The impact of hormonal health on women living with epilepsy is neither discussed enough, nor researched enough.
Here is what we do know
Women living with epilepsy frequently observe an upsurge in seizures around the time of their periods.
During the menstrual cycle, there are variations in hormone levels that are correlated with an increase in seizure activity.
Catamenial epilepsy is the medical term for an increase in seizures throughout the menstrual cycle.
This is not an unusual occurrence.
About one-third of women with seizures that aren’t well under control have catamenial epilepsy.
What is Epilepsy?
Epilepsy is a neurological disorder that causes seizures.
A seizure can look like a staring spell, or it can cause a person to collapse, shake, and become unaware of what’s going on around them.
Epileptic seizures are not caused by high fevers, and are not contagious.
Epilepsy is defined as having two or more unprovoked seizures.
Epilepsy is one of the world’s oldest recognized conditions, with written records dating back to 4000 BCE.
Two crucial hormones, estrogen and progesterone, undergo changes over the course of a woman’s lifespan and during her menstrual cycle.
The variations in estrogen and progesterone levels can be extremely pronounced during the roughly 28-day cycle.
For instance, estrogen levels may be relatively high at the time of ovulation (mid-cycle).
The ratios of estrogen and progesterone alter significantly during puberty, perimenopause, and menopause.
These ratios may impact epileptic seizure frequency.
Estrogen tends to increase seizures.
Progesterone tends to reduce seizures.
It has been observed that when estrogen levels are high, seizure activity tends to cluster.
In contrast, progesterone is being studied as a possible treatment for seizures.
However, there is much research to be done.
Perimenopause is characterized by unpredictable hormone fluctuations.
When a woman is going through perimenopause, estrogen levels can frequently be fairly high.
As they go through perimenopause, some women living with epilepsy may experience significantly more seizures.
This is assumed to be a result of the high estrogen levels.
However, perimenopause is a process.
A change in seizure pattern requires an evaluation by a physician.
There can be many causes for increased seizures and not all are related to hormones.
Low and consistent estrogen levels are present during the menopausal transition in women.
Women with epilepsy frequently experience a decrease in their seizure frequency throughout menopause.
As a result, women with epilepsy frequently experience an increase in seizure frequency during perimenopause and a decrease in seizure frequency at the menopause.
Women with a history of childhood epilepsy are more likely to notice this pattern.
What the Research Says
Unfortunately, there are few studies examining how menopause affects epilepsy.
With the probable exception of women with catamenial epilepsy, who may experience an increase in seizure frequency during perimenopause and a decrease following menopause, menopause appears to have no influence on seizure management in general.
The preceding information does not constitute medical advice or treatment.
Resources: https://epilepsysociety.org.uk/living-epilepsy/women/menopause-and-epilepsy https://mnepilepsy.org/ https://epilepsyaz.org/women/menopause-and-epilepsy/ https://pubmed.ncbi.nlm.nih.gov/25079452/ https://www.who.int/news-room/fact-sheets/detail/epilepsy