I seem to have more seizures just before my period. What can I do?

Among women with epilepsy, about half say that they have more seizures around the time of their menstrual period (especially just before it). Some others report seizures at the time of ovulation, when the ovary releases an egg. This occurs about halfway between periods. Seizures that are linked to the menstrual cycle are called catamenial epilepsy. Controlling these seizures is a difficult problem. (Read more information from the Epilepsy Foundation.) There is no clearly effective hormonal therapy. Some women take slightly higher doses of their seizure medicine at these times, or they add another medicine.

Talk to your doctor. Not all doctors are familiar with treatments for catamenial epilepsy, however. The Epilepsy Foundation also has more information for doctors.

Can I have a healthy baby if I have epilepsy?

Over 90% of babies born to women with epilepsy are normal and healthy. The risk that the child of a woman with epilepsy will have a major birth defect is 6%, compared to 2.5% in the general population. This increase is probably related to seizure medicines and perhaps some genetic factors.

It is important to discuss pregnancy with your physician ahead of time. There are many things you can do to reduce the risk to your baby. You probably will need to continue taking seizure medicines, but your doctor will work with you to find the lowest amount that will control your seizures. Getting good care before and during your pregnancy will help to improve the chances that your baby will be healthy.

Will my seizure medicine interfere with birth control pills?

Certain seizure medicines (including Dilantin, Phenytek, Tegretol, Carbatrol, Phenobarbital, Mysoline, Trileptal, and Topamax) increase the breakdown of the hormones in birth control pills and make them less effective. Some women successfully use a type of pill with a higher amount of estrogen, but there is no guarantee of full protection. It may be wise to use another method of birth control (such as a diaphragm or condom) along with or instead of the birth control pills.

What resources are available for women with disabilities like epilepsy?

A conference for women with disabilities was held in September of 2005,sponsored by the Center for Excellence in Women's Health at Harvard Medical School, and the Center for Women with Disabilities at Beth Israel Deaconess Medical Center in Boston, Massachusetts. While the conference did not address epilepsy specifically, issues surrounding the needs of women with disabilies were very relevant. The sessions explored the meaning of disability, the influence of culture, the need for effective communication, and the lack of awareness and expertise that many health care professionals have in addressing health needs of women with disabilies. Needs ranging from reproductive care, sexuality, mobility, chronic fatigue, pain and mental health were just a few of the topics discussed.

The link below will take you to the Harvard Medical School website where you can view powerpoint slides from the presentations. While the full presentations are not available, the content may offer 'food for thought'and raise questions for women to discuss with their health care providers, and for health care professionals to explore with women with seizures.

• Women with Disabilities Symposium - Presentations List

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed: 3/9/06