Epileptic seizures cause changes in movement, behaviour, feeling, or awareness. Epilepsy affects both genders equally. However, women encounter unique challenges due to cyclic hormonal fluctuations.
Women and girls with epilepsy have more seizures during their menstrual cycles
Epilepsy is a problem with your brain's electrical system. In this condition, a surge of electrical activity in the brain leads to seizures. Epileptic seizures cause changes in movement, behaviour, feeling, or awareness. Epilepsy affects both genders equally. However, women encounter unique challenges due to cyclic hormonal fluctuations.
Hormonal changes and epilepsy
Women experience significant hormonal changes from puberty to menopause, and these changes may affect the frequency and severity of seizures, reproductive cycles, contraception, and pregnancy. Understanding these challenges is crucial for preparing and managing epilepsy effectively. Discussed below are some frequently asked questions by women and girls with epilepsy.
Is it common to experience more seizures just before periods?
About 50% of women and girls with epilepsy have more seizures during their menstrual cycles, the condition is called catamenial epilepsy (menstrual seizures). Managing these seizures is often challenging. It is crucial to discuss this with your specialist doctor. They might suggest modifying the dosages of certain medications during your periods or adding another medicine for a short course of time during periods that help manage menstrual seizures.
Do seizure medications interfere with birth control pills?
Women with epilepsy frequently worry about the potential interactions between birth control and seizure drugs. Certain seizure medications are known to interact with contraceptive pills, rendering them less effective and thus resulting in unplanned pregnancy. Alternative birth control measures may be required in these cases.
Can epilepsy affect a baby's health?
Over 90% of babies born to women with epilepsy are normal. Seizures alone usually do not result in birth abnormalities, but they can influence the heart rate and oxygen supply to the fetus. Prenatal treatment and counseling, and thorough planning and communication with healthcare specialists are advisable while planning for pregnancy to reduce risks and improve outcomes for the mother and the unborn child.
Is it advisable to breastfeed while on medications for seizures?
Breastfeeding has multiple health benefits to the baby and the mother. Overall benefits of breastfeeding for mothers and infants may outweigh the potential risks. Most of the anti-seizure medicines secreted in breast milk are in negligible amounts to cause any issues with the baby. It is still advisable to consult your neurologist to address any possible issues and adjust treatment regimens as necessary.
How does epilepsy affect menopause and bone health?
About 40% of women experience worsening seizures with menopause, while some women may have an improvement in their seizure frequency. Hormone (estrogen) replacement treatment, frequently used to treat menopausal symptoms, is not recommended for women with epilepsy as it is associated with an increased incidence of seizures. Moreover, menopausal women are more prone to fractures due to low bone density, they should take calcium and vitamin D supplements.
What should a transgender woman know about epilepsy?
Transgender people who have been diagnosed with epilepsy can face greater challenges as hormone replacement therapy can increase the seizure frequency. Anti-seizure medicines may decrease hormone levels and interfere with treatment. Transgender women with epilepsy need to consult their neurologist before taking gender-affirming hormonal therapy.
Take home message: Women with epilepsy can achieve control over their seizures and preserve their health and well-being by expert medical guidance and adhering to their individualized treatment plans.
(Dr. Lakshmi Krishna V, Consultant - Neurologist, Manipal Hospital Sarjapur Road)
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