Whether the age of seizure onset in women with epilepsy (WWE) relates to the age of menarche has been a longstanding focus of controversy. [1–3] Menarche serves as a readily identifiable point in time marker for the longer process of reproductive maturation (puberty). [1–3] Puberty includes the genetically programmed but environmentally modifiable courses of adrenarche and gonadarche. [4] Given the potent neuroactive properties of some of the adrenal and gonadal steroids that come online and surge in production during the process of reproductive maturation, [4,5] the process may have potential importance for epilepsy.

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