There are sex differences and effects of
steroid hormones, such as
androgens,
estrogens, and
progestogens, that influence
seizures.
Androgens exert early organizational and later activational effects that can amplify sex/gender differences in the expression of some
seizure disorders. Female-typical sex
steroids, such as
estrogen (E2) and
progestins, can exert acute activational effects to reduce convulsive
seizures and these effects are mediated in part by the actions of
steroids in the hippocampus. Some of these anticonvulsive effects of sex
steroids are related to their formation of
ligands which have agonist-like actions at
gamma-aminobutyric acid (GABAA) receptors or antagonist actions at glutamatergic receptors. Differences in stress, developmental phase, reproductive status, endocrine status, and treatments, such as anti-epileptic drugs (AEDs), may alter levels of these
ligands and/or the function of target sites, which may mitigate differences in sensitivity to, and/or tolerance of,
steroids among some individuals. The evidence implicating sex
steroids in differences associated with hormonal, reproductive, developmental, stress, seizure type, and/or
therapeutics are discussed.