Many  problems associated with epilepsy and medications from epilepsy are unique to women.  There is not any one medication that is best for women with seizures.  The best medication must be chosen for the specific type of seizure and the individual situation of the woman.  Women who are pregnant, planning pregnancy, or taking birth control pills to prevent pregnancy must be aware of the interactions between medications, hormones, and seizures.

Some hormones (such as estrogen) may make seizures worse, while others (progesterone) decrease the likelihood of having seizures.  At normal levels, these hormones many have little influence on seizures.  However, in some extreme cases, hormones may increase seizures.   In addition, seizures can affect the production of hormone and/or create abnormal hormone production; this can cause difficulty with reproduction.  Finally, the medications used to treat seizures may affect hormone levels.

One important interaction between epilepsy medications and hormones is the reduction of hormone levels by some (but not all) seizure medications.  This interaction can reduce the effectiveness of birth control pills, allowing pregnancy to occur even though a woman is taking birth control pills.  This problem is most often seen with the medications Dilantin, Tegretol, phenobarbitol, and Topiramate.  Many women with epilepsy who take seizure medications should therefore consider other methods of birth control.   It is important to tell your doctor about all the medications you are taking.

Seizure medications can interfere with pregnancy.  The effects of medication on pregnancy usually occur very early, often before a woman realizes that she is pregnant.  Women with epilepsy should not stop taking their medications if they become pregnant.  Women of childbearing age should therefore discuss with their doctor the possible effects and outcomes of pregnancy.  The doctor can help her decide which is the safest treatment during pregnancy, balancing the risk of seizures with that of medications.  The majority of women with seizures complete their pregnancy without difficulty and have healthy babies.  It is important to work with a doctor to avoid complications during pregnancy, because medications may need to be adjusted during the pregnancy.

Finally women may be more susceptible to some cosmetic changes and osteoporosis due to seizure medicines.  There is not perfect medication for epilepsy.  Working with your doctor, you will be able to find a medication that is best for you and best for your current situation.   Only by discussing your concerns with your physician can the best medication be chosen.

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