According to the American Academy of Family Physicians, about 1 percent of the population suffers from epilepsy. And although men and women are equally affected, women may be more susceptible to seizures because of hormonal changes.

“Some women experience changes in activity during an attack when there are changes in the levels of estrogen and progesterone,” says Paul T. Gross, MD, a neurologist at the Lahey Clinic in Burlington, Massachusetts, which has a special interest in epilepsy. “In general, estrogen promotes seizure activity, and progesterone protects from seizure activity.”

Attacks of epilepsy are caused by excessive stimulation of nerve cells in the brain. Medics also proved that progesterone often blocks the excitability of nerve cells, and estrogen, on the contrary, increases excitability. Because of this, women have repeatedly dealt with inactivity during seizures with regular menstrual cycles, during the menopausal period and during menopause.

Effect of perimenopause and menopause on epileptic seizures:

“During the normal menstrual cycle, there is a surge of estrogen during ovulation and a decrease in progesterone during the menstrual cycle,” explains Dr. Gross. “Both these times can be periods of increased seizure activity for some women.” You may think that, as estrogen levels begin to decline during perimenopause and menopause, most women with epilepsy will experience a decrease in seizure activity at this time – but this is not so simple.

As was previously explained by the Epilepsy Fund, premenopausal and menopausal women were compared with epilepsy, it became known that most simply did not notice the changes or experienced an improvement in their activity in seizures. About 40 percent, however, said their seizures were worse during menopause. A completely different study that was produced in Europe showed similar results: 70% of women noticed significant improvements, and 30% – deterioration.

In general, the study shows that the effects of menopause on epilepsy are unpredictable. “This is because, as estrogen decreases during menopause, as does progesterone,” says Gross. “In any case, the majority of women do not have a significant decrease in activity after an episode after menopause.”

In addition, most of the factors that are manifested only with age can affect seizure activity, your epilepsy treatment does not need to be changed or adjusted during perimenopause or menopause. Any decision made regarding a deviation from the prescribed course of treatment will be based on the number and severity of your seizures.

Treatment of epilepsy and hormone replacement therapy (HRT)

If you are considering hormone replacement therapy (if you want to learn more about HRT – welcome to ) after menopause to help cope with the symptoms, discuss all the risks and benefits of HRT with your neurologist, as well as your general practitioner or primary care doctor. Although HRT may reduce the risk of cardiovascular disease and osteoporosis in women, it has been shown to increase the risk of developing uterine and breast cancer, and this may or may not affect your seizures.

“I would not say that women with epilepsy should not take HRT,” says Gross, “but I said that hormone replacement therapy should be done with caution, and full awareness of all risks, especially in women who have had a history of increased seizure activity during menstrual cycles.”

Keep in mind that menopause is a process, and your seizures may change with time. Decisions regarding the treatment of epilepsy should be periodically reviewed with physicians. Together, you can come up with a better plan for your individual needs.


Please enter your comment!
Please enter your name here