Studies conducted by American Academy of Family Physicians reveal that about 1 percent of the population suffers from seizures induced epilepsy. And though women and men both are affected similarly, but research reveals that women are more vulnerable to seizures mainly because of their hormonal shifts.
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Why Women Experiences Fluctuations in Their Seizure Activity?
When a women experiences changes in their progesterone and estrogen levels; they also experience changes in their seizure activity. According to an expert neurologist, estrogen increases the seizure activity while progesterone helps in controlling it to some extent. This happens because estrogen promotes overstimulation of nerve cells, while progesterone usually prevents & controls the nerve cells from getting overstimulated in the brain. As a consequence, women experience fluctuation in their convulsions during: Perimenopausal 
period, menopause and regular menstrual cycles.
In the course of a regular menstrual cycle, there is an increase flow of estrogen especially during the time of ovulation and progesterone flow is minimized during menstrual flow. At both these times, the seizure activity is at the peak for some women. You may be thinking that as estrogen levels are at minimum during menopause and perimenopaise period, women with epilepsy will experience fewer seizures during this time – but it’s not that simple as it looks.
Study on Relationship between Seizure Activity and Menopause
A study conducted by Epilepsy foundation compared menopausal and premenopausal period in epileptic women and observed that majority of the women experienced no change or any improvement at all in their seizure activity. However, 45 percent did mention that during menopause they experienced their worst seizure activity. Another similar study was conducted in Europe which revealed almost the same results: 70 percent reported an improvement or no change in their seizure activity during menopause, while 30 percent reported that they experienced the worst seizure activity during menopause.
These research programs revealed that effects of menopause on seizure activity are random or erratic. This is mainly because both the hormones: estrogen and progesterone goes down during menopause. In any case, there is no visible trace of lower seizure activity after menopause for most epileptic women.
As women age there are many changes that can greatly affect their seizure activity and there is no need to change or modify epilepsy treatment during menopause. Any alteration in your treatment largely depends on the severity & the number of seizures you experience during or after menopause.
Recommended Treatment and Its Associated Risks
Many gynecologists recommend a hormone replacement therapy (HRT) to control seizure activity in women associated with menopause. However, this decision should be made very carefully as HRT is comprised of progesterone, testosterone and estrogen, seizure frequency can be affected. It is essential that you discuss all associated risks with HRT with your neurologist. Though HRT can reduce the risk of osteoporosis and cardiovascular diseases but on the other hand, it can also increase the risk of breast and uterine cancer. Neurologists do not know for certain and cannot guarantee that HRT will surly control your seizure activity. However, if you have no option left and your seizure activity is at its maximum during menopause and making it difficult to live everyday life, then surly HRT is the risk that you have to take.