These pages are about women and epilepsy in the UK. If you are looking for information about women and epilepsy in another country, please contact your local epilepsy organisation
Every woman goes through the menopause. It is the time of the last ever period and is sometimes called ‘the change of life.’ Before the menopause your periods often happen less often. Around the time of the menopause you may have hot flushes, night sweats, and trouble sleeping. Poor quality sleep can cause poor concentration and make you feel irritable.
When the menopause happens
In the UK, most women reach the menopause around the age of 51. If you have frequent seizures with your epilepsy, you may have the menopause a few years earlier than this.
More information about the menopause is available from NHS Choices.
The menopause and seizures
You may notice a change in your seizures pattern around the time of the menopause. It is often difficult to predict how seizures will change. Some women have more seizures, and some women have fewer seizures. Catamenial (cyclical) epilepsy is when seizures follow a pattern that is related to the cycle of your periods. Women with this type of epilepsy may have more seizures in the run up to and during their menopause. But after the menopause, they often have less.
HRT involves taking hormone supplements to control the hot flushes and night sweats of the menopause. Many women don’t have severe menopausal symptoms, so don’t choose to take HRT. HRT is helpful for women who find that the symptoms of the menopause are worsening their quality of life.
HRT comes in many different forms. Oestrogen alone is used in women who have had a hysterectomy (operation to remove their womb). In women who have not had a hysterectomy, a synthetic progestogen hormone, or natural progesterone is added to protect the lining of the womb from overgrowing. Oestrogens sometimes increase seizures. Natural progesterone generally reduces seizures.
HRT - the evidence
There are not many studies looking at HRT and epilepsy, and all of the studies have very small numbers of women. This means there is still not enough information about the risk of seizures when taking HRT. More research is needed.
HRT and epilepsy medicines
In some women, some types of HRT can cause them to have more seizures than usual. There may be effects of HRT on your epilepsy medicine. For example, HRT containing oestrogen can lower the levels of lamotrigine in the blood and increase the risk of seizures. If you take lamotrigine and want to take HRT, your doctor should discuss these risks with you.
If you decide to try HRT, your doctor may help you consider the best type for you, or they may refer you to a specialist for advice.
Further information about the menopause and HRT
If you would like to see this information with references, visit the Advice and Information references section of our website. If you are unable to access the internet, please contact our Epilepsy Action Helpline freephone on 0808 800 5050.
Epilepsy Action would like to thank Penny Burt, Nurse Specialist (Epilepsy), Dr Yvonne Hart, Consultant Neurologist, Newcastle Upon Tyne Hospitals NHS Foundation Trust, and Michael Marsh, Consultant Obstetrician and Gynaecologist, King’s College Hospital, for their contributions to this booklet.
The following interests have been declared:
Penny Burt has received sponsorship to attend epilepsy conferences from UCB Pharma, GlaxoSmithKline, Desitin and Eisai.
Yvonne Hart has received payments for lectures given, advisory work and/or sponsorship to attend epilepsy conferences from UCB Pharma, GlaxoSmithKline, Bial, Desitin and Eisai.
Epilepsy Action does not believe these interests have influenced the content of this information in any way.
Michael Marsh has declared no conflict of interest.
This information has been produced under the terms of The Information Standard.
- Updated February 2017To be reviewed February 2020