Women suffering from epilepsy require special attention throughout their life. In this review, management of epilepsy during the periods of perimenopause, menopause and late maturity is discussed. The effect of epilepsy on age at menopause, changes in seizure frequency during perimenopause and menopause, and the risks of hormone replacement therapy are also presented. Altered antiepileptic drug pharmacokinetics with increasing age and the management of this vulnerable population is also discussed.