Women with the brain disorder epilepsy may have several special considerations because of the relationship between the female sex hormones, estrogen and progesterone, and seizures. Some women find that the frequency and pattern of their seizures fluctuate during times of significant hormonal change, such as during puberty, pregnancy and menopause (the end of menstruation). Many women also notice a change in their seizures during their menstrual cycle.

Estrogen and progesterone are hormones that regulate the menstrual cycle and prepare the body for reproduction. Estrogen excites electrical activity in the brain, increasing the risk of seizures, whereas progesterone suppresses electrical activity and reduces seizure risk. Therefore, when imbalance occurs and there is more estrogen in the body than progesterone, it can increase the risk of seizures in women with epilepsy.  

Over 90 percent of women with epilepsy give birth to a normal, healthy baby, according to the National Institute of Neurological Disorders and Stroke (NINDS). However, there are special considerations for pregnant women with epilepsy. For example, most pregnant women with epilepsy are encouraged to lower their dose of seizure medication or switch to a different medication to reduce the risk of birth defects. Additionally, women should take special precautions after giving birth to ensure the safety of themselves and their child, such as avoiding bathing the child alone and feeding the child on the floor to reduce the risk of an accidental fall should a seizure occur.

When women enter menopause, their seizure activity may or may not change. In addition, some menopausal women with epilepsy experience complications related to hormone replacement therapy (HRT) because of its use of synthetic estrogen and progesterone.

Additionally, women with epilepsy may face special complications associated with their seizure medications. For example, some seizure medications interfere with the effectiveness of oral contraceptives.