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Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.
Question:
How does estrogen use and menopause affect someone with a seizure disorder?
Answer:
Seizures are periodic outbursts of nerve activity that result in uncontrolled muscle spasms and loss of consciousness. The cause of seizures is often unknown. However, many affected patients recognize certain conditions that can trigger a seizure. For example, in some women, high levels of circulating estrogen increase the risk of a seizure event.
"Catamenial epilepsy" describes the disorder characterized by a cyclic pattern of seizures timed to the menstrual cycle. It is due to a lowering of the seizure threshold caused by estrogen. Not all women display this pattern, but in those who do, the risk of seizure may decrease in menopause when estrogen levels diminish. Estrogen therapy, however, is associated with an increase in seizure risk in these patients.