During a woman's lifetime, her ovaries produce two essential hormones needed for pregnancy and menstruation: estrogen and progesterone. The balance and change between these two hormones varies during a woman's reproductive years, including puberty, menstruation, pregnancy and menopause. Although these hormone fluctuations are important in reproductive health, they can also affect seizure activity. It is believed that estrogen enhances the seizure activity and progesterone has the opposite effect.
Puberty and MenstruationPuberty is the period of time when maturation of the reproductive system takes place. During this time, estrogen and progesterone are being made, which trigger the onset of menstruation and the development of breasts. Due to this rise in hormones, women with epilepsy may also see an increase in the frequency of their seizures. Some women may also experience an increase in the frequency of their seizures around their menstrual period. Known as catamenial epilepsy, seizures occurring around a woman’s menstrual cycle may need additional management. It is believed that the effect of estrogen and progesterone on the brain function leads to this increase in seizure frequency.
PregnancyAs with any chronic disease, pregnancy with epilepsy is possible, but may require careful planning. There are a variety of contraceptives available to a woman if she chooses to avoid pregnancy, but precautions should be taken -- especially with contraceptive pills. Some antiepileptic medications may counteract the effects of contraceptive pills, making a woman susceptible to pregnancy.
Some women with a seizure disorder can have normal pregnancy and deliver a normal baby. However, epilepsy can create a concern during pregnancy, especially when it comes to uncontrolled seizures and antiepileptic medications. It is believed that an alteration in hormone levels during pregnancy could lead to an increase in seizure frequency, though this may not be the case with every woman. It is estimated that seizure frequency increases in 20 to 33% of pregnancies, decreases in 7 to 25% of pregnancies, and remains unchanged in the remaining 50 to 83% of women who are pregnant with epilepsy.
MenopauseMenopause occurs when menstruation has ceased and the ovary stops producing estrogen and progesterone. Due the effect of these hormones on the brain, some women may experience alteration in seizure recurrence during menopause.
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