Which contraceptives are safe in seizures?

Question

Hello doctor,

I hope you are doing well.

I am a 27-year-old woman who has been managing seizures for the past three years and am currently on anti-seizure medication. I would like to seek your guidance regarding how this condition may affect aspects of my health as a woman, particularly in relation to fertility, pregnancy, and hormonal changes.

I understand that certain anti-seizure medications may influence menstrual cycles and potentially reduce the effectiveness of oral contraceptive pills. Could you please advise if this is the case, and what contraceptive options might be safer and more suitable in my situation?

I am also considering pregnancy in the near future and would appreciate your insights on the potential impact of seizures and related medications on pregnancy, as well as on the health of the baby during pregnancy and breastfeeding. Additionally, do seizures tend to worsen during pregnancy due to hormonal changes?

I have noticed that I sometimes experience increased seizure-like activity before my menstrual cycle, and I am curious to know whether hormonal fluctuations could be a contributing factor. Finally, I would like to understand whether IVF is a viable option for women with epilepsy, and if hormonal treatments associated with IVF could influence seizure activity.

Thank you very much for your time and guidance.

I look forward to your advice.

Answer 1

Hi,

Welcome to icliniq.com.

I have read your query and understand your concerns.

Hormonal fluctuations can affect epilepsy, and some women have catamenial epilepsy, a pattern of increased seizure activity during their menstrual cycle. Furthermore, some anti-seizure drugs may make oral contraceptive tablets less effective. Alternative means of contraception, like barrier techniques or copper or hormonal intrauterine devices (IUDs), might be more appropriate in these situations. The particular drug you are currently taking will determine which choice is best for you.

Most women with epilepsy go on to have safe babies, which is encouraging. Achieving adequate seizure control before conception, taking high-dose folic acid to lower the risk of neural tube abnormalities, and utilizing the lowest effective dose of a pregnancy-safe drug are important considerations. If pregnant women take their prescriptions as directed, seizures usually do not get worse. While in vitro fertilization (IVF) is a viable option and breastfeeding is generally seen as safe, the hormonal medications included in IVF may necessitate careful monitoring of seizure activity.

To guarantee the greatest results, pre-pregnancy planning with your neurologist is crucial. If you have any more queries, do not hesitate to get in touch. To provide you with more precise guidance, I would also like to know the anti-epileptic drugs you are currently using.

I hope this helps.

Thank you.

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