Epilepsy and menopause
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Epilepsy and menopause have complicated interactions. Treatment of epilepsy may cause exacerbation of osteoporosis and alter the effects of hormone replacement therapy (HRT) whereas HRT may influence the frequency of seizures.
Materials and methods
An extensive search was performed in the Cochrane Central Trials Registry, the Web of Science, and PubMed for publications using the keywords “(epilepsy OR Seizure) AND (menopause OR osteoporosis)”; “Anti-epileptic drugs AND (menopause OR osteoporosis); HRT AND epilepsy” between 1970 and 2010 and English language. All eligible trials were included.
The frequency of catamenial type of epileptic seizures may increase during perimenopause due to hyperestrogenism and subside after menopause. Sexual dysfunction can be severe depending upon the effect of lack of estrogen in menopause and epilepsy itself. Osteoporosis and fractures may increase due to hypoestrogenism in menopause and cytochrome P450 inducing anti-epileptic drugs. According to the current data, conjugated equine estrogens plus 2.5 mg of medroxyprogesterone acetate may increase the frequency of epileptic seizures. Women with epilepsy may need to take HRT, at least for symptomatic relief and to allow adequate sleep when “hot flushes” are disruptive. A combination of a single estrogenic compound such as 17-β-estradiol along with natural progesterone could be considered in these patients.
KeywordsEpilepsy Menopause Anti-epileptic drugs Osteoporosis Seizure
- 20.Roscizewska D (1978) Menopause in women and its effects on epilepsy. Neurol Neurochir Pol 12:315–319Google Scholar
- 24.Shorvon SD (2011) The etiologic classification of epilepsy. Epilepsia. doi:10.1111/j.1528-1167.2011.03041.x
- 26.Bartoli A, Gatti G, Cipolla G, Barzaghi N, Veliz G, Fattore C et al (1997) A double-blind, placebo-controlled study on the effect of vigabatrin on in vivo parameters of hepatic microsomal enzyme induction and on the kinetics of steroid oral contraceptives in healthy female volunteers. Epilepsia 38:702–707PubMedCrossRefGoogle Scholar
- 30.Mengel HB, Houston A, Back DJ (1994) An evaluation of the interaction between tiagabine and oral contraceptives in female volunteers. J Pharm Med 4:141–150Google Scholar
- 52.National Institutes of Health (2000) Osteoporosis prevention, diagnosis and therapy. NIH Consens Statement 17:1–52Google Scholar