Menstrual Disturbances and Epilepsy

By: Aaliyah Ellison-McPeters

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What are Menstrual Disturbances Generally? 

Menstrual disturbances or disorders are any ailments that affect a woman’s typically normal menstrual cycle. Studies show that the potential causes for these abnormalities are frequent seizures and the use of anti-epileptic drugs; there is also a type of disorder called catamenial epilepsy that induces seizures around the menstrual cycle. In contrast, a study involving 271 women with epilepsy showed that menstrual disorder rates were similar among women with different types of epilepsy. These disturbances can include a variety of problems such as painful period cramps (dysmenorrhea), abnormal bleeding— usually heavy, or the absence of any bleeding, also known as amenorrhea.  

Many menstrual disorders many women and girls face are frequently caused by uterine fibroids,  polycystic ovary syndrome (PCOS), which are cysts on the ovaries, and endometriosis. Hormonal imbalances, uterine abnormalities like cysts or fibroids, and other medical conditions can cause problems such as heavy bleeding. Certain medical conditions like thyroid problems, blood clotting disorders, and disease of the liver or kidneys are among the list of disorders that can affect the health of a woman’s cycle. In the case of amenorrhea, the cause is often traced back to a malfunction in the endocrine system and the regulation of hormones. Menstrual disturbances are treated in several ways, depending on the source of the problem. Oral contraceptives, non-steroidal anti-inflammatory drugs, and non-surgical or minimally invasive procedures are typical treatments for varying degrees of dysmenorrhea. For heavy bleeding, hormone therapy, dilation, and curettage (D&C) or hysteroscopic procedures to remove problem areas of the uterus are typical treatments. 

Anti-epileptic Drugs and Menstrual Disorders 

Anti-epileptic drugs treat seizures by changing chemical levels within the brain and affecting the hormone release of sex hormones such as estrogen and progesterone. These hormones are essential for the optimal function of a woman’s reproductive cycle. Specifically, enzyme-inducing anti-epileptic drugs with endocrine side effects can increase the sex hormone globulin concentrations in women. Over time, an elevation of this hormone lowers the occurrence of estradiol—a form of estrogen predominately secreted from the ovaries, adrenal gland, and the placenta during pregnancy. Low estradiol may cause menstrual disorders, overall sexual health, and potentially reduced fertility.  

Seeking Treatment 

Menstrual disturbances include various problems, and the treatment options will vary depending on the problem. A typical treatment of menstrual disorders is hormone therapy, which is not recommended for epileptic women, as estrogen hormone replacement therapy can increase seizure frequency. However,  birth control is used to treat some menstrual disorders, and it is essential to speak with your neurologist to determine if your current AED affects the efficiency of the pill or contraceptive prescribed.  


Afzali, M., Habibabadi, J. M., Mohammadi, B., Masoumi, S., Ranjbar, M., Cheshmavar, M., & Naghibi,  S. N. (2021). The relationship between menstrual disorders and education in women with intractable epilepsy. American Journal of Neurodegenerative Disease, 10(6), 76-82.

Bosak, M., Słowik, A., & Turaj, W. (2018). Menstrual disorders and their determinants among women with epilepsy. Neuropsychiatric Disease and Treatment, 14, 2657-2664.  

Brodie, M. J., Mintzer, S., Pack, A. M., Gidal, B. E., Vecht, C. J., & Schmidt, D. (2013). Enzyme induction with anti-epileptic drugs: cause for concern? Epilepsia, 54(1), 11–27.

Contraception and Epilepsy | Epilepsy Society. (2020, March 15). epilepsy/women-and-epilepsy/contraception-and-epilepsy 

Menstrual disorders Information | Mount Sinai—New York. (n.d.). Mount Sinai Health System. Retrieved  September 27, 2023, from 

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