Epilepsy and Women
Women with Epilepsy face many unique issues because of the hormonal changes experienced by females. Hormonal changes that occur as a part of the monthly menstrual cycle may lead to increased seizures at certain times of the month. In addition, women are faced with many concerns regarding contraception, reproduction, child birth, and menopause.
Listed below are some important facts for all women with Epilepsy:
- Some antiepileptic medications can cause your Birth Control pills to not work properly. If you are using birth control pills and on antiepileptic medication, discuss with your provider whether there is an interaction and if a back up method of birth control is needed. A barrier method, such as condoms or cervical cap, may provide better protection against pregnancy.
- Seizure medications can cause increase risk for fractures and osteoporosis. Discuss the appropriate dose of Calcium and Vitamin D for you with your provider. A typical dose of 1200mg of calcium and 800IU of Vitamin D per day may help prevent bone loss.
- All women of childbearing age taking antiepileptic medications should take a Folic Acid 1mg supplement daily. If you are trying to get pregnant AND have a history of family history of neural tube defect, then you may need a higher dose and should discuss this with your provider.
- If you are planning to become pregnant, please inform both your epilepsy provider and your gynecologist. It is best to get your seizures under control and make sure you are on an appropriate antiepileptic medication before you become pregnant. If you become pregnant, whether it was planned or not, please let your epilepsy provider know right away.
- If you are pregnant, please register with the AED Pregnancy Registry (1-888-233-2334). The Registry keeps a record of antiepileptic medications and their effects on pregnancies. After you register, you just have to complete three short phone conversations and all information is kept confidential.
- It is important to remember most pregnant women with epilepsy have a normal pregnancy. There is a slightly greater chance (about 2% greater chance than women without epilepsy) of having a baby with a birth defect, such as cleft lip, neural tube defect, or problems with the heart or kidneys. Proper planning and prenatal care helps reduce these risks.
- As your body changes during pregnancy, you may require an increased dose in your antiepileptic medication to prevent breakthrough seizures. Frequent office visit to monitor the level of medication in your blood will help ensure you are on an adequate dose to control seizures. Ensuring that you have adequate sleep and that you are taking your antiepileptic medications as prescribed will help reduce the likelihood of increased seizure frequency during your pregnancy.
- After you have the baby, you may be at an increased risk for seizures due to the stress of giving birth on your body and the stress associated with becoming a parent. Please ensure that friends and family are able to help you with the baby during the first few weeks so that you can get adequate rest.
- While taking antiepileptic drugs, breastfeeding is still encouraged. The baby has been exposed to the medication during the pregnancy and the amount in the breast milk should cause little risk.
- When caring for your baby, perform diaper or clothing changes on a blanket on the floor to prevent accidents if you have a seizure. Using a stroller in the house rather than carrying the baby may also help to also prevent falls during seizures. When bathing your baby, always make sure that someone else is present. A loss of awareness or seizure during bath time can result in a dangerous situation.
- If you experience any increase in seizures during your pregnancy or after you have had your baby, please let your epilepsy provider know right away. In the weeks after you deliver your baby, your antiepileptic medication will be tapered down to a dose similar what you were taking before pregnancy. Please let your provider know of any medication side effects.
- It is important to remember that most pregnant women with epilepsy have an uncomplicated pregnancy and deliver healthy babies. A good partnership with your healthcare providers can help work toward this goal if you are planning to become pregnant or are currently pregnant.