Comprehensive Epilepsy Center
Women's Health - Menopause
The median age for menopause in the U.S. is 50-52 years, but women with epilepsy may experience earlier menopause. Seizures
may change with menopause.
Menopause is defined as twelve continuous months without a menstrual cycle. Peri-menopause lasts for about five years before
menopause and is a time when hormones change a lot.
During menopause, estrogen and progesterone production decrease and the pituitary FSH and LH increase. Irregular menstrual
cycles are common.
Menopausal Syndrome
Hot flashes are experienced by 75%-85% of women. Most women have hot flashes for about one year, rarely they may last for
five years. The hot flash begins with a sensation of pressure in the head, followed by warmth in the head and neck region.
This is followed by sweating and usually last 10-20 minutes.
Decreased estrogen also leads to vaginal dryness, osteoporosis, changes in hair and skin, and emotional changes with anxiety,
depression and irritability. Additionally, sleep disorders may occur, especially insomnia and sleep apnea.
Treatment of symptoms
Estrogen is effective treatment of hot flashes and vaginal dryness. Estrogen also helps to reduce bone loss, and studies have
shown that it reduces the risk of heart disease and dementia.
Side effects of estrogen include breast tenderness, nausea, heart disease, stroke and has been linked to a increase in breast
and endometrial cancer.
Estrogen has the potential to increase seizures. Estrogen can be used if you have epilepsy and if your doctor feels that the
potential benefit outweighs the risk. You must monitor for the potential for increased seizures. Most women with epilepsy
will try estrogen and monitor their seizure frequency closely.
Seizures and Menopause
Seizures may change (decrease or increase) with menopause and some women will begin to have seizures with menopause. We are
beginning to recognize that menopause may be a risk factor for seizures.
Many women with seizures that were linked to the menstraul cycle will have fewer seizures after menopause. However, during
peri-menopause seizures may actually increase.
