Contraception for Women With Epilepsy

Introduction:

Regarding contraception or birth control for women with epilepsy, it is pivotal to consider the possible interactions between the epileptic medications they take and the contraceptives they are about to take. Certain epilepsy medicines could affect the efficacy of contraceptives, particularly hormonal contraceptives like birth control patches, pills, and rings. Moreover, certain hormonal contraceptives, like pills, could interfere with the efficacy of their medications. It is essential to pick the right contraceptive method for epilepsy.

What Are the Potential Interactions Between Contraceptives and Epilepsy Medicine?

Antiepileptic medications can interact with the effectiveness of contraception provided by hormonal contraceptives. Not all antiepileptic drugs interact, but some could interact and reduce efficacy.

• One group of drugs called liver enzyme-inducing drugs could interact with hormonal contraceptives. These drugs increase the rate at which the liver breaks down the contraceptive hormones in administered birth control. These drugs include Phenytoin, Carbamazepine, Phenobarbital, and Topiramate.

• The other two antiepileptic drugs could increase hormone levels in the system. This includes Sodium Valproate and Felbamate.

Lamotrigine and Contraception:

Lamotrigine is the drug most affected by hormonal contraceptives in women with epilepsy. The studies show that oral hormonal contraceptive pills affect the amount of Lamotrigine that stays in the blood. So, hormonal contraception interferes with the concentration of Lamotrigine in women who are taking it for epilepsy treatment.

What Are the Contraceptives Affected by Anti-epileptic Drugs?

Epilepsy medications can interfere with hormonal contraceptives, and hormonal contraceptives, in turn, affect the efficacy of antiepileptic drugs like Lamotrigine. So, certain antiepileptic medications can make several hormonal contraceptives less reliable and effective, increasing the risk of unplanned pregnancy.

The common hormonal contraceptives that can be affected by epilepsy medications include the following.

• Combined Oral Contraceptive Pills: Combined oral contraceptive pills are generally known as pills that contain both progesterone and estrogen hormones. This helps prevent the ovaries from producing or releasing eggs every month. Not all antiepileptic medications are effective, but certain antiepileptic drugs make the pills less efficient. So, the doctors usually recommend taking the pill at a higher dosage or using an alternative birth control aid.

• Emergency Contraceptive Pills: The emergency contraceptive pill is generally called the morning pill. This form is emergency contraception because this pill can be taken within 72 hours following sexual intercourse. The clinical reports say that some antiepileptic drugs can affect the efficacy of these morning pills. So, discussing the antiepileptic drugs one takes with the healthcare provider if accessing this form of a pill is essential.

• Progesterone-Only Pill: This is also known as a mini pill. The progesterone-only pill contains the only hormone, progesterone. This is regarded as less effective contraception when compared to the combined pills. The progesterone-only pill is generally not recommended for women on antiepileptic medications.

• Vaginal Ring: The vaginal ring is a small, flexible plastic ring to be placed inside the vagina. This contraceptive releases a continuous dosage of both the hormones estrogen and progesterone. Similar to combining contraceptive pills, the vaginal ring prevents an egg's release from the ovaries every month. This also seems to be less effective for women taking certain epilepsy medications.

• Contraceptive Implant: The contraceptive implant is typically an implantable medical contraceptive device used effectively for birth control. This implant works according to the timely release of hormones, hindering ovulation in women. The significant hormone this contraception constitutes is progesterone. The efficacy of this contraceptive method can be significantly affected by certain antiepileptic drugs.

• Natural Contraception: Natural contraception is sometimes referred to as a rhythm method. Natural contraception is practiced when the individual works at a particular time of the menstrual cycle when it is safer to have sex. The hormonal changes in the body can largely influence this natural contraception.

What Are the Recommended Contraceptives for Women With Epilepsy?

The studies show that antiepileptic drugs primarily affect hormonal contraceptive methods, not non-hormonal birth control methods.

The contraception methods that do not interfere with epilepsy medications include the following.

• Condoms: Condoms are a barrier device that reduces the probability of pregnancy and sexually transmitted infections(STIs). This is a non-hormonal method that has nothing to do with the hormones in women. So, this can be used by women with epilepsy.

• Contraceptive Injections: The contraceptive injection helps prevent pregnancy. The synthetic progesterone hormone (Depot medroxyprogesterone acetate) is injected into the woman. This works by preventing the body from making its hormones. This also prevents the release of eggs from the ovaries every month. So, women with epilepsy can have Contraceptive injections often, even every ten weeks.

• Diaphragms: The diaphragm, known as caps, is a non-hormonal barrier method. It fits inside the vagina, preventing the entry of sperm into the cervix (the access region of the womb). So this prevents pregnancy by creating a barrier between the sperm of the man and the uterus of the woman. This can be implemented for women with epilepsy.

• Intrauterine Devices: An intrauterine device is a form of contraception where the healthcare professional inserts it into the uterus by means of a procedure. It is shaped like a ‘T’ to fit well-fit inside the vagina. This is effective in preventing unplanned pregnancies. This approach is helpful for women with epilepsy without affecting the efficacy of their medications.

Conclusion:

The medications for epilepsy can interfere with the hormonal contraceptives they use, and vice versa. So, It is recommended to consult with a healthcare professional who could help provide tailored and personalized advice according to the specific situation. The doctors consider suggesting adjunct methods, including non-hormonal aids. In contrast, doctors might recommend specific hormonal contraceptive methods that are less likely to influence antiepileptic medicines. Nevertheless, health experts say it is vital to find a balance between maintaining seizure control and effective contraception.