title: The effect of menopause and perimenopause on the course of epilepsy.
abstract: OBJECTIVE
  The purpose of this study was to obtain preliminary information about the effect of menopause and perimenopause on the course of epilepsy, and to determine whether seizure type, use of hormone-replacement therapy (HRT), or a history of catamenial seizure pattern would influence this course.
  
  
  METHODS
  We performed a questionnaire study of women with epilepsy currently in menopause and perimenopause, requesting information regarding the course of their epilepsy and treatment. Statistical analysis was performed by using Pearson chi2 with 95% confidence limits.
  
  
  RESULTS
  Forty-two menopausal women (ages 41-86 years) responded. Twelve subjects reported no change in seizures at menopause, 17 reported a decrease in seizure frequency, and 13 reported an increase. Sixteen (38%) took synthetic HRT. Sixteen (38%) additional subjects (having some overlap with the HRT group) reported having a catamenial seizure pattern before menopause. HRT was significantly associated with an increase in seizures during perimenopause (p = 0.001). A history of catamenial seizure pattern was significantly associated with a decrease in seizures at menopause (p = 0.013). Thirty-nine perimenopausal women (ages 38-55 years) responded. Nine subjects reported no change in seizures at perimenopause, five reported a decrease in seizure frequency, and 25 reported an increase. Eight (15%) subjects took synthetic HRT, and 28 (72%) reported having a catamenial seizure pattern before menopause. HRT had no significant effect on seizures; however, a history of catamenial seizure pattern was significantly associated with an increase in seizures at perimenopause (p = 0.02).
  
  
  CONCLUSIONS
  These pilot data suggest that synthetic HRT may be associated with an increase in seizure frequency in menopausal women with epilepsy. A catamenial seizure pattern may be associated with seizure decrease during menopause but with an increase during perimenopause.
authors.affiliation: Comprehensive Epilepsy Center, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York 10021, USA. clharden@mail.med.cornell.edu
authors.forename: C L
authors.initials: CL
authors.lastname: Harden
authors.forename: M C
authors.initials: MC
authors.lastname: Pulver
authors.forename: L
authors.initials: L
authors.lastname: Ravdin
authors.forename: A R
authors.initials: AR
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002979:Climacteric / Q000502:physiology*; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D004967:Estrogens / Q000502:physiology; D005260:Female; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008598:Menstruation / Q000502:physiology; D008875:Middle Aged; D010052:Ovariectomy; D010053:Ovary / Q000502:physiology; D011374:Progesterone / Q000502:physiology; D012720:Severity of Illness Index
chemical_list: D004967:Estrogens; D011374:Progesterone