18. Perimenopause and Menopause

  1. Cynthia L. Harden MD Professor of Neurology2,
  2. Sanjeev V. Thomas MD, DM Professor of Neurology3 and
  3. Torbjörn Tomson MD, PhD Professor of Neurology and Epileptology4
  1. Cynthia L. Harden

Published Online: 24 JAN 2013

DOI: 10.1002/9781118531037.ch18

Epilepsy in Women

Epilepsy in Women

How to Cite

Harden, C. L. (2013) Perimenopause and Menopause, in Epilepsy in Women (eds C. L. Harden, S. V. Thomas and T. Tomson), John Wiley & Sons, Oxford. doi: 10.1002/9781118531037.ch18

Editor Information

  1. 2

    Chief, Division of Epilepsy and Electroencephalography, Hofstra North Shore-LIJ School of Medicine, Cushing Neuroscience Institutes, Brain and Spine Specialists, North Shore-Long Island Jewish Health System, Great Neck, New York, USA

  2. 3

    Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala State, India

  3. 4

    Karolinska Institutet, Stockholm, Sweden

Author Information

  1. North Shore-Long Island Jewish Health System, New York, USA

Publication History

  1. Published Online: 24 JAN 2013
  2. Published Print: 11 MAR 2013

ISBN Information

Print ISBN: 9780470672679

Online ISBN: 9781118531037



  • epilepsy;
  • perimenopause;
  • menopause;
  • hormone replacement therapy;
  • catamenial


Women with epilepsy may experience changes in their seizure frequency at perimenopause and menopause. Current but limited evidence suggests that women with epilepsy are at risk for increased seizures at perimenopause. If a catamenial seizure pattern occurred during reproductive years, menopause may be associated with a decrease in seizure activity. Frequent seizures over a lifetime may be associated with early cessation of ovarian function and earlier than expected onset of menopause. Hormone replacement therapy (HRT) for women with epilepsy should be used with caution, due to a risk of increased seizure activity with a commonly used form of HRT, specifically conjugated equine estrogens combined with medroxyprogesterone acetate.