Epilepsy Talk

Is there a connection between seizures and hormones? | December 6, 2022

Many women with epilepsy have asked their doctors about the connection between seizures and hormones. But not every woman has seen her concerns given the attention she’d hoped for.

Although it is not very well understood at this point, there are scientifically documented connections between seizures and hormones that not all physicians are educated about.

What are hormones?

Hormones are chemical substances formed in organs and glands that travel through your body and through your bloodstream.

They control muscle growth, heart rate, hunger, the menstrual cycle and many other functions.

They generally don’t cause seizures, but can influence their occurrence.

Some women with epilepsy experience changes in their seizure patterns when their hormones are fluctuating.

There’s a dynamic relationship between hormones, brain function, and seizures.

The brain is the seat of the body’s hormones and regulates the release of the major sex hormones — estrogen, progesterone, and testosterone.

These hormones, in turn, provide feedback to the brain and control the amount of hormones released at different points in time.

Research has shown that seizure discharges in certain brain areas can alter the output of hormones from the brain, and sex hormones can influence how the brain works.

For example, estrogen has been shown to increase seizure activity, while progesterone can have anti-seizure effects.

Seizures that are most likely to be affected by hormonal changes are partial seizures that involve the temporal or frontal lobes of the brain.  

However, hormonal associations may also be seen with generalized seizures. 

The temporal and frontal areas of the brain are closely connected to the hypothalamus and pituitary glands of the brain, which control the release of hormones.

Seizure activity may influence levels of hormones in the body, and the levels of estrogen and progesterone in the body can affect seizures.

And even though not all seizures are caused by hormones, they still can influence their frequency.

Is there a connection between seizures and hormones?

Yes.

Hormones are crucial systemic players and act at different sites of the entire body, including the brain.

The brain is not only the target of hormone action, but also serves as the “conductor” of the “neuro-endocrine symphony”.

Changes in neuronal activity, such as seizures in people with epilepsy, may affect hormonal regulation and secretion.

In turn, hormones modify susceptibility to develop seizures.

Also, antiepileptic drugs and hormones can have a direct interaction.

Hormones may alter seizure threshold, change the frequency and severity of seizures.

Are all seizures caused by hormone changes?

No.

Hormones generally do not cause seizures but can influence their occurrence.

For example, puberty is a time when hormones are stimulating body changes.

It is not unusual for certain kinds of seizures to disappear at puberty, while other seizure disorders may start at this time. 

Many women with epilepsy see changes in the number or the pattern of their seizures around the time of ovulation (mid-cycle), or just before and at the beginning of their menstrual periods.

This condition is called “catamenial epilepsy.”

What do the sex hormones do?

Sex hormones have several functions…

Primarily, they control and maintain our reproductive systems.

They also have an influence on muscle mass, bone strength, emotions, and behavior.

In fact, sex hormones begin to influence brain function before birth, as early as a month or two after conception!

Research shows that the female hormones, estrogen and progesterone, act on certain brain cells, including those in the temporal lobe, a part of the brain where partial seizures often begin.

Estrogen excites these brain cells and can make seizures more likely to happen.

In contrast, natural progesterone can inhibit or prevent seizures in some women.

Findings also indicate that women who have seizures coming from the temporal lobe often have more reproductive disorders.

They may include: polycystic ovaries, early menopause and irregular (or no) ovulation.

How do I find out if I have hormone-related problems?

Women who have special concerns about seizures and hormones should obtain a referral to a specialist, either a neurologist or a neuroendocrinologist (a neurologist with training in hormone disorders and their effects on brain function).

If you suspect that hormones play a role in your seizures, talk to your physician or the nurse who helps monitor your seizures.

Blood tests of certain hormone levels and of your seizure medication may provide helpful information.

Additional tests, such as a pelvic ultrasound, may also be recommended to rule out other causes for menstrual irregularities.

Some suggestions:

1. Request a referral to a specialist. Some family doctors aren’t educated about the link between hormonal imbalances and seizures. A specialist will be better equipped to handle your concerns.

2. Track your seizure patterns. Many patients suspect a hormonal link to their seizures, but haven’t tracked the occurrences of those seizures. Keep a monthly log and track the date, time, length and frequency of your seizures.

3. Consider any recent hormonal changes. Before visiting a specialist, look for any hormonal patterns on your seizure log. This may include increased seizure frequency before your menstrual cycle or with the onset of menopause.

4. Pay attention to times of stress. Experiencing stress can trigger hormonal imbalances in your body. Chart times of stress and their effect on your seizures.

5. Explore treatment options. Although experimental, there are options for treating seizures caused by hormonal imbalances. Women can take progesterone supplements to reduce seizures. Also, some women find success by undergoing a hysterectomy, which eliminates the menstrual cycle and hormonal imbalance.

Awareness of how hormones can relieve or exacerbate seizure frequency and severity, as well as of how seizures and epilepsy may significantly affect reproductive and sexual function by interacting with hormone secretion and metabolism is key.

And identifying hormonal influences on seizure patterns may lead to a better understanding of treatment options for seizure control, which is important for optimal seizure management throughout a woman’s life.

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Resources:

https://www.activebeat.com/your-health/women/6-signs-of-hormone-havoc-in-women/?utm_medium=cpc&utm_source=google&utm_campaign=AB_GGL_US_DESK-SearchMarketing&utm_content=g_c_179097237047&cus_widget=&utm_term=hormonal%20imbalance%20in%20women&cus_teaser=kwd-299998681&gclid=CjwKCAiA5qTfBRAoEiwAwQy-6bT4rnpkX7xe90_WYccdU4GT-jF66UaL-DRNhYo5rh49a_-8r-MSjRoC5PYQAvD_BwE

https://www.webmd.com/epilepsy/guide/your-changing-hormones#1

http://www.cf-epilepsy.com/women-hormones-seizures/

https://epilepsysociety.org.uk/living-epilepsy/women/hormones-puberty-and-menstruation

https://mnepilepsy.org/hormonal-issues-in-women-with-epilepsy/

https://www.sciencedirect.com/science/article/pii/S1059131115000400

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2818554/

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