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Published on: May 16, 2019
The Menopause Transition and Epilepsy: A Focus on Therapeutics
Kelsey M Smith1, Stephanie S Faubion2, Lata Vadlamudi3,4
1Department of Neurology, Mayo Clinic, Rochester, MN.
Neurology. Clinical Practice
|August 13, 2026
Summary
Managing epilepsy during perimenopause and menopause presents challenges due to hormonal shifts and limited data on menopausal hormone therapy (HT). More research is needed to guide safe and effective treatment for women with epilepsy.
Area of Science:
- Reproductive endocrinology
- Neurology
- Clinical pharmacology
Background:
- Perimenopause and menopause involve hormonal changes impacting women's health.
- Women with epilepsy face unique challenges during menopause, including seizure control and medication interactions.
Purpose of the Study:
- To review current knowledge on managing epilepsy during perimenopause and menopause.
- To highlight the influence of hormonal changes and menopausal hormone therapy (HT) on seizure control and antiseizure medication (ASM) metabolism.
- To identify gaps in research for future studies.
Main Methods:
- This is a narrative review.
- Information was gathered on hormonal changes, menopause symptoms, HT, ASMs, and epilepsy management.
Main Results:
- Menopause symptoms can affect quality of life; HT is effective but data in women with epilepsy are limited.
- HT may impact seizure control and ASM metabolism (e.g., lamotrigine).
- Limited data may discourage HT use in women with epilepsy.
Conclusions:
- There is a significant lack of data to guide epilepsy management during perimenopause and menopause.
- This review summarizes existing data on HT and nonhormone therapies for menopause symptoms in women with epilepsy.
- Further research is crucial to address the unique considerations for this patient population.
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