Epilepsy and Puberty in Women
| In general, we need more information to determine how seizures are affected by the changes in women's bodies during puberty and menopause. Currently, little is known about how physical changes associated with these periods of life cause increases or decreases in seizures or what precise relationship exists, if any. There are, however, a few indicators that may aid in prediction and there are some studies that measure how commonly women experience seizure onset, exacerbation or diminishment during these phases. |
Puberty
Research indicates that there may be a relationship between the onset of puberty and changing seizure patterns. Some young women may experience their first seizures within months of the time that they begin to menstruate. Many women who began to have seizures as children find that their seizure types and patterns change with the onset of puberty. Different trends can be seen among women with different types of seizures. Medical treatment may vary accordingly.
Adolescence can be very challenging. Changing seizure patterns can create additional stresses for young women with epilepsy. You may have questions about sexuality and epilepsy. You may need to find new ways to tell your friends and to cope with seizures at school or in social situations. Having a strong support network, recognizing the signs of depression and having someone to talk to can be very helpful.
The exact effects of epilepsy on puberty and puberty on epilepsy are unclear. Seizure patterns may change, stay the same, or disappear. One important issue regarding girls with epilepsy is the effects of their antiepileptic drugs (AEDs) on their growth and development.
For example, valproate is effective for treatment of a variety of seizure types both in adults and in children with epilepsy, but it induces obesity and polycystic ovaries in a considerable percentage of women, particularly when the medication is started before the age of 18. Valproate may induce hyperandrogenism (when testosterone levels are a lot higher than normal levels) in girls with epilepsy and it is seen that the frequency of hyperandrogenism increases with pubertal development. Hyperandrogenism can cause some appearance changes, such as increased hair growth and coarsening of facial features. It is advised that endocrine observations be made of girls taking certain AEDs (valproic acid, carbamazepine) for epilepsy.
Furthermore, complications can arise when teens taking anticonvulsants are also taking birth control pills. A study showed that 67% adolescent girls taking both oral contraceptives and anticonvulsants experienced menstrual irregularities.
For the adolescent, epilepsy is a traumatic disorder that adds to the normal troubles of puberty. There are many other issues that must be addressed by a health care provider, counsellor, teacher and parent(s):
- Psychosocial issues
- freedom
- self-control
- feelings of invincibility
- and fears of dying, injury, public humiliation and social isolation
- Social stigma, including teasing and cruelty from peers
- Rebellious behaviour, including recreational use of drugs and alcohol
- Struggles with emerging sexuality, birth control and pregnancy
- Compliance problems, including denial of the disorder
- Need for early career counselling
- Concerns about driving
- Lifestyle management
- Cosmetic side effects of AEDs (increased appetite and weight gain, changes in hair texture, acne)
- Cognitive side effects of AEDs that interfere with schoolwork
|
