![]() ![]() Further studies in women with catamenial epilepsy are needed in this area. ![]() Our review highlights an overall lack of information on the effectiveness of a wide range of other hormonal and non-hormonal treatments currently being used. We found very limited, mostly low-certainty evidence, of no difference in seizure outcomes for norethisterone and progesterone versus placebo in women with catamenial epilepsy. We judged the certainty of the evidence to be very low to moderate, as the included studies provided unclear information on methods of blinding, recruited small numbers of participants, and were inconsistent in reporting treatment outcomes. The included studies reported limited information on side effects, but women taking progesterone were no more likely to withdraw from the study due to side effects than those receiving placebo. The included studies did not demonstrate any significant differences between groups when comparing progesterone or norethisterone to placebo for seizure outcomes. The four included studies involved a total of 192 women aged between 13 and 45 years experiencing catamenial epilepsy. We did not find any studies testing non-hormonal treatments or any studies in women with irregular periods. In all of these studies, the treatment was compared to a placebo (a harmless sugar pill). We included four randomised controlled trials (studies in which participants are randomly assigned to one of two or more treatment groups) of hormonal treatments in the review, two trials evaluating progesterone and two evaluating norethisterone. We also examined the reasons why women dropped out of the studies and any reported side effects. Our outcomes of interest were: average change in seizures, percentage of women achieving a reduction in seizures by at least 50%, and percentage of women who became seizure-free. ![]() We searched electronic databases to find relevant studies in which treatment was continued for at least 12 weeks. The aim of this review was to examine the effectiveness of hormonal and non-hormonal treatments in stopping seizures in women with catamenial epilepsy. ![]() This review aimed to address these issues in order to inform clinical practice and future research. There are also concerns about the possible impact on fertility, the menstrual cycle, bone health, and cardiovascular health. There is uncertainty regarding which treatment works best and when in the menstrual cycle treatments should be taken. Women may not receive appropriate treatment for their catamenial seizures. medroxyprogesterone (Depo-Provera) or gonadotropin‐releasing hormone (GnRH) analogues (triptorelin and goserelin)) are treatment options.Ĭatamenial epilepsy is common in women with epilepsy, and may have a significant negative impact on quality of life. In women who do not have regular periods, and who therefore cannot predict their period days, stopping periods using synthetic hormones (e.g. clobazam or acetazolamide) taken prior to and during a period may be used. progesterone supplements) and non-hormonal treatments (e.g. If a woman has regular periods, hormonal (e.g. The link between high levels of oestrogen and risk of seizures remains unclear.Ĭurrent treatment of catamenial epilepsy depends on whether a woman has regular or irregular menstrual periods. Studies in animals have demonstrated that lower progesterone may affect how the brain reacts to the brain chemical gamma-Aminobutyric acid (GABA), which is important in preventing seizures. The reason for this increased risk may relate to changes in the levels of progesterone (a hormone released by the ovaries) around the time of a menstrual period and oestrogen (a female sex hormone) surge around ovulation. There are specific times within the menstrual cycle when women are most at risk: in the days leading up to a menstrual period and during a menstrual period (perimenstrual or catamenial type 1 pattern) at the time of ovulation (catamenial type 2 pattern) and in the second half of their cycle (luteal phase, or catamenial type 3 pattern). Catamenial (menstrual) epilepsy describes a worsening of seizures in relation to the menstrual cycle and may affect around 40% of women with epilepsy. ![]()
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