Epilepsy is one of the most common neurologic disorders, affecting up to 1% of the population in the United States. More than one million women and girls have seizure disorders. Epilepsy and seizure drugs may affect birth control, pregnancy, hormone levels, and the female reproductive cycle.
Epilepsy and birth control
Women who have epilepsy and who are sexually active should talk with their doctors about birth control and pregnancy. Many seizure drugs can prevent birth control pills from working well, which may lead to unplanned pregnancy. Other ways of birth control may work well in certain cases. Do not wait until it is too late to discuss birth control with your doctor.
Some epilepsy drugs deplete the body of important vitamins. All women who have epilepsy and who are of child-bearing age should take a multi-vitamin that has folic acid daily.
Epilepsy and pregnancy
Women with seizures can have healthy children if they get good prenatal care. It is important that women who have epilepsy should talk with their doctors before getting pregnant.
Many women with epilepsy take several drugs in high doses that may lead to needless drug exposure to unborn babies. In some cases, drugs may be reduced before pregnancy, especially if seizures are well controlled. If pregnancy is unplanned, women should not stop their seizure drugs unless first talking with their doctors. This often leads to more frequent seizures, which can also harm the baby.
Seizures during pregnancy
The rate of seizures usually does not change much during pregnancy. However, some women have more seizures, while others have fewer. Women who have epilepsy should have their drug blood levels checked often. This caution is taken because blood levels slowly fall during pregnancy and reach their lowest level around the time of delivery. This may result in breakthrough seizures. All seizures that happen during pregnancy should be told to your doctor.
Most pregnant women with epilepsy have normal vaginal deliveries. However, cesarean sections are required in some cases. A cesarean section is the removal of the baby through a cut made in the abdomen. When seizures happen during labor or delivery, cesarean sections are usually done at once.
Women taking seizure drugs can breastfeed their infants. Some drugs can cause babies to become very sleepy and testy after feedings. If this happens, stop breastfeeding until you talk with your doctor.
Medications and birth defects
Seizure drugs can produce birth defects. However, uncontrolled seizures can pose serious problems to unborn babies. Severe birth defects are rare in infants of women who receive regular prenatal care and whose seizures are managed with medication carefully. Women should never stop seizure drugs without talking with their doctors.
Epilepsy and hormones
Hormones influence the function of the brain throughout life. Many women have a greater number of seizures just before or during their menstrual periods. This may be caused by changes in estrogen and progesterone levels that normally happen during the female reproductive cycle. Many women with epilepsy have abnormal menstrual cycles, including missed periods. If missed periods occur regularly, see your doctor.
- Epilepsy Foundation Eastern Pennsylvania. Women with epilepsy Accessed 10/21/2014.
- Epilepsy Society. Women and epilepsy Accessed 10/21/2014.
- Epilepsy Ontario. Women and epilepsy Accessed 10/21/2014.
- Cunningham F, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Chapter 55. Neurological and Psychiatric Disorders. In: Cunningham F, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. eds. Williams Obstetrics, 23e. New York, NY: McGraw-Hill; 2010.
- Demian E, Rizk M. Chapter 16. Preconception Care. In: South-Paul JE, Matheny SC, Lewis EL. eds. CURRENT Diagnosis & Treatment in Family Medicine, 3e. New York, NY: McGraw-Hill; 2011.
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