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Menopause and hormone replacement therapy

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

Menopause
Hormone replacement therapy

About the menopause

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 the NHS website.

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.

About hormone replacement therapy (HRT)

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

For more information about HRT and the menopause, see the British Menopause Society's website and Menopause Matters.

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. 

Code: 
B017.05

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 Epilepsy Action's information quality standards.

  • Updated February 2017
    To be reviewed February 2020

Comments: read the 13 comments or add yours

Comments

Please can you give us some information pertaining to HRT as I seem to be suffering a lot with menopause but did have hysterectomy at the age of 30 I am now 52 but but I am an epileptic since the age of 17 and the seizures have increased more and more. I am just really looking for help many thanks

Submitted by Donna Fitzpatrick on

Hi Donna

I’m afraid we don’t have any more information than the page where you have left your comment.

Some women do experience an increase in the number of seizure they have during menopause.

Regards

Cherry  

Epilepsy Action Helpline Team

Submitted by Cherry-Epilepsy... on

Hello I have a similar experience to the last person writing a recount of HRT and the struggles of increased seizures I'd love to be put in touch with her or any other ladies with the same experience in order to try and make more information available

Submitted by Judie Martlew on

I'm experiencing exactly the same: surgical menopause 15 years ago, now going through horrendous ordeal in my 50s with little help. Would love to speak to others for support.

Submitted by Ruth Rees-Dwyer on

Hi Ruth

Sorry to hear you are having such a terrible time with the menopause.

We are unable to put you directly in touch with others. But we do have an active presence on social media that you may find helpful to contact others that may be in a similar situation.  We have our forum4e online community, and we are on facebook and twitter.

If you need further support with the menopause you may find the British Menopause Society's website and Menopause Matters helpful.

If we can be of any more help, please feel free to contact us again, either by email or the Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Friday, 8.30am until 5.30pm.

Regards

Diane

Epilepsy Action Helpline Team

Submitted by rich on

Hi - do you have any research or publications available to assist me with the use of HRT patches or pills - with my seizures.
I'm having tough time with menopause and don't want to make my controlled seizures (15yrs now) bad again.

Submitted by Jacki Wain on

Hi Jacki

We don’t have any more information that what you can see on the website.

But we do have a link to the referenced copy of the information.

You may also benefit from some advice from a neurologist or epilepsy nurse. If it would be difficult or time consuming to wait for an appointment with one of them, it may be possible for your GP to consult them on your behalf.

I hope it’s possible to make your menopausal symptoms more manageable.

Regards

Cherry  

Epilepsy Action Helpline Team

Submitted by rich on

I have recently started using Vagifem (local HRT) without any problem. I would like to know if there is any reason why I shouldn't try systemic HRT. I am seizure free but still take 600 mg a day of Tegretol. One reason for wanting to do this is to help protect my bone density.

Submitted by Katherine Read on

Dear Katherine

Thank you for your question.

There is very little information on HRT and epilepsy.  This means there is still not enough information about the risk of seizures when taking HRT.

As you’ve seen on our webpage, we have a small amount of information on systemic HRT.

If you need further information about HRT we have also listed some helpful organisations.

Regards

Diane

Epilepsy Action Helpline Team

Submitted by rich on

Hi, I think I am just in the early stages of menopause (I get hot sweats and my periods have virtually stopped.) I am taking Keppra,Toprimate and lamotrogine atm with clobazam for back-up should I need it. I am experiencing more than normal seizures atm and wondered if it be worth me changing any of my meds would help? Thanks b.x

Submitted by Bianca on

Hi Bianca,

Some women do experience an increase in the number of seizure they have during menopause. It would be best to talk to your epilepsy specialist about this and your treatment options.

If you are not under a specialist, you will need to ask your family doctor to refer you.

Regards

Diane

Epilepsy Action Helpline Team

Submitted by rich on

Hi am just wondering would the HRT patch be a slower release to trial ,as I am 50 I am on phenytoin, but trialed clobazam 4wks together ended up phenytoin levels through the roof as well as my mental state , am now taking depression/anxiety tablets with side effects ,personally I think it’s hit and miss as a epileptic from birth thanks

Submitted by Kristine on

I am epileptic from age of 12, I'm now 53 I've been seizure free for over 30 years, except for once when I forgot my medication for a while, after giving birth, I now want to take hrt for night sweats and loss of sex drive, I've consulted my doctor who consulted a neurologist, as I'm not seen for my epilepsy at all, and they just say not enough is known, so basically it's down to me, do I risk it, I'm taking epilim 200 and clonazapam.to control my epilepsy, anyone been controlled as long as me, and on her,

Submitted by Gillian Baker on

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