Topic: Hormones and Epilepsy

[Jade Alice]

Hi there. I am a 20 year old pre-transition mtf. I am in the process of being cleared for HRT by my therapist. I wanted to ask if anyone has or has known any other trans girls going on HRT while taking seizure medications. I am on two seizure meds valproic acid and carbamazapine. From my own research these medications can have moderate to severe interactions with estradiol. I haven't had a seizure in 10 years now since beginning the meds. I know these are mainly questions for Drs, but figure might as well ask if anyone has gone through something similar and what the results were. Thank you!

[Northern Star Girl]

Hi there. I am a 20 year old pre-transition mtf. I am in the process of being cleared for HRT by my therapist. I wanted to ask if anyone has or has known any other trans girls going on HRT while taking seizure medications. I am on two seizure meds valproic acid and carbamazapine. From my own research these medications can have moderate to severe interactions with estradiol. I haven't had a seizure in 10 years now since beginning the meds. I know these are mainly questions for Drs, but figure might as well ask if anyone has gone through something similar and what the results were. Thank you!

@Jade Alice
Dear Jade
    Thank you for submitting your very first post here on the Forums.   Please know that I am not ignoring your important information seeking questions but But, FIRST THINGS FIRST, I need to Officially Welcome You and give you important rules and information about the Susan's Place Forums.
   
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[Northern Star Girl]

@Jade Alice
Dear Jade Alice:

Please feel free to stop by the Introductions Forum to tell more members about yourself!
 
With more exposure to more members here you will be able to get more responses to your questions and concerns.

Wishing your well as you continue to be involved in the forums.

NOTE: Now, after all of this Greeting and Welcoming stuff, I will give you and your readers your thread back so you can get some answers from other members.

Again, Welcome to Susan's Place.
Danielle

NOTE:  Now that all of this Greeting and Welcoming stuff is done, I will let you and others have this thread back so your can continue your conversation and hopefully get the answers you are seeking.

[Rakel]

Hi there. I am a 20 year old pre-transition mtf. I am in the process of being cleared for HRT by my therapist. I wanted to ask if anyone has or has known any other trans girls going on HRT while taking seizure medications. I am on two seizure meds valproic acid and carbamazapine. From my own research these medications can have moderate to severe interactions with estradiol. I haven't had a seizure in 10 years now since beginning the meds. I know these are mainly questions for Drs, but figure might as well ask if anyone has gone through something similar and what the results were. Thank you!

Good evening Jade,

Your question about drug interaction is typically answered by Pharmacists, which I have been for over 40 years, now retired.

Both your seizure medications interact with Estradiol.

Carbamazepine increases liver enzymes making the Estradiol less effective. This can be mitigated by using Estradiol patches , injection or sublingual methods. These routes of administration avoid the first pass through the liver, making the Estradiol last a bit longer.

The same thing happens with the Valproic Acid, this time it is the Estradiol that increases the elimination of the Valproic Acid, making your Valproic Acid blood levels lower. If this happens, your seizures could return.

Either way, if your doctor closely monitors your medication blood levels, you may be able to take HRT successfully.

[Jade Alice]

@Jade Alice
Dear Jade Alice:

Please feel free to stop by the Introductions Forum to tell more members about yourself!
 
With more exposure to more members here you will be able to get more responses to your questions and concerns.

Wishing your well as you continue to be involved in the forums.

NOTE: Now, after all of this Greeting and Welcoming stuff, I will give you and your readers your thread back so you can get some answers from other members.

Again, Welcome to Susan's Place.
Danielle

NOTE:  Now that all of this Greeting and Welcoming stuff is done, I will let you and others have this thread back so your can continue your conversation and hopefully get the answers you are seeking.

Thank you 😊

[Jade Alice]

Good evening Jade,

Your question about drug interaction is typically answered by Pharmacists, which I have been for over 40 years, now retired.

Both your seizure medications interact with Estradiol.

Carbamazepine increases liver enzymes making the Estradiol less effective. This can be mitigated by using Estradiol patches , injection or sublingual methods. These routes of administration avoid the first pass through the liver, making the Estradiol last a bit longer.

The same thing happens with the Valproic Acid, this time it is the Estradiol that increases the elimination of the Valproic Acid, making your Valproic Acid blood levels lower. If this happens, your seizures could return.

Either way, if your doctor closely monitors your medication blood levels, you may be able to take HRT successfully.

Thank you very much for the info! A bit scary though. I sure hope I can get the full effects of HRT and my Drs handle it correctly.

[amber71]

Hi jade
Can I ask if you started treatment and if so how is it working out ?
I have the same problem , I take carbamazepine for my epilepsy and my oral estradiol
Isnt having any effect.
I've been taking it for 8 months now and my blood results are still in the male range.
Did you find a solution to this problem?
Thanks
Amber

[Rakel]

Good morning Amber,

Talk to  your doctor about using Estradiol as a patch, injection or sublingual. Even though the drug interaction is still there, these methods seem to be less pronounced than oral Estradiol.

You do not need 8 months to get a good blood level. Just a few weeks on your new regimen should be enough time to get a steady blood level.

Keep in mind that everyone responds differently to hormone therapy. We cannot predict your results, but we can make a scientific judgment based on blood levels. See your doctor for any adjustments to  your hormone regimen.

[amber71]

Thankyou I will do 😁
I am getting bloods done again on Thursday,  so I'll see what my levels are like and take it from there.
I dont see my specialist at the gender clinic till next month so I guess it's a waiting game x