Interaction between epilepsy and endocrine hormones: Effect on the lifelong health of epileptic women

Women with epilepsy face unique challenges, some of which arise from the interaction between epilepsy and endocrine hormones. Epilepsy and endocrine hormones reciprocally influence one another such that hormonal changes impact epilepsy and epilepsy impacts hormonal functioning. In this article, the effect of that interaction on the lifelong health of epileptic women is examined. Fluctuations in sex hormones can increase the vulnerability to seizures in many epileptic women. One third to one half of women with epilepsy experience catamenial seizures (changes in seizure frequency at specific times during the menstrual cycle). Seizures can result in endocrine abnormalities that can effect menstrual irregularities, fertility, and sexual dysfunction and have been linked to polycystic ovary syndrome. The mechanisms of seizure-associated abnormalities have not been determined, but some theories include seizure-related disruption of hormones or brain regions mediating reproduction; antiepileptic drugs; and structural or functional central nervous system dysfunction associated with the disease of epilepsy (but not with seizure activity per se). By being aware of how endocrine hormones and epilepsy interact throughout the patient's life span, the healthcare provider is better equipped to manage endocrine-associated changes in seizure frequency and epilepsy-associated changes in neuroendocrine function.