Friday, December 19, 2008

Medical Articles Re. Loss Of Periods From Seizures

http://womenshealth.about.com/cs/epilepsy/a/seizureswmshlth.htm

http://www.epilepsyfoundation.org/living/women/handbook/chapter12.cfm

I just read too, that perimenopause precedes menopause by about 4 years. So I may have only 3 years left to be able to get pregnant. Perimenopause is defined as the onset of irregular menses, with or without hot flashes. I already have that. I've had 8 months of irregular menses, highly irregular, and yet I somehow still got pregnant, and I probably only have 3 more years left to be able to have any chance at all, before menopause. I would be hitting menopause earlier than even most epileptics, at the age of 37.

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Early menopause in women with epilepsy

The age of menopause and perimenopause may also be influenced by epilepsy. Klein et al. reported a significant risk of early onset of perimenopause in women with epilepsy compared to controls, as measured by symptom report and serum hormone levels.61 This increased risk was found in women with both primary generalized epilepsy and localization-related epilepsy.

A recent study of 68 menopausal women with epilepsy found that women with high seizure frequency (several seizures monthly) experienced menopause at an early age, with cessation of menses occurring at 46 to 47 years. Menopause occurred approximately 3 years later for women with well-controlled epilepsy, even when factors that produce early menopause, such as smoking, were controlled for. Type or duration of antiepileptic drug use did not influence this result.62

Therefore, high seizure frequency may be associated with an age of menopause as much as 4 to 5 years earlier than the population normative menopausal age of 51 years. These findings suggest that central nervous system factors are most important in the relationship of epilepsy to menopause, although a direct effect of epilepsy on the ovaries could also be occurring.

Adapted from: Klein P and Herzog AG. Endocrine aspects of partial seizures. In: Schachter SC, Schomer DL, eds. The comprehensive evaluation and treatment of epilepsy. San Diego, CA: Academic Press; 1997. p. 207-232.
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Titre du document / Document title
Premature ovarian failure in women with epilepsy
Auteur(s) / Author(s)
KLEIN Pavel (1) ; SERJE Adriana (1) ; PEZZULLO John C. (1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of Neurology, Georgetown University Hospital, Washington, D.C., ETATS-UNIS
Résumé / Abstract
Purpose. Women with epilepsy (WWE) have an increased risk for several reproductive endocrine disorders that may affect their fertility. The incidence of premature ovarian failure (POF) in women with epilepsy has not been systematically studied. This study examined the incidence of POF in women with epilepsy. Methods: Fifty consecutively evaluated cognitively normal women with epilepsy, aged 38-64 years, whose seizures began before age 41 years, were interviewed for symptoms of perimenopause and menopause. Endocrine studies, performed in women aged 45 years or younger at the time of evaluation, included serum follicle-stimulating hormone (FSH; done on menstrual cycle day 3 in menstruating women), inhibin A levels when FSH was normal, thyroid-stimulating hormone (TSH), prolactin, and, in menstruating women, menstrual cycle day 20 serum progesterone level. Nonsurgical premature menopause was defined as secondary amenorrhea of >12 months' duration with FSH levels of >14 International Units (IU) in women younger than 42 years. Premature perimenopause was defined by the presence of one or more of the following: somatic perimenopausal symptoms; change in previously regular menstrual cycles without evidence of other reproductive endocrine disturbance; and FSH level of >14 IU or inhibin A level of <7 pg/ml. Similarly aged neurologically normal women seen in the menopause and sleep clinics served as control subjects. Statistical analysis included Fisher's exact test, Kruskal-Wallis test, t test, and multivariate logistic regression analysis with significance set at p < 0.05. Results: Seven (14%) of 50 women with epilepsy had nonsurgical premature perimenopause (six of seven) or menopause (one of seven), compared with three of 82 control (p = 0.042). Five of 41 women with localization-related epilepsy (LRE) had POF compared with two of nine women with primary generalized epilepsy (PGE; p = 0.595). Mean age of POF was 39.6 years (range 37-42 years). Seizure duration, age at seizure onset, seizure severity and lateralization, smoking history, age of menarche, body mass index and incidence of depression was not statistically different between women with and without POF. There was no statistically significant association between POF and antiepileptic drugs (AEDs). Women with POF were more likely to have had catamenial exacerbation of their seizures than were women without POF (p = 0.02). Conclusions: Women with epilepsy have an increased risk for developing POF. This finding should be considered in counseling women with epilepsy on family planning.
Revue / Journal Title
Epilepsia ISSN 0013-9580 CODEN EPILAK
Source / Source
2001, vol. 42, no12, pp. 1584-1589 (21 ref.)
Langue / Language
Anglais
Editeur / Publisher
Blackwell, Malden, MA, ETATS-UNIS (1909) (Revue)
Mots-clés anglais / English Keywords
Endocrinopathy ; Female genital diseases ; Ovarian diseases ; Cerebral disorder ; Central nervous system disease ; Nervous system diseases ; Human ; Adult ; Female ; Hormonal investigation ; Risk factor ; Complication ; Incidence ; Premature menopause ; Early ; Ovarian failure ; Epilepsy ;
Mots-clés français / French Keywords
Endocrinopathie ; Appareil génital femelle pathologie ; Ovaire pathologie ; Encéphale pathologie ; Système nerveux central pathologie ; Système nerveux pathologie ; Homme ; Adulte ; Femelle ; Exploration hormonale ; Facteur risque ; Complication ; Incidence ; Ménopause précoce ; Précoce ; Insuffisance ovarienne ; Epilepsie ;
Mots-clés espagnols / Spanish Keywords
Endocrinopatía ; Aparato genital hembra patología ; Ovario patología ; Encéfalo patología ; Sistema nervosio central patología ; Sistema nervioso patología ; Hombre ; Adulto ; Hembra ; Análisis hormonal ; Factor riesgo ; Complicación ; Incidencia ; Menopausia precoz ; Precoz ; Insuficiencia ovárica ; Epilepsia ;
Localisation / Location
INIST-CNRS, Cote INIST : 1145, 35400009474868.0150

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