Could my menstrual cycle or hormones trigger seizures?

Question

Hello doctor,

I am a 28-year-old woman who has had two seizures in the past month. My neurologist wants to start me on anti-seizure medication. I am worried about side effects, especially weight gain and fatigue, and how the medication might affect my ability to work or drive. I wanted to know:

Could my menstrual cycle or hormonal changes trigger seizures?
Are there safe treatment options for women who are planning a pregnancy in the future?

I would like to know how to prevent seizures while maintaining a normal and healthy life. Please help.

Thank you in advance.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Since you have had two seizures within a short time, your neurologist is right to start anti-seizure medication to prevent further episodes and protect brain function. Most women with epilepsy live completely normal, productive lives once their seizures are well-controlled.

1. Common medication options:

For women, medicines such as Lamotrigine or Levetiracetam are usually preferred. Both are effective, generally do not cause significant weight gain or drowsiness, and are considered safer for future pregnancy. Other drugs, such as Valproate, are avoided in young women because of the higher risk of birth defects.

2. Hormones and menstrual cycle:

Yes, in some women, seizures become more frequent just before or during menstruation, which is called catamenial epilepsy. Hormonal changes in estrogen and progesterone can affect brain excitability. Keeping a track like a seizure diary and tracking your menstrual cycle helps identify patterns, and your doctor can adjust the medication or its timing accordingly.

3. Lifestyle and safety:

Take your medication every day at the same time. Missing doses is a major cause of seizure recurrence. Ensure seven to eight hours of sleep each night and manage stress, as both are strong seizure triggers. Avoid alcohol and flashing lights if they tend to provoke your seizures. Until you have been seizure-free for at least six months, driving should be avoided by law in most areas for safety reasons.

4. Pregnancy planning:

When planning pregnancy, continue your medication; never stop it suddenly. Work with your neurologist to maintain stable drug levels and start Folic acid (4 mg daily) before conception to protect the baby’s brain development.

With the right medication and a consistent, healthy lifestyle, seizures can be effectively controlled. Lamotrigine or Levetiracetam are safe, hormone-friendly options for women, allowing you to live, work, and plan a family with confidence.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.