How Does Epilepsy Affect Women’s Health?

May is officially recognized as Women’s Health Month. This month, we’re taking the time to highlight women’s unique health issues and the importance for women of all ages to make their health and well-being a priority.  For women with epilepsy, seizures and medication can further impact their health and wellness. We encourage girls and women to know what issues may affect them and talk openly with their healthcare team.  

Watch the webinar recording on A Focus on Health for Women and Girls with Epilepsy.

Hormones and Epilepsy  

From puberty through menopause, changes in hormones can impact epilepsy. Levels of estrogen and progesterone – the two primary female hormones – rise and fall each month throughout the menstrual cycle. Estrogen increases brain activity, making seizures more likely to happen when estrogen levels are highest. On the other hand, progesterone can decrease some brain activity, making seizures less likely to happen when progesterone levels are higher than estrogen.  

Catamenial Epilepsy  

For some women, menstruation acts as a seizure trigger. This is called catamenial epilepsy, which is a pattern between seizures and the menstrual cycle related to the rise and fall of hormones. It’s a good idea to keep track of your seizures and your menstrual cycle to see if there’s a connection. If a pattern suggests catamenial epilepsy, your healthcare team can better understand if and how to adjust your treatment. We suggest using a diary, either physical or digital, to help keep track of your seizures and your cycle to see if there’s any relation between your menstrual cycle and your seizures.  

Birth Control  

Some seizure medications can decrease the effectiveness of birth control pills and other hormonal contraceptives. Alternatively, birth control can affect the efficacy of some seizure medications. Talk to your healthcare providers about possible interactions. The more you know, the more prepared you can be to prevent unintended pregnancy.  

Family Planning and Pregnancy  

Women with epilepsy are at higher risk for unplanned pregnancies. Women with epilepsy are also more likely to give birth to children with congenital disorders. Some doctors recommend that all women of childbearing age take folic acid (folate) every day, which helps with embryo development and reduces the risk of certain disorders.  

Planning ahead can help you have a safe, healthy pregnancy. Talk to your neurologist about your timeline for pregnancy, ideally as much as a year beforehand. Seizure control is crucial before and during pregnancy.  

Menopause  

Most women with epilepsy go through menopause at the same time as women without epilepsy, around age 50. With hormone changes, women with catamenial epilepsy may experience a fluctuation in seizures during menopause as well. Hormone replacement therapy (HRT) is helpful for many women, but there are other factors for women with epilepsy to consider.  

Bone Health  

As all women get older, bone health and preventing osteoporosis is important for overall health and preventing injury. For women with epilepsy, seizures and the risk of falls make bone health even more important. Additionally, some seizure medications increase the risk of bone loss. It’s important to know about your medication and what you can do for bone health. 

Healthy Eating and Exercise  

Healthy eating and regular exercise are generally recommended for your health, including bone health. Exercise can have many benefits for women with epilepsy beyond just the physical. Eating a well-balanced diet with enough calcium and vitamin D helps bone health, too. Talk to your healthcare team about exercise that’s best for you, as safety comes first.  

There are many health considerations for women with epilepsy that affect their quality of life. The more knowledge, awareness, and open communication, the more likely you are to find the right treatment and take control of your personal health.