Epilepsja i zdrowie w okresie menopauzy: Przewodnik kliniczny Europejskiego Towarzystwa Menopauzy i Andropauzy (EMAS) oraz Światowego Centrum Epilepsji

INTRODUCTION: Menopause presents unique clinical challenges for women with epilepsy, with hormonal changes, antiseizure medication interactions, and comorbid health risks converging to potentially influence seizure susceptibility, treatment requirements, and long-term health outcomes. AIM: To provide a clinical guide for the parallel assessment and management of epilepsy and menopausal health. MATERIALS AND METHODS: Review of the literature and consensus of expert opinion. RESULTS AND CONCLUSION: Women with epilepsy may be at increased risk of early menopause and are more likely to develop cardiovascular disease, osteoporosis, and cognitive impairment than women without epilepsy. There is a paucity of data regarding the optimal management of menopausal symptomatology and treatments for osteoporosis in women with epilepsy, since the condition is often an exclusion criterion in randomized controlled trials and observational studies. A personalized approach is required. Systemic menopausal hormone therapy (MHT) can be considered if the potential benefits outweigh the risks. The use of transdermal estrogen may be preferred to minimize dose-related fluctuations in hormone levels. Potential drug interactions between antiseizure medications and systemic MHT should be taken into consideration and alterations to antiseizure medication may be necessary. Healthcare providers should be appropriately trained to assess and manage epilepsy at the menopause and beyond, with provision of multidisciplinary teams.