Catamenial Epilepsy

Understanding Catamenial Epilepsy

Catamenial epilepsy is a sub-classification of epilepsy.  It refers to seizure patterns that seem to coincide with stages of menstruation.  (The word “cata” means having to do with and “mensa” means month, from which we get the notion of a woman’s time of the month.) 

Disclaimer: What follows is meant purely for explanatory purposes and should not be taken in lieu of a doctor’s visit.  If you believe your seizure pattern relates to your menstrual cycle, you should discuss this with your physician and decide on a treatment pattern.

The Menstrual Cycle and Seizure Patterns

Many women who suffer from epilepsy notice that they are more likely to have seizures during certain points in their menstrual cycle—most typically during the pre-menstrual cycle and into the main phase of menstruation.  This higher frequency of epileptic episodes during a particular point in the menstrual cycle is what physicians term catamenial epilepsy.  To receive this designation, a woman must document at least a two fold greater likelihood of having seizures during one phase of menstruation.

Women, of course, are more likely to suffer from epilepsy than men are.  Scientific researchers believe that the hormones involved in menstruation and wide jumps and drops involved in the menstrual cycle may significantly contribute to epileptic episodes.  There is varied evidence for this connection, but one of the most compelling is the decrease in epileptic episodes by many women when they reach menopause.  The leveling of hormonal patterns seems to leave women much less vulnerable to seizures.

Hormones and Catamenial Epilepsy

Generally speaking, researchers believe that estrogen may act as a catalyst for epileptic episodes while progesterone dampens both the frequency and severity of episodes.  Sufferers and the lay public should not, however, take this broad observation and overly simplify it.  The fluctuation between hormones also plays an important role in seizure frequency.  Sudden drops or increases in hormones can play just as important a role in seizure activity.  In fact, in many women seizures occur in the post-menstrual cycle.

In most women who suffer from catamenial epilepsy, however, researchers have documented a marked deficiency in progesterone levels.  This finding suggests that seizures may have more to do with the lack of regulation by progesterone rather than abnormally high levels of the estrogen catalyst.


For most women, treatment involves forms of hormone therapy that try to regulate hormone levels so that chemical aides can help moderate swings in hormone levels.  Unfortunately, such treatments produce menopause like effects for many women, including increased risk of osteoporosis.  Just as significantly, many women have their sex lives severally impaired by the epilepsy drug therapy, experiencing symptom that vary from vaginal dryness to pain during intercourse.

For this reason, treatment requires close monitoring by a medical professional so he or she can address problems before they increase in severity.  In addition, many patients also opt out of chemical treatment and look to treat their epilepsy behaviorally.  Typically, this behavioral approach involves avoiding epileptic triggers during high frequency periods in order to decrease the likelihood of attacks.  For example, an epileptic that is particularly susceptible to attacks after seeing flashing lights might avoid this stimulus during the phase of their menstrual cycles that they have designated as high frequency.

Similarly, patients can train themselves to recognize the symptoms that forewarn of an imminent attack and sit themselves down so they do not injure themselves during attacks.  Women with small children may also look for extra help during those days when they are most likely to have episodes.

Regardless of the approach you choose, you should do so in consultation with your physician so everyone can be on the same page when it comes to your health.