Progesterone Therapy & Catamenial Epilepsy

Epilepsy is a neurological condition marked by recurring seizures. We are not here to discuss  the complex subject of epilepsy and epilepsy treatments in general, but specifically catamenial epilepsy, or epilepsy that aligns itself with the menstrual cycle.

Catamenial Epilepsy & The Hormone Connection

Reproductive hormones are neuroactive, and their cyclic variation during the menstrual cycle can either excite neuronal activity, or calm it.

There appear to be three, possibly more, patterns of catamenial seizure exacerbation. Those that are known are during the pre-menstrual days, the pre-ovulatory days or during the entire luteal phase in anovulatory cycles.

What causes this? Estrogen can increase brain excitability, potentially making seizures more likely, while progesterone has a calming, protective effect on the nervous system. When progesterone levels drop (such as right before menstruation), seizure risk can rise. This link is now well-documented in medical research and has led to growing interest in using progesterone as a supportive therapy.  See here, here.

How Progesterone May Help

• Stabilizes brain activity: Progesterone and its metabolites enhance GABA activity, the brain's main calming neurotransmitter, which helps reduce seizure likelihood.
• Balances estrogen: By countering estrogen's excitatory effects, progesterone helps to maintain balance in the hormonal system.

Natural Solutions: Steps to Consider

• Track your cycle and symptoms: If you notice a pattern between seizures and your cycle, consider keeping a detailed diary.
• Discuss progesterone therapy with your healthcare provider: Supplementing with bio-identical progesterone may be something to consider. 
• Optimize vitamin D levels: Vitamin D is essential for normal cell function. Like progesterone, vitamin D is neuroprotective. See our page on Progesterone & Vitamin D.
• Reduce seizure triggers: Prioritize good sleep, manage stress, and avoid known dietary or environmental triggers.

For a deeper dive into the science, visit our dedicated page on progesterone therapy and epilepsy and the associated research papers.