Auras and Hysterectomy

I read the archives from the 2 young ladies concerning Auras and Menstrual Cycles.  I too suffer from Auras only before or right after my menstrual cycle. Most of the time they were right before I would fall asleep at night.  My symptoms are identical to those they described; slight flush, deja vu and a metallic taste in my mouth. I am taking 1200 mgs of Tegretol, and 50 mgs of Topamax daily. About a year ago I started through menopause. My periods would only come every 3 or 4 mos. Therefore I would only have auras every 3 or 4 mos. Six weeks ago I had a total hysterectomy and my Gynecologist keeps insisting that I need to be on some type of hormone pill. Everytime I try to take these hormone pills I have the auras every so often.  My question is this: Is there some type of hormone that is triggering these auras that I should stay clear of like estrogen?  Is it necessary that I take hormones?  Maybe if I don't take any hormones I possible could get off some of this Tegretol?  It's such a trial and error thing.  I just knew that the hysterectomy would be my answer.

[CCF-Neuro-M.D.-JT]

By the symptoms you describe and the type of medications you're on, I assume you're talking about auras related to seizures rather than migraines.  Catamenial epilepsy is a term that describes seizure disorders related to the menstrual cycle.  There are studies in the medical literature describing the beneficial effects of progesterone given in the ovulatory phase of menses (2weeks before the actual period) on seizure reduction, especially if the woman has insufficient levels of progesterone during this time.  The question of medication adjustment of both the antiseizure drug and need for hormonal replacement in your case needs to be carefully evaluated by your neurologist and GYN. There are risks in taking just progesterone postmenopausally that should be discussed with your GYN. But it's possible, depending on the actual nature of your seizures, or if they're just auras, that you may be able to wean down off the medications now after your surgery. Talk to your docs about your concerns, and bring up the possibility of progesterone and see what they say. GOod luck.