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[Hormonal contraception and epilepsy].

S Bozhinova, P Bozhinov, V Porozhanova

    Akusherstvo I Ginekologiia
    |January 22, 2002
    PubMed
    Summary
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    Women with epilepsy using certain antiepileptic drugs (AEDs) may experience reduced oral contraceptive (OC) effectiveness. Consult your doctor for appropriate birth control options, including specific AEDs or higher-estrogen OCs.

    Area of Science:

    • Pharmacology
    • Neurology
    • Reproductive Health

    Context:

    • Optimizing quality of life for women with epilepsy requires effective contraception.
    • Hormonal oral contraception (OC) is a common birth control method.
    • Classic antiepileptic drugs (AEDs) can interfere with OC efficacy.

    Purpose:

    • To review the interactions between antiepileptic drugs (AEDs) and oral contraceptives (OCs).
    • To provide recommendations for managing contraception in women with epilepsy on AEDs.

    Summary:

    • Classic AEDs (Phenytoin, Phenobarbital, Ethosuximide, Carbamazepine) induce hepatic enzymes, lowering estrogen and progesterone levels, potentially compromising OC effectiveness.
    • Recommendations include using non-inducing AEDs (e.g., Valproic acid), newer AEDs (Lamotrigine, Gabapentin, Topiramate, Tiagabine), or OCs with ≥50 micrograms of estrogen for those on inducing AEDs.

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  • Patients should be aware that midcycle bleeding may signal OC failure, and its absence does not guarantee effectiveness. Additional contraceptive methods are advised.

    • Impact:

    • Informs healthcare providers on managing contraceptive needs for women with epilepsy.
    • Empowers patients with epilepsy to make informed decisions about birth control.
    • Contributes to improved reproductive health outcomes for women with epilepsy.