Menstruation and epilepsy
Hormonal changes at the start of puberty may affect seizures in some adolescents with epilepsy.
Hormones and seizures
If menstruation is the trigger for changes in seizure frequency, the scientific term used is catamenial epilepsy. This term refers to the timing of the seizure. It does not change the primary epilepsy diagnosis.
A small number of adolescent girls have increased seizures at certain times in their menstrual cycle when their hormones change. This does not always happen and in some cases seizures may lessen
Two main hormones relating to menstruation are progesterone and oestrogen. The levels of these hormones change during the menstrual cycle.
- Oestrogen lowers the seizure threshold, making it more likely a seizure will occur in some girls.
- Progesterone increases the seizure threshold, making seizures less likely in some girls.
Some treatments are available for adolescents with changes in their seizure patterns that are related to the menstrual cycle. If your child's seizures increase in puberty, your neurologist may change their anti-seizure medicines. This may improve seizure control.
Puberty and developmental disabilities
If a child has an intellectual disability, parents may worry about their child going through puberty and starting menstruation (or periods). Many parents worry whether their child will understand why they are bleeding and be able to cope with changing pads and tampons.
They may also worry about the risk of an unwanted pregnancy. These concerns should be discussed with your GP and paediatrician who can counsel you regarding contraception.
The Royal Children's Hospital Melbourne talks about puberty-related issues in children with a developmental disability. It also covers common worries about periods. For example, the website advises that it is helpful to explain to your daughter that:
- The blood is normal
- It will happen regularly
- It is part of her body changing
- She is not hurt.
Periods may not be a big problem. They are a normal part of being a girl, and good for bone and heart health.
Read more about periods and puberty from Family Planning Australia.
Managing difficult periods
For girls whose periods are more problematic and experience issues such as severe pain, irregular periods, or excessive bleeding, you could talk to your neurologist, GP or paediatrician about your concerns.
- They can explain the different options or suggest that you see a hormone specialist or paediatric gynaecologist.
- Various options are available for problematic periods. These include hormone treatments (tablets, devices that can be placed into the body, or injections) or intrauterine devices (IUDs).
- These options may help with good menstrual hygiene, decrease the number of periods, and reduce period pain.
- As each child is different, you can discuss your concerns with your doctor, who knows their medical history.