iVillage

There are many unique challenges facing the more than one million women and girls in the United States who are living with epilepsy. The interaction of anti-epileptic drugs and changing hormones can impact a female epilepsy patient at almost every stage of her life.


The reproductive hormones known as estrogen and progesterone can affect seizure frequency. As a young girl begins to mature and her hormone levels fluctuate, changes in seizure patterns may occur, particularly during the menstrual cycle. In addition, typical teenage behavior can create physical stress, which in turn may increase the risk of seizures.


Anywhere between puberty and menopause, a woman's estrogen and progesterone levels rise and fall every month. Estrogen goes up in the first half of the menstrual cycle, and progesterone goes up in the second half. The connection between hormone and seizures may cause problems with a woman's menstrual cycle. Some females with epilepsy may experience irregular or longer cycles, and anti-epileptic drugs can affect hormone levels in the blood.


Seizures and anti-epileptic drug therapy can also impact women with epilepsy who are sexually active and/or using birth control. Changes in hormones, caused by seizures or medication, can influence libido and sexual function. A physician should be consulted when choosing birth control, as some birth control methods and certain anti-epileptic drugs can interact adversely.


It is important to work closely with your doctor when choosing the appropriate birth control as some anti-epileptic drugs may lower concentrations of estrogens, making birth control less reliable. Oral, implant, and injectable forms of birth control can all be adversely affected by anti-epileptic drugs.


There are special issues to consider for females who are pregnant or are planning to become pregnant. Most females with epilepsy will deliver a healthy baby. It is important not to discontinue taking your medication, as uncontrolled seizures can have serious health consequences for your unborn baby. However, the use of some anti-epileptic drugs during pregnancy has been associated with a higher risk of birth defects. Females with epilepsy may find it difficult to become pregnant. Females who are pregnant may experience an increase in seizure frequency, and overall, have a greater risk of pregnancy- and delivery-related complications. Whenever possible, a single AED during pregnancy should be used. Data shows that there are higher risks of birth defects in females taking multiple AEDs. For this reason, it is important for females to discuss their plans for pregnancy with their doctor.


Just as it does in all people, weight gain or loss can occur in people with epilepsy. However, certain anti-epileptic drugs can sometimes make weight gain more likely.

If you have gained weight since being placed on anti-epileptic drugs, here are some questions you can ask your doctor:

• Is my weight gain being caused by my medication?
• Am I taking an inappropriate amount of medication? Or could I be taking it incorrectly?
• Could my medication's generic version eliminate this side effect?
• Should I increase my amount of exercise, or go on a specialized diet to help reverse this process? Or could this affect my medication?

Weight changes can be seen in certain hormonal disorders, as well as depression. Your health team can advise you on safe ways to achieve a more healthy weight.


For women with epilepsy, the erratic reduction in hormones in all stages of menopause can alter seizure frequency and may potentially require a change in treatment. In addition, bone loss may occur earlier in females who take certain anti-epileptic drugs over the long term.

Regardless of age or stage of life, it is important for a woman with epilepsy to have a strong relationship and open lines of communication with her healthcare provider.


Bone loss may occur earlier than usual in women taking certain anti-epileptic drugs as some treatments may decrease bone mineral density. Additionally, it is also important to remember that hormone replacement therapy (HRT), which may protect bone health, can increase seizure frequency, although this correlation has not been extensively studied.

Making changes to your lifestyle can help minimize the risk of bone loss and osteoporosis. Eating a high-calcium diet and taking calcium supplements with vitamin D can help minimize the loss as well as regular weight-bearing exercise.