ABOUT 50 million people suffers from epilepsy everywhere in the world. Half of them are women.
So far, treatment for girls and men has been an identical. However, men and women experience epilepsy otherwise.
For women, fluctuating hormones – from reproductive years through pregnancy, perimenopause and menopause – can affect frequency attacks at many stages of their life.
As we describe in our recent articlewe must take this under consideration and adapt therapies for girls accordingly.
What is epilepsy?
In people without epilepsy, the general electrical activity of the brain is stable. Signals acting on neurons (brain cells) enable a balance between excitation (increased electrical activity of the brain) and inhibition (reduced electrical activity of the brain).
However, in epilepsy this balance is disturbed. When there may be a burst of uncontrolled electrical activity, some or the entire neurons are momentarily over-excited or operating in an “overdrive” mode. This results in a seizure (or seizure).
This disruption can occur unpredictably, a bit like an earthquake by which a seizure occurs unexpectedly and then normally ends abruptly.
Epilepsy can seriously affect people quality of life. The risk of epilepsy can also be increased in people with epilepsy premature death not only on account of epilepsy itself, but additionally other complications of seizures and suicide.
What role do hormones play?
The hormones estrogen and progesterone are produced within the ovaries and brain. Regardless of whether a lady has epilepsy or not, the degrees of those hormones change throughout her life. However, epilepsy can affect the production of estrogen and progesterone.
Estrogen signals generally greater electrical activity and progesterone signals less. The ratio of those two hormones is significant for the right balance of electrical activity within the brain.
However, an unfavorable relationship disturbs the balance, resulting in an avalanche of symptoms.
Some specific one anticonvulsants it will probably also change this ratio by reducing estrogen and progesterone levels.
Let’s take the instance of “catamenic epilepsy,” which one study reports about half women with epilepsy.
With such a epilepsy, women may experience more seizures at certain times during their menstrual cycle. This happens most frequently just periods when progesterone levels drop and the estrogen to progesterone ratio changes. In other words, progesterone appears to guard against seizures.
Perimenopause is one other time of hormonal changes. If a lady suffers from catamenic epilepsy, this could lead to a rise within the variety of attacks during perimenopause, when the degrees of each hormones grow to be irregular and periods grow to be more irregular. However, during menopause, when each hormone levels are consistently low, a decrease within the variety of seizures is observed.
Scientists do long known concerning the cyclical nature of fluctuations in reproductive hormones in women and their impact on epilepsy. However, this has not yet translated into the way in which we treat women.
What should we do?
We urgently need to research how hormonal fluctuations at different stages of a lady’s life affect her epilepsy and quality of life.
We need to raised understand whether we can reduce the frequency of seizures progesterones at certain times of the menstrual cycle. We also need to raised understand whether estrogens (menopausal substitute therapy, also referred to as hormone substitute therapy or HRT) may worsen seizures later in life.
If we don’t investigate the impact of hormonal fluctuations on epilepsy, we risk not treating the particular trigger that causes epileptic seizures in many ladies.
About 30% women with epilepsy don’t reply to pharmacological treatment. We don’t know the way much of that is on account of hormonal aspects.
However, we know that seizures play an enormous role in increasing the burden of this disease. And this weight will be improved by higher treatment of seizures.