Menopause

Women with epilepsy experience earlier than expected menopause.  A possible explanation might be the effects of seizures on regions of the brain that regulate reproductive hormones.

• During Perimenopause (transition period to menopause) many women experience irregular menstrual periods. And, some women experience an increase in the frequency of their seizures, especially women with catamenial epilepsy.  Possible explanations for this increase may be the relative increase in the estrogen level or the discomfort of perimenopausal symptoms such as hot flashes or difficulties sleeping.

• The effect of Postmenopause (time following the cessation of your menstrual periods) on seizure frequency is unclear.  It may be associated with a decrease in the frequency of seizures, especially in women with catamenial epilepsy.  Medication doses may need to be adjusted due to changes in metabolism.

• Hormone Replacement Therapy (HRT) following menopause is treatment that is used for some symptoms of menopause such as hot flashes, vaginal dryness, and difficulty sleeping. It also may help prevent osteoporosis. Treatment should be carefully discussed with your gynecologist due to the many possible side effects:
  - Possible increase in risk of stroke 
  - Possible risk of breast or uterine cancer

In women with epilepsy using estrogen as HRT, seizure frequency may increase. The type of HRT that included progestin (a form of progesterone) is less likely to cause a worsening of seizures.