Background and purpose
Hormonal replacement therapy (HRT) is used for symptomatic treatment of menopause. Some evidence suggests a proconvulsant effect of estrogen and an anticonvulsant role of ...progesterone. Thus, the use of exogenous sex steroid hormones might influence the course of epilepsy in peri‐ and postmenopausal women with epilepsy (WWE). We conducted a systematic review on the impact of HRT on the frequency of seizures of WWE.
Methods
PubMed and Scopus were searched for articles published from inception until August 2022. s from the past 5 years from the European Academy of Neurology and European Epilepsy Congresses were also reviewed. Article reference lists were screened, and relevant articles were retrieved for consultation. Interventional and observational studies on WWE and animal models of estrogen deficiency were included. Critical appraisal was performed using the revised Cochrane risk‐of‐bias tool for randomized trials and ROBINS‐E tool.
Results
Of 497 articles screened, 13 studies were included, including three human studies. One cross‐sectional study showed a decrease in seizure frequency in WWE using combined HRT, a case–control study showed an increase in comparison with controls, and a randomized clinical trial found a dose‐dependent increase in seizure frequency in women with focal epilepsy taking combined HRT. Ten studies addressing the impact of HRT in rat models were also included, which showed conflicting results.
Conclusions
There is scarce evidence of the impact of HRT in WWE. Further studies should evaluate the harmful potential, and prospective registries are needed for monitoring this population.
Background and purpose
Neurological disorders pose a profound unmet medical need for which new solutions are urgently needed. The consideration of both biological (sex) and socio‐cultural (gender) ...differences between men and women is necessary to identify more efficacious, safer and tailored treatments. Approaches for putting sex and gender medicine into practice have gathered momentum across Europe, but it is currently unclear to what extent they have been implemented in the field of neurology and neuroscience.
Methods
We mapped current activities in research, funding and education aimed at integrating sex and gender consideration in neuroscience and neurology in Europe. We examined and analyzed data gathered from literature searches, policy documents and reports by the European Commission and national funding agencies, web‐based searches, Web of Science, and searches of project databases of funding agencies. An informative/non‐systematic search was performed for sections on policies and funding, education, and basic research, while a systematic literature and database review was conducted for quantitative analysis of research output and funded projects in terms of sex and gender analysis.
Results
Our mapping shows that there is a growing interest in and attention given to sex and gender considerations in neurological fields, both from funding agencies and researchers. However, most activities, especially for education, are limited to the individual motivation of researchers and are not organically built within curricula and strategic research priorities.
Conclusion
We recommend actions that might help increase the consideration of sex and gender specifically in the field of neuroscience and neurology.
Approaches for putting sex and gender medicine into practice have gathered momentum globally. In this paper we map such initiatives specifically in Europe, in the context of neurology and neuroscience, showing a growing attention to consideration of sex and gender in these fields. We call for closer collaboration between stakeholders to ensure that sex and gender analyses are properly integrated in education, medical diagnosis and treatment, and basic research, in the push towards precision medicine.
In this letter-to-the-editor the Task Force on Gender and Diversity issues in Neurology founded under the auspices of the European Academy of Neurology (EAN) addresses various gender issues that are ...arising during the COVID-19 pandemic. These issues concern different aspects, spanning from gender disparities in health care workforce to gender differences amongst patients suffering from COVID-19, risk factors, occurrence of neurological complications and (outcomes of) management. Due to the continuous flow of COVID-19 related papers this review cannot be comprehensive. We attempted to select the most relevant literature on this topic.