Menstrual cycle can influence seizures due to what mechanism?

• A. Hormone level changes
• B. Changes in blood sugar
• C. Weather changes
• D. Exercise intensity

Answer: (A)

Seizure activity tied to the menstrual cycle is driven by fluctuations in hormone levels. Estrogen tends to increase neuronal excitability, partly by enhancing excitatory transmission, while progesterone and its metabolite allopregnanolone boost GABA-A receptor–mediated inhibition, which helps suppress seizures. Throughout the cycle, the balance between these hormones shifts; notably, when progesterone drops before and during menses, the inhibitory effect weakens and seizure threshold can lower in some individuals. This pattern of cyclical seizure risk is known as catamenial epilepsy.

Other factors like blood sugar changes, weather, or exercise intensity can influence seizures in general, but they are not the hormonal mechanism linked to the menstrual cycle, so hormone level changes best explain the menstrual influence on seizures.