Epilepsy And Women

About equal numbers of males and females have epilepsy, but managing the condition in females is different. Today scientists and doctors are beginning to understand why this is.

Estrogen and progesterone may affect a female's seizures. As hormone levels go up and down, seizure patterns may change. More estrogen may increase seizure frequency and more progesterone may decrease seizure frequency. In addition females with epilepsy are more likely than other women to have problems with their menstrual cycles and fertility. Some anti-epileptic drugs (AED's) may lower the amount of the female hormones in the body. If this does happen, birth control pills may become less effective. Also, some AED's may affect hormones that regulate bone health, a leading cause to thinning bones related to osteoporosis.

At certain times in a female's life, the levels of estrogen and progesterone, and the balance between them, suddenly change: puberty, pregnancy, menstruation and menopause. These are times to be aware that hormone levels may affect seizure activity and control of them. The Epilepsy Association of Central Florida has always endorsed keeping a seizure diary in order to better communicate and discuss changes in seizure activity with your physician.

Puberty: Almost overnight a young girls body changes and she becomes more self-conscious. Also, AED side effects and increased seizure activity and may add more concerns. Many young girls with epilepsy may want to stop taking their medications or forget to take them. Skipping or stopping medications can lead to increased seizure activity. And, adolescent behavior such s staying up late (lack of sleep), experimenting with drugs and alcohol, or stress at school, etc. will also have an impact on seizure control.

Menstrual: All seizure activity begins in the brain. The production of hormones also begins in the brain. The pituitary gland located in our brain controls the hormone levels. When a seizure occurs close to the pituitary gland the gland's functioning may change sending signals to release more or less homones. When this occurs a woman may experience; irregular cycles, longer cycles, cysts on the ovaries (polycystic ovaries), infertility, and early menopause. Some AED's may complicate menstrual problems.

Birth Control and Pregnancy: Using birth control pills or other hormonal contraception may affect your anti-seizure medication(s). Some AED's can affect some hormonal birth controls. If you want to take the "pill" or, any form of hormonal birth control, ask your physician about the best treatment for your seizures.

Females with epilepsy may face possible challenges around pregnancy, they may have difficulty becoming pregnant, and if the person is pregnant they may find an increase in seizure frequency. Risk of delivery complications such as premature labor and cesarean delivery are somewhat greater as well. Our advice is to plan ahead and communicate your desire to become pregnant with ALL your physicians. With communication and proper care these risks can be greatly reduced. Most women with epilepsy, and with proper care, have normal births.

Menopause: What most people call menopause actually has three stages: perimenopause, menopause, and the stage following final menstrual period called post menopause. During these times the female body gradually begins to make less estrogen and progesterone. For women with epilepsy this can create issues such as: increased seizure frequency, their medication may need to be changed, and ovulation is unpredictable and an unplanned pregnancy can occur. Many women during this time may take hormone replacement therapy. This therapy may also impact seizure patterns. If you are a woman with epilepsy and are approaching menopause, or, you may be going through menopause, or, have already gone through it, keep a seizure diary and communicate with ALL your physicians in regards to seizure activity and any side effects you may be noticing with hormone replacement therapy.

The best advice we can give you is to communicate with your healthcare providers to reduce your seizure risk and other related issues.

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