Epilepsy: Menstrual Disorders

The menstrual cycle can lead to changes in seizure frequency in some people with epilepsy.

What causes increased seizures in people born with female reproductive organs?

During the menstrual cycle, the body goes through many hormonal changes over the course of the cycle, which can increase the likelihood of experiencing a seizure. There are two main hormones involved in regulating the menstrual cycle: Progesterone and Estrogen. Due to the fluctuations in hormones, a person with female reproductive organs may be more or less likely to have a seizure at certain times in their menstrual cycle.

When am I at the highest risk for a seizure during my cycle?

There are two points in the menstrual cycle where an individual with female reproductive organs is at the highest risk for a seizure. The first is just before or during your period, between days 0-7. The second is just before ovulation between days 8-14. If you have epilepsy and you have noticed an increase in seizures related to your menstrual cycle, talk to your health care provider (HCP).

Are there certain gynecology conditions that affect people with epilepsy?

Yes, people diagnosed with epilepsy may be at a higher risk of polycystic ovarian syndrome (PCOS).

What is PCOS?

Polycystic ovary syndrome (PCOS) is a hormone imbalance that can cause irregular periods, unwanted hair growth, and acne. PCOS often begins during a girl’s teen years and can be mild or severe.

What are the signs of PCOS?

Some of the most common signs of PCOS include:

  • Irregular periods that come every few months, not at all, or too frequently
  • Extra hair on the face or other parts of the body, called hirsutism (her-suit-is-em)
  • Treatment-resistant acne
  • Weight gain and/or trouble losing weight
  • Patches of dark skin on the back of the neck and other areas, called acanthosis nigricans(“a-can-tho-sis ni-gri-cans”)

I have heard diet and exercise helps PCOS. Will this also help my epilepsy?

While exercise and weight loss have been found to help improve PCOS in some patients, larger studies are needed to determine the best recommendations regarding efficacy of certain seizure medications and seizure risk in those with epilepsy and PCOS.

Am I at an increased risk for menstrual dysfunction due to my epilepsy?

People with epilepsy may be at a greater risk for menstrual cycle disturbances compared to the general population. These changes may include irregular cycles, prolonged menstrual cycles, or lack of menses. Studies estimate that 1 out of 3 people with epilepsy will have menstrual cycle dysfunction, compared to 1 out of 7 people in the general population.


If you are someone with epilepsy that has problems with your menstrual cycle, please consult with your epilepsy doctor, gynecologist, or primary care doctor.