For women, seizures can be linked to more than just abnormal signals within the brain. According to the Epilepsy Foundation, about half of women with epilepsy who are considered of childbearing age suffer from seizures during menstruation. Known as catamenial seizures, these are directly related to hormone fluctuations and can be difficult to control. The good news is that these types of seizures are also predictable. Learning about catamenial seizures is the first step to treatment.
What Causes Catamenial Seizures?
Catamenial seizures occur in menstruating women as a result of changes in sex hormones. The two main players are estrogen and progesterone. While these hormones are most often viewed from a reproductive health standpoint, the brain is actually in control of them. In turn, sex hormones can actually affect the way the brain works. They can also cross over blood and affect the brain. First, estrogen can increase the likelihood of seizures because it lowers the brain’s natural ability to protect itself from abnormal nerve cell activity. It’s no coincidence that estrogen spikes when bleeding begins. Since estrogen also controls ovulation, some women can also experience seizures mid-cycle.
Progesterone, on the other hand, actually helps to protect the brain against seizures. It is also present in higher levels when an egg is fertilized. When an egg is not fertilized, the amount drops. This explains the role of progesterone in women who have seizures during menstruation. There is also a possibility that other sex hormones can cause spikes in epileptic seizures, though more studies need to be done.
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Catamenial Seizures with Dr. Denise Taylor
When do They Occur?
The likelihood of catamenial seizures spike around ovulation (mid-cycle), as well as a week prior to the start of menstruation. According to NYU Langone Medical Center, catamenial seizures are most likely to occur during the following times:
- ovulation, or the middle of the menstrual cycle (day 14 in a 28-day cycle)
- the day of or the day before bleeding starts
- any point during the last two weeks if cycles are abnormal
How They’re Treated
Like other types of epileptic seizures, catamenial seizures can be difficult to cure. Also, like other types of seizures, they are best treated with medications. The most effective approach is to increase the dosage of antiepileptic medications. This is done only in slight amounts, and only right before seizures are expected. It is crucial to jot down episodes throughout each cycle to determine the best time to use this approach. Also, this treatment measure only works in women with predictable, regular menstrual cycles.
A progesterone-containing oral contraceptive may also help prevent catamenial seizures. This is due to the fact that high progesterone levels have natural anti-seizure capabilities. A doctor may also recommend diuretics to help get rid of water retention. There is a possible link between premenstrual water retention and catamenial seizures.
The earlier you treat seizures, the better the outcome. You may also experience a reduced frequency.
Epilepsy and Catamenial Seizures
Catamenial seizures can be frightening among women. While menstruation can increase the likelihood of seizures in women with epilepsy, it’s important to understand that women without epilepsy cannot get them. Due to drops in estrogen, they are also unlikely in menopausal women.
If an undiagnosed woman experiences seizures at certain times of the month, then it may be time to see a neurologist. Having a seizure does not automatically mean you have epilepsy. According to the National Institute of Neurological Disorders and Stroke, a patient must have at least two seizures to be classified as having epilepsy. If a woman experiences more than two seizures around menstruation, then this is good cause for a catamenial seizure classification.
- (n.d.). Retrieved from http://epilepsy.med.nyu.edu/epilepsy/epilesy-and-women/menstruation#sthash.1TCpQs07.dpbs
- Schachter, Steven C., Shafer, Patricia O., & Sirven. Joseph I. (2013, October). Menstruation. Retrieved from http://www.epilepsy.com/learn/triggers-seizures/menstruation
- Seizures and Epilepsy. (2014, August 27). Retrieved from http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm
Author Bio: Kristeen Cherney is a freelance health and lifestyle writer who also has a certificate in nutrition. Her work has been published on numerous health-related websites. Previously, she worked as a communications and marketing professional. Kristeen holds a BA in Communication from Florida Gulf Coast University, and is currently pursuing an MA in English with a concentration in rhetoric and cultural studies. When she’s not writing or studying, she enjoys walking, kick-boxing, yoga, and traveling.