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Hormones and Epilepsy

  • Writer: Austin Cole
    Austin Cole
  • Feb 9
  • 4 min read

If you’ve ever felt like your seizures follow a calendar, or noticed a shift in your brain health during a major life change, you aren't imagining it. Your hormones might be the missing piece of the puzzle.


Hormones are chemical messengers that help regulate growth, mood, sleep, metabolism, and reproduction. Because hormones also interact with brain cells, shifts in hormone levels can sometimes change brain excitability, which can affect how likely seizures are to happen.


For many young adults with epilepsy, hormone related changes show up during puberty, across the menstrual cycle, during high stress periods, or when starting, stopping, or switching hormone based medications (like birth control). This does not mean hormones are the cause of epilepsy, but for some people they can meaningfully influence seizure patterns.


This page explains the basics of how hormones can affect seizures and what you can do with that information.


Why hormones can affect seizures

Your brain is an electrical network. Anything that shifts brain excitability can potentially affect seizure risk, and hormones can do exactly that. Some hormones can make neurons more ready to fire, while others tend to calm brain activity and stabilize signaling.


Two reproductive hormones come up a lot in epilepsy discussions:


  • Estrogen: often associated with increased brain excitability in some people

  • Progesterone: often associated with a more calming, anti seizure effect in some people

That does not mean estrogen is “bad” or progesterone is “good.” It means that when these hormones rise and fall in predictable patterns, some people notice predictable shifts in seizure frequency, intensity, or timing.


Puberty: a common time for change

Puberty is a major hormonal transition, and it is also a common window when seizure patterns can change. That can look like seizures beginning for the first time, seizure frequency changing, or triggers shifting. It can also be a time when medication responses feel different than they used to.


If you are a young adult who has noticed changes since your teen years, you are not imagining it. For some people, epilepsy and puberty overlap in a way that can affect seizure control, especially when sleep patterns, stress levels, and daily routines are changing at the same time.


Practical tip: if you are seeing changes, track them (sleep, stress, medication timing, cycle timing if relevant) and bring that data to neurology visits. Patterns are easier to address when they are visible.


Menstrual cycles and catamenial epilepsy

Some people with epilepsy have seizures that cluster around specific points in the menstrual cycle. When seizure patterns are tied to the cycle, it is often called catamenial epilepsy.


Many people report seizure increases:

  • Around ovulation (mid cycle), when the estrogen to progesterone ratio may be higher

  • In the days leading up to a period, when progesterone drops

Not everyone experiences this, but it is common enough that it is worth considering if you menstruate and notice a calendar pattern to seizures. Some people also notice changes when cycles are irregular, when sleep is disrupted around the cycle, or when cramps and pain increase stress and fatigue.


Practical tip: use a simple tracker for 2 to 3 months (period start date, ovulation estimate if you track it, seizure days, sleep, and stress). This gives your clinician clearer signal than memory alone and can help guide next step decisions.


Stress hormones (cortisol) and seizures

Stress is a very real seizure trigger for many people. One reason is that stress affects the body’s hormone systems, especially cortisol, a key stress hormone. Research shows links between seizure activity, seizure frequency, and cortisol changes, suggesting stress biology can interact with seizure threshold.


Stress also tends to stack triggers: disrupted sleep, skipped meals, dehydration, and inconsistent medication timing often happen during stressful periods, which can compound risk even further.


Practical tip: stress management does not have to mean vague advice. Think in concrete levers that protect seizure threshold:

  • consistent sleep timing

  • regular meals and hydration

  • realistic scheduling (avoid chronic sleep debt)

  • therapy or coaching for anxiety or depression when present


Hormones in males: testosterone and epilepsy

Hormones matter for men too. Testosterone can influence energy, mood, sexual function, and bone health. In men with epilepsy, low testosterone is reported more often than many people realize, and both seizures and certain anti seizure medications may contribute.


This topic matters because quality of life symptoms can be overlooked when the focus stays only on seizure counts. Hormones can affect motivation, recovery, mood stability, and overall wellbeing.


If you are experiencing symptoms like low libido, fatigue, depressed mood, or reduced motivation (especially if symptoms started or worsened after a medication change) it is worth discussing hormone testing with your clinician. This is about quality of life, not just seizure frequency.


Hormonal treatments: birth control, hormone therapy, and seizure meds

Hormonal treatments can affect seizures, and seizure medications can affect hormonal treatments. The most important high impact topic here is birth control and anti seizure medication interactions.


Some anti seizure medications (often called enzyme inducing medications) can increase how quickly the body breaks down hormonal contraceptives. That can make certain forms of birth control less effective. On the flip side, certain hormonal methods can also affect levels of some anti seizure medications, which may matter for seizure control or side effects.


Practical tip: if you use hormonal contraception (or are considering it), make sure the prescribing clinician knows your exact anti seizure medications. In many cases, there are effective options that avoid problematic interactions.


Sometimes, clinicians consider hormone related strategies for people who have clear cycle linked seizure patterns. Evidence is mixed overall, and results can vary by person, meaning this is highly individualized. The best next step is usually documentation (tracking) plus a conversation with a neurologist who is comfortable managing menstrual related seizure patterns.


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