Seizures are electrical disturbances in the brain that temporarily cause the brain to function abnormally. Seizures range from uncontrollable movements and loss of consciousness to brief strange sensations while being fully conscious. When a close friend started having seizures, diagnosed as simple partial seizures, after giving birth, I discovered research linking hormonal changes in women to seizures. Some women with epileptic seizures have worse and more frequent seizures during puberty, just before a menstrual period and when they don’t ovulate as happens during perimenopause, the lengthy period before menopause.
Causes of seizures
In many cases the cause of seizures is unknown, but young children may develop seizures after a high fever or a metabolic disorder. Adults may develop seizures after a stroke, tumor, head injury, and abnormal heart rhythms, which can deprive the brain of oxygen.
Types of seizures
Seizures are either general or partial. In a generalized seizure both parts of the brain are affected; people lose consciousness and suffer uncontrollable movements. Generalized seizures can last a long or short time. Partial seizures are simple or complex. In simple partial seizures only a small part of the brain is disturbed and people retain consciousness. Symptoms vary with the part of the brain that is affected. In partial complex seizures, abnormal brain activity spreads from one location to nearby areas. Complex partial seizures are usually preceded by an aura and people may have impaired consciousness, but don’t completely lose it. Other types of seizures are confined to children or specific situations.
Many women, who experience seizures, have increased number of seizures just before their menstrual period, when hormone levels of estrogen are high relative to progesterone. The ratio of estrogen to progesterone decreases during the rest of the cycle. Recent studies by Andrew Herzog and his team at Beth Israel Deaconess Medical Center in Boston, MA, found that women with general and partial seizures had increased frequency of seizures when they were not ovulating. Lack of ovulation, called anovulation, is associated with higher estrogen to progesterone levels. Women with epileptic seizures also have an increased frequency of seizures during perimenipause, which presents a higher estrogen to progesterone ratio. Estrogen levels may be low during perimenopause or onset of menopause, but only the ratio of estrogen to progesterone, not the total amounts matter. A placebo-controlled study found that a subset of women were able to reduce the frequency of seizures by taking natural progesterone hormone.
The authors of the progesterone study write: “…progesterone may provide clinically important benefit for a subset of women with perimenstrually exacerbated seizure.” (A.C. Herzog et al.). Progesterone treatment is not an accepted method of treating seizures so far, but may become so in time for some women. Right now, seizure treatments include medications, nerve stimulations, and surgery. For the mildest seizures, simple partial seizures, diet and stress reduction may reduce seizures in some people. The cause for the development of seizures in women after childbirth is not known, but may also be triggered by hormonal changes. Although hormones may have profound effects on some women with seizures, women with anovulatory cycles,and in perimenopausal or menopausal periods need to weigh the benefits of hormone therapy with potential side effects.
A.C. Herzog et al. Progesterone vs. placebo therapy for women with epilepsy: A randomized clinical trial Neurology (2012) doi: 10.1212/WNL.ObO13e318259e1f9