Have you noticed that you have more seizures at certain times of the month? This could be a sign of catamenial epilepsy. Catamenial epilepsy is when there is an increase in the frequency of seizures during a certain phase of the menstrual cycle.
If you believe you might be having catamenial seizures, speak with your doctor. They may diagnose it based on your medical history.
Let's learn more about what catamenial epilepsy is, its symptoms and the way it's treated. We also explore how menopause and pregnancy affect it.
What is catamenial epilepsy?
The word ‘catamenial’ means something that is related to menstruation (the period). It comes from the Greek word ‘katamenios’, which means ‘monthly’.
Some women with epilepsy notice that they have more seizures at certain times in their menstrual cycle. At different stages of the cycle there are different levels of the hormones estrogen and progesterone in your body. Hormones are chemical messengers which influence your body.
When there is more estrogen in your system, your brain cells may become more excitable - this means they are more likely to discharge electricity and cause a seizure. Progesterone on the other hand is an anticonvulsant. It ‘calms’ the cells in your brain, making it less likely you'll have a seizure.
If you have catamenial epilepsy, these changes in hormone level may affect when you have seizures.
What are the symptoms of catamenial epilepsy?
The main symptom of catamenial epilepsy is a noticeable increase in the number of seizures you have at certain times of the month. It will normally follow a pattern. For example, if you usually have your period in the first week of the month, you might also notice that you have most - if not all - of your seizures at this time. This might indicate that you are having catamenial seizures.
Women who have catamenial epilepsy can have all kinds of seizures including, but not limited to, focal aware (simple partial), focal impaired aware (complex partial), absence seizures and tonic clonic seizures.
What about catamenial epilepsy and menopause?
During the menopause there are big changes in hormone levels in your body. If you have catamenial epilepsy you may notice an increase in the number of seizures you have right before the menopause transition. But, later on you may notice that there is a decrease. This is because there are lower levels of estrogen in your body after menopause.
Catamenial epilepsy and pregnancy
There are also big changes in hormone levels during pregnancy, and this may affect catamenial seizures. Research shows that some women with catamenial epilepsy experience fewer seizures during pregnancy. This may be because the normal monthly cycle of hormones is put on hold.
If you have catamenial epilepsy, speak with your epilepsy treatment team about how to prepare for pregnancy.
Treatment of catamenial epilepsy seizures
Talk with your doctor about treatment for catamenial epilepsy. At present, there is no specific treatment for catamenial epilepsy which works for everyone. There are a few different treatment options that your doctor may recommend if you are having catamenial seizures. These could include:
- Hormonal treatments: Women with catamenial epilepsy may be more likely to have seizures when there are lower levels of progesterone in their systems. Some research has found that hormone therapies can be helpful for some women (for example, by taking pills containing natural progesterone at certain times of the month).
- Anti-seizure medication: These work in different ways to reduce the excitability of your brain cells.
Read about Nessa's experience of living with catamenial epilepsy here.
Managing catamenial epilepsy
Scientists are still learning about catamenial epilepsy, and more research is needed to develop treatments. If you notice you seem to be experiencing catamenial seizures, speak with your doctor about it.
You might find it useful to record all your seizures in Epsy and note down when they happen in relation to your period. This can help your doctor understand your condition patterns better and provide treatment that is personalized to you.
To learn more about issues affecting women with epilepsy read our blog.
