The Connection Between Hormones And Epilepsy

If there’s one thing that we all learned in our health-based classes at school, it’s that every part of the human body works together to keep us going. This means that even if two functions don’t necessarily seem like they’re related, one could affect the other in surprising ways.

For instance, today’s topic is the connection between hormones and epilepsy. Because it’s not a connection that everyone would automatically think of, but the two elements can be surprisingly intertwined.

Something that I want to note before we dive in is that on the occasions where hormones and epilepsy are talked about, it’s normally centered around female hormones. And although it’s true that female’s hormones affect their epilepsy symptoms more than male’s hormones do, there is a connection for males as well.

So today we’ll be talking about hormones from both angles.

Female Hormones And Epilepsy

Not every female with epilepsy will find that their hormones affect their seizures; but for many females hormones can play a role in everything from when they have seizures during the month to when their epilepsy will potentially go into remission. 

For instance, when a female with epilepsy reaches puberty then some of the new hormones may cause them to have a lot more seizures than usual during this time of their life. This is the case for a lot of young girls with epilepsy, and in many instances the seizures will subside or at least go down in number after a girl’s hormones have settled.

But for some, the hormone fluctuations that occur on a monthly basis due to menstrual cycles can actually cause issues throughout the female’s adult life as well. And the way these issues play out can be different for every girl and woman. 

Some women might note that they have more seizures when they’re ovulating, and some might have more seizures during their periods. This is why it’s helpful to keep a seizure journal, where you take note of when you have your seizures; because then you can narrow down seizure patterns that may be linked to your menstrual cycle.

If you believe that your periods may be causing more seizures during certain times of the month then it’s typically suggested that you take extra precautions around that time. Try to get more sleep, be more careful around potential triggers, etc. Anything that you can do that you know reduces your seizures normally, try to be sure to do it during times of the month that are tricky for you.

Some doctors might also prescribe a secondary medication or higher doses of medication during the times of the month where you have more hormonally caused seizures. But a possible downside is that certain anti seizure medications can actually affect female hormones in a negative way, which could indirectly lead to more seizures.

The main issue with anti seizure medication is that it can change endocrine levels, which can lead to a variety of issues. But the issues that relate to today’s topic are sexual problems, issues with menstrual cycles, and even a reduction of fertility. This means that girls and women need to be mindful of the possible hormonal effects of the medicine that they’re prescribed.

The truth is, women with epilepsy often have fertility struggles. In fact, women with epilepsy have about a 25-33% lower fertility rate than non-epileptic females. Reproductive abnormalities are also considerably more common among this community.

Polycystic ovary syndrome (PCOS) in particular is much larger of a risk for female epilepsy patients. About 8-13% of the non-epileptic female population has PCOS but within the epileptic female community the percentage is around 26%! This is partly due to epilepsy but certain types of anti seizure medication may also cause PCOS.

Another thing that I want to talk about in this section is catamenial epilepsy; which is the ultimate example of how hormones can not only affect epilepsy, but sometimes control it.

Catamenial Epilepsy -

Catamenial epilepsy is a type of epilepsy in which the seizures are completely linked to a female’s menstrual cycles. It’s also a type that may be more common than you think, it’s estimated that around 40% of females with epilepsy have catamenial epilepsy. It’s especially common in females that are of reproductive age.

There are a few different types of catamenial epilepsy, and they’re split up based on which times of the month the seizures are the worst.

Catamenial Type 1 or C1 -  This type results in perimenstrual seizures, which occur either right before or during a period.

Catamenial Type 2 or C2 - With this type, seizures will worsen around ovulation. It’s often called a periovulatory pattern.

Catamenial Type 3 or C3 - When seizures occur more often during the second half of a cycle, or the luteal phase, then it falls into the final type.

The seizures that occur with catamenial epilepsy can be caused by two different factors; the amounts of progesterone and estrogen present in the body.

Progesterone is a hormone that is responsible for thickening the lining of a female’s uterus, which in turn prepares the body for potential pregnancy each month. But it also helps make neurosteroids in the brain, therefore controlling the excitability of nerve cells. This means that progesterone has anticonvulsant effects.

But during certain phases of the menstrual phase, progesterone levels drop and that can cause seizures. Progesterone levels drop during the luteal phase of the menstrual cycle, but also right before and during a period.

Catamenial type 3 is caused by the lack of progesterone levels secreted during the luteal phase. Sometimes catamenial type 1 can also be due to progesterone levels.

Estrogen is the most important reproductive hormone in a female body, and is responsible for regulating the menstrual cycle as well as helping to grow the uterine lining. But it also has proconvulsant effects, although we don’t know exactly why.

Estrogen levels increase around ovulation, which is why it’s associated with catamenial type 2. But right before and during the period, when progesterone levels are at their lowest, the estrogen levels remain steady. Meaning that there’s an imbalance of the two hormones and that can cause seizures, which is why estrogen can also cause catamenial type 1.

The treatment for catamenial epilepsy can be tricky since it’s often somewhat drug resistant, and as we discussed earlier, there are some anti seizure drugs that actually make the problem worse. Nevertheless, one or more seizure controlling medications will probably be prescribed.

Hormonal drugs are another option, although they can sometimes negatively interact with anti seizure medications. These drugs are aimed to change either progesterone or estrogen levels within the body, depending on what type of catamenial epilepsy the affected person has.

In some of the most severe cases, surgery may even be suggested. Potential surgery options might be to remove the ovaries and completely stop menstruation or perhaps a surgery that targets the affected area of the brain. It depends on the case.

Male Hormones And Epilepsy -

Although males with epilepsy don’t have as much to worry about, hormonally speaking, as females with epilepsy; there are still struggles involved.

I noticed during my research for this post that there really hasn’t been a lot of scientific research on the connection between male hormones and epilepsy, which probably contributes a lot to the lack of information. But I did find a few articles that shed some light on the topic.

Although we mostly associate male hormones with testosterone, males also have some amount of estrogen in their bodies. But it works a bit differently in their systems; because since they don’t have ovaries, their estrogen actually comes from their testosterone when that hormone is converted into estrogen within the brain.

But estrogen in males actually serves a similar purpose as it does in females, it’s critical for their reproductive and sexual functions. This also means that although the risk is lower for men to have estrogen related seizures, because they tend to have lower levels of the hormone, that it’s not impossible.

Furthermore, some research does suggest that males with epilepsy actually have fertility struggles as well. And whether through the epilepsy itself or the drugs used to treat it, they may also have lower testosterone levels than non-epileptic men. 

I even saw a study that suggested anti seizure medication may cause a delay in male development during puberty. If you’re interested in that then check out this article.

Conclusion -

This post really only scratched the tip of the iceberg when it comes to hormones and seizures, but I hope that it spreads some information that’s helpful or interesting to you. And I also hope that eventually, more scientific research will be done on the topic to fill in some of the areas we don’t know much about.

If you have more information to share then feel free to do so in the comments below, I’d love to hear from you guys. And if you’d like me to write another post related to this topic then I’m more than happy to.