WHAT IS CATAMENIAL EPILEPSY?

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A seizure is a burst of uncontrolled electrical activity between brain cells (also called neurons or nerve cells) that causes temporary abnormalities in muscle tone or movements (stiffness, twitching or limpness), behaviors, sensations or states of awareness.  Seizures are not all alike. A seizure can be a single event due to an acute cause, such as medication. When a person has recurring seizures, this is known as epilepsy. [Source]

Epilepsy is a brain disorder that causes recurring, unprovoked seizures. Your doctor may diagnose you with epilepsy if you have two unprovoked seizures or one unprovoked seizure with a high risk of more. Not all seizures are the result of epilepsy. Seizures may relate to a brain injury or a family trait, but often the cause is completely unknown. The word "epilepsy" simply means the same thing as "seizure disorders." It does not state anything about the cause of the person's seizures or their severity. [Source] 

The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that makes pregnancy possible. Each month, one of the ovaries releases an egg. This is called ovulation. Hormonal changes at this time get the uterus ready for pregnancy. If the released egg isn't fertilized during ovulation, the lining of the uterus sheds through the vagina. This is a menstrual period. [Source]

 The ovarian cycle controls the production and release of eggs and the cyclic release of estrogen and progesterone.  The ovaries are small, oval-shaped glands located on either side of your uterus. They produce and store your eggs (also called ovum) and make hormones that control your menstrual cycle and pregnancy. During ovulation, one of your ovaries releases an egg. If a sperm fertilizes this egg, you can become pregnant. [Source]

 Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, skin, muscles and other tissues. These signals tell your body what to do and when to do it . [Source]

Days 1-14

The follicular phase starts on the first day of your period and lasts for 13 to 14 days, ending in ovulation. During this phase, the ovarian follicles mature and to prepare one of them for release during ovulation. During the same period, there are concurrent changes in the endometrium, which is why the follicular phase is also known as the proliferative phase. [Source]

The luteal phase happens in the second part of your menstrual cycle. It begins around day 15 of a 28-day cycle and ends when you get your period. The luteal phase prepares your uterus for pregnancy by thickening your uterine lining. A disorder involving your luteal phase can affect getting and staying pregnant. [Source]

Luteinizing hormone (LH) is a chemical in your body that stimulates important processes in your reproductive system, like ovulation. [Source] Your doctor might want you to get a luteinizing hormone test to check your fertility or check for a pituitary gland problem.  [Source]

 Follicle-stimulating hormone (FSH) is a hormone produced by the anterior pituitary in response to gonadotropin-releasing hormone (GnRH) from the hypothalamus. FSH plays a role in sexual development and reproduction in both males and females.  [Source]

 Estrogen is a steroid hormone associated with the female reproductive organs and is responsible for developing female sexual characteristics. Estrogen is often referred to as estrone, estradiol, and estriol.  [Source]  The rise in estrogen during ovulation may also rigger seizures in women with CE. [Source] 

Progesterone is primarily known as the pregnancy hormone in females, and most of its function relates to maintaining pregnancy specifically by preparing the endometrium, decreasing myometrial contractions for implantation, promoting gestation, and inhibition of lactation during pregnancy.   [Source]  The drop in progesterone just before menstruation may trigger seizures in women with CE  [Source].

The classification as C1, C2, or C3 allows the provider to individualize and optimize their medication. [Source]

• C1 pattern - perimenstrual or day 25 of a current cycle until day 3 of the following cycle.  The perimenstrual subtype (C1) is characterized by the rapid drop in progesterone during menstruation (days 25 to 3 of the following cycle). Although the proconvulsant estrogen does drop as well in this period, the progesterone experiences a more rapid decrease. This pattern has been the most responsive to treatment.  

• C2 pattern - periovulatory or days 10 to 15 of the same cycle.  The periovulatory subtype (C2) is characterized by the rapid surge of estrogen at day 10 to 15.  

• C3 pattern - inadequate luteal phase or day 10 of a current cycle to day 3 of the following cycle.  The inadequate luteal phase subtype (C3) is characterized by an inadequate rise of progesterone during the luteal phase (days 10 to 3 of the following cycle).