This systematic review assessed the impact of hormone replacement therapy (HRT) on seizure frequency in peri- and postmenopausal women with epilepsy (WWE). Estrogen may increase seizure risk, while progesterone may reduce it, suggesting exogenous hormones could influence epilepsy outcomes. Of 497 articles screened, 13 were included—three human studies and ten involving animal models. The human studies yielded mixed results: one suggested reduced seizures with combined HRT, another indicated increased seizures, and a clinical trial found a dose-dependent seizure increase in women with focal epilepsy. Animal studies showed inconsistent findings. Overall, evidence remains limited and inconclusive. Further research and prospective registries are needed to evaluate the risks of HRT in WWE.
Author(s):
Carvalho V et al.
References including authors:
Carvalho V, Colonna I, Curia G, Ferretti MT, Arabia G, Molnar MJ, Lebedeva ER, Moro E, de Visser M, Bui E; Gender and Diversity Issues in Neurology Task Force of the European Academy of Neurology. Sex steroid hormones and epilepsy: Effects of hormonal replacement therapy on seizure frequency of postmenopausal women with epilepsy-A systematic review. Eur J Neurol. 2023 Sep;30(9):2884-2898. doi: 10.1111/ene.15916. Epub 2023 Jul 4. PMID: 37326003.