Some women gain three or four pounds (1-2 kg) in weight in the few days preceding their menstrual period. This gain is largely fluid, manifested by feeling bloated, with distended, sore breasts. Some women with epilepsy, particularly those with partial seizures, may notice an increase in frequency of seizures at the same time. It is not known if water retention is the responsible factor, or whether there is some more complicated hormonal cause. Dehydration with diuretic drugs has been used in attempts to abolish clusters of seizures occurring in relation to menstruation, but with limited success.
The weight gain associated with oral contraception does not seem to precipitate seizures. Oral contraception for women with epilepsy is satisfactory, provided that they understand the interactions between the pill and anti-epileptic drugs.
Stress and worry-It is impossible to quantify stress and worry. Problems perceived as molehills by some may be mountains to others. A period of hard work at school or office, or a time of emotional unhappiness at home, is often associated with an increased number of seizures. A vicious circle may arise, whereby stress and worry precipitate seizures, which in themselves cause further anxiety and hence further seizures. Sometimes an increased number of seizures leads to some crisis in employment, and the anxiety this causes results in a further deterioration in both epilepsy and job prospects.