Although epilepsy similarly affects men and women, health issues and concerns faced by women living with epilepsy is different from men. Women face many unique challenges — from changes during the monthly cycle which may trigger seizures to concerns regarding pregnancy. Menopause, anticonvulsants, hormones, stress and mood disorders also affect in a different way in females.
Epilepsy, a brain disorder that causes people to have recurring seizures is influenced by female hormones — estrogen and progesterone. Both of these hormones interact with brain cells including those in the temporal lobe, a part of the brain where partial seizures often begin. Estrogen is an excitatory hormone, which makes brain cells give off more of electrical discharge. Progesterone, on the other hand, is an inhibitory hormone, which calms those cells down.
When the body is making more estrogen than progesterone, it can make the nervous system excitable. In other words, a woman could be at greater risk for seizures.
Many women develop their first seizures when they enter puberty. This is because before puberty, not many sex hormones circulate in body.
Seizures that are affected by a woman’s menstrual cycle are called catamenial epilepsy. Some women have most of their seizures when there is a lot of estrogen in their body, such as during ovulation. Other women have seizures when progesterone levels tend to drop, such as right before or during their period.
Seizures may start around the last half of menstrual cycles and continue through the whole second half of the cycles. Women with epilepsy have more anovulatory cycles (cycles that do not release an egg) than women without epilepsy. Data suggest that as many as 40 per cent of menstrual cycles in women with epilepsy do not release an egg.
A woman’s seizures might go away when she reaches menopause; this usually happens in women who have catamenial epilepsy.
If a woman can identify the role of hormones playing in her seizure patterns, it can help her treatment. Keeping a calendar of menstrual cycle and the days of having seizures helps; including notes about other factors that might be important, such as missed medication, sleep loss, stress or other illness. By sharing these records with the doctor, a woman can work together to manage her epilepsy more effectively.
Dr Shagufa Anwar,
General Manager, Business Development of Apollo Hospitals, Dhaka
Source: The Daily Star, February 20, 2010