Do seizure medications cause irregular periods?

Question

Hello doctor,

I have been having seizures for a few years and on medication, but lately, my periods have been off. Sometimes, it is really heavy, and then they skip a month. Could this be from the seizure medications or something else? I am not taking birth control and am just wondering if hormones are playing a role here.

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

You are right to wonder about the connection between your seizure medications and your menstrual changes. Yes, seizure medications can affect hormonal balance and menstrual cycles, especially if you are on enzyme-inducing drugs like Carbamazepine, Phenytoin, or Phenobarbital. These can disrupt estrogen and progesterone levels, leading to irregular or heavy periods, skipped cycles, or even symptoms similar to polycystic ovary syndrome (PCOS) in some women. Hormones also affect seizure thresholds, meaning that hormonal fluctuations during your cycle can influence seizure control, and vice versa. It is a two-way street.

It is worth reviewing what medication you are on (some are more hormone-disruptive than others), your cycle patterns, any symptoms of PMS (premenstrual syndrome), hair changes, or weight gain that might point toward hormone imbalance or PCOS.

You do not need to be on birth control to notice these effects, but some women with epilepsy do benefit from hormonal regulation, sometimes even using hormonal contraceptives (carefully selected to avoid interaction with seizure medications). I would recommend speaking with both your neurologist and gynecologist, ideally a team familiar with catamenial epilepsy or hormone-related seizure patterns. Blood work for hormone levels and a pelvic ultrasound may be helpful, too. I am here to help you navigate this. It is manageable with the right coordination of care.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.