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Catamenial epilepsy is a type of seizure related to the menstrual cycle. The name of this condition is derived from the Greek and it means “by month” or “monthly”. In this type of epilepsy, seizures are triggered by menstruation.

However, only in a small number of cases can women experience epileptic seizures only at the time of menstruation. More commonly, women tend to have more seizures during a particular period of their menstrual cycle. The seizures are more frequent at the time of ovulation or at the beginning of menstruation.

Causes of Catamenial epilepsy

A woman’s menstrual cycle is associated with hormonal fluctuations. The levels of estrogen and progesterone drastically change during the different periods of a cycle. These two hormones play an important role in Catamenial epilepsy patterns. The estrogen is known to assist the seizures, while the progesterone protects the woman against the seizures.

Normally, the estrogen levels are high during the time of ovulation, and the progesterone levels significantly drop just before or during the period of menstruation. Women with anovulatory cycle are experience higher levels of estrogen at the end of follicular phase, and these levels are high until a couple of days before the menstruation.

However, the balance of estrogen and progesterone in these women is disturbed, because their body produces little or no progesterone. The relative excess of estrogen trough out the second half of menstrual circle makes these women prone to seizures.

Treatment methods

There are a number of available treatment methods for patients suffering from Catamenial epilepsy. Most of the treatments are focused on progestagens or porgestins.  However, progesterone therapies are associated with a number of highly unpleasant side-effects such as vaginal dryness, dyspareunia, osteoporosis and coronary diseases.

Antiestrogens, such as clomiphene, are also being used in treatment of Catamenial epilepsy. There is the evidence of reduced seizures in women with intractable partial epilepsy, using the antiestrogens treatment. However, these medications have been related with possibly severe side effects such as hot flashes, polycystic ovaries, and unplanned pregnancy.

Hormone replacement therapy was until recently considered as one of the major treatment methods for catamenial epilepsy. However, the results have shown that hormonal replacement therapy has an extremely negative effect on the seizure patterns. It is associated with the increase of seizure occurrence and their severity.

This kind of treatment is especially dangerous for menopausal and pre-menopausal women with epilepsy, and may produce an increase in seizures and auras. Most recent scientific studies reveal that a noteworthy proportion of women with epilepsy reported that hormonal replacement therapy actually worsens their state.

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