Having a grand mal seizure during menstruation is usually associated with menstrual epilepsy.
This type typically presents with seizures that worsen before or during the menstrual period, or only during the premenstrual or menstrual period.
The etiology and pathogenesis are not fully understood, but are now mostly thought to be related to cyclically changing estrogen levels, progesterone levels, estrogen-progestin ratio, hormone receptor levels, sex hormones, and metabolic levels of AEDs. For example, elevated estrogen during menstruation can contribute to epileptic discharges and induce seizures, and progesterone, which has antiepileptic effects, decreases during menstruation.