Talking to your GP about epilepsy, perimenopause and menopause

We have more information about epilepsy and menopause here.

Making your appointment with the GP

• Ask if there is a doctor at your surgery with a special interest in menopause
• Ask your surgery for a double appointment so you have enough time to talk about everything you need to
• Keep a diary or list of your menopause symptoms- you can use the Balance App to help with this
• Keep a diary of your epilepsy symptoms – you can use the Balance app or print our perimenopause and menopause symptom checker

How to advocate for yourself

Try to stay informed. You can use the following resources:

• Our information on epilepsy and menopause
• Women’s Health Concern and the British Menopause Society factsheet Epilepsy, the menopause and HRT
• National Institute for Health and Care Excellence guideline on menopause

It may also be helpful to:

• Make a note of your questions and concerns to take to your appointment
• Bring someone you trust to support you, if needed
• Listen to yourself and trust your instincts. You know your body best
• Ask your GP to explain your care and treatment options and the pros and cons of each
• Keep detailed records of your medical history, including any medications you are taking
• Be aware that your GP may need to refer you to a specialist for further advice, especially if your epilepsy is not well controlled. Or, if your seizures increase after starting treatment for menopause symptoms

Shared decision making

Shared decision making is when health professionals and patients work together to make a decision about treatment and care.

The care and support you receive should be based on your needs and what matters most to you. If you are not happy with your GP’s approach, you can ask to see another doctor at your practice.

You can also book a review with your consultant neurologist or epilepsy nurse if your seizures are being affected by the menopause. You can discuss your symptoms with them.

Key points

• Hormone changes during perimenopause and menopause can affect epilepsy
• Having epilepsy is not a reason hormone replacement therapy
• HRT is recommended by the National Institute for Health and Care Excellence (NICE) as a first treatment for vasomotor symptoms (hot sweats, flushes) and low mood due to menopause
• Your epilepsy should be monitored if you start taking HRT, in case your epilepsy medicine needs adjusting

The following are suggested questions to help you make the most of your GP appointment.

Talking to your GP about your perimenopause or menopause symptoms

• What types of perimenopause or menopause treatment are suitable for me and my symptoms?
• What are the benefits and risks of each treatment option?
• How will my perimenopause or menopause symptoms affect my epilepsy?
• Could my perimenopause or menopause symptoms cause or increase the risk of seizures?
• HRT can improve my heart and bone health. Are there any risks to my health if I decide not to take HRT?
• What other treatments can I try?

Hormone replacement therapy (HRT)

Based on my menopausal symptoms, my type of epilepsy and my epilepsy medication…

• Is HRT suitable for me?
• What type of HRT is best for me?
• When will HRT start working?
• What are the benefits and risks of taking HRT?
• Are there any serious side effects or long term effects from taking HRT?
• Will HRT affect how well my epilepsy medicine works or vice versa?
• What dose do I need and why?
• How will my epilepsy be monitored while I’m on HRT?
• How and when do we decide I should stop taking HRT?
• HRT can improve my heart and bone health. Are there any risks to my health if I decide not to take HRT?
• What other treatments can I try?

Other treatments

Vaginal hormones can help control vaginal and urinary symptoms related to menopause. You can use this with or without HRT.

Based on my menopausal symptoms, my type of epilepsy and my epilepsy medication… 

• Can I try vaginal tablets, pessaries, creams or gel?
• Are there any side effects to be aware of?
• Can we arrange a follow-up appointment to discuss how I’m getting on with this treatment?

Non-hormonal prescription medication options

Non-hormonal prescription medication may be offered for hot flushes and night sweats.

Based on my menopausal symptoms, my type of epilepsy and my epilepsy medication… 

• Are there any non-hormonal prescription medications that are suitable for me?
• If so, are there any side effects?
• Will these interact with my epilepsy medicine?
• Could this medicine affect my epilepsy?
• How long should I take this medication for?
• Can we arrange a follow-up appointment to discuss how I’m getting on with this treatment?

Mood symptoms

Antidepressants are not a first-line treatment for menopause symptoms. But you may be offered antidepressants if your GP believes you have depression or anxiety.

Based on my symptoms, my type of epilepsy and my epilepsy medication…

• Should I think about taking antidepressants? Or Why am I being offered antidepressants?
• If so, can they affect how well my epilepsy medicine works or vice versa?
• How long should I take this medication for?
• Can we arrange a follow-up appointment to discuss how I’m getting on with this treatment?

Bone health during menopause

Going through menopause and taking some epilepsy medicines can both increase the risk of osteoporosis.

• Can I be tested for vitamin D deficiency or calcium deficiency?
• Can I be assessed for a fracture risk?
• Can I be referred for a bone density (DEXA) scan to measure my bone strength?

Cognitive behavioural therapy (CBT)

CBT may help with low mood and anxiety caused by menopause and some physical symptoms, such as hot flushes and joint pain.

• Can I try CBT alongside or instead of HRT?
• Do you think I would benefit from CBT?

Lifestyle changes

 You can also ask your GP for help if you need support with diet or lifestyle changes that may help with menopause symptoms. These may include:

• Weight loss support
• Reducing your alcohol intake
• Exercise
• Stopping smoking

Herbal or complementary medicines for menopause symptoms

 Some over-the-counter herbal treatments or supplements to manage menopause can interfere with epilepsy medication.

• Are there any complementary therapies that could help ease my symptoms?
• If so, are they safe to take alongside my other medicines?

More support and information

You can also find information on the Epilepsy Action Talk and Support group on menopause online.