and your hormonal and family history. Your doctor also can run blood tests to rule out other medical causes as well as to measure hormone levels.

Keep a detailed diary of symptoms.

Make note of what they are, when they started, how long they last, and whether they occur daily or sporadically and at what time of day. This has helped me both as a patient and a physician to see patterns and make informed decisions about causes and treatments.

Note any acute or sudden changes.

If acute symptoms are persistent—we all can have a bad day once in a while—discuss with your physician in a timely manner.

Take care.

The key to managing these symptoms whether caused by neurologic disease or menopause is eating well, sleeping and resting as the body demands, exercising, and getting regular check-ups, and following up with your doctor.

Once my doctor and I solved the mystery of my chills and sweating, I felt like myself again, not a crazed woman with clothes sticking to her body, makeup running, hair drenched, and fanning herself frantically.

I know, however, that menopause is in my future. To be fully prepared, I will heed my own advice as well as continue to stay active. I also learned a few things about keeping cool and know that I can wear cooling vests and clothing of breathable material. I can also carry fans, drink cold beverages, and apply cold packs to my neck and the back of my knees.

Dr. Leon retired from her neurology practice four years after she was diagnosed with Parkinson’s disease. She lives in Nacogdoches, TX, and is the author of Parkinson’s Diva, which she self-published in 2015.