When women enter menopause (the end of menstruation), numerous hormonal changes take place. Women are generally considered to have entered menopause if they do not have a menstrual cycle for 12 consecutive months. This happens to most women between the ages of 45 and 55, although it can occur earlier or later.

During menopause, the ovaries stop releasing eggs, which causes female sex hormone (estrogen and progesterone) levels to drop significantly. Hormonal levels that become imbalanced may affect the frequency and pattern of seizures in women with epilepsy.

It is understood that estrogen excites electrical activity in the brain and progesterone suppresses it. However, going through menopause does not always mean that seizures will stop or become less frequent. Some women with epilepsy experience more seizures during menopause, whereas others have less. Most women with epilepsy do not notice any change in the pattern or frequency of their seizures.

To relieve the symptoms of menopause, some women choose to undergo hormone replacement therapy (HRT). This usually takes the form of synthetic estrogen and progesterone supplements. There are several benefits associated with HRT, such as reduced bone loss. However, there is also evidence that HRT can contribute to breast cancer and may increase the risk of seizures in some women with epilepsy. Women with epilepsy should consult their physician about whether HRT is appropriate.