How Epilepsy Affects Women

Seizures and Your Reproductive Health

woman having epileptic seizure episode
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Over 2 million Americans have epilepsy, a group of disorders characterized by recurring seizures. Approximately half of epilepsy patients are women and girls, and the disease affects women in some uniquely female ways. Find out how epilepsy affects fertility, hormones, and other reproductive conditions in women.

What Is Epilepsy?

Epilepsy is the second most common neurological disorder seen by physicians, after headaches.

It is characterized by recurrent episodes of seizures caused by a disturbance in the brain's electrical system. There are several types of seizure disorders, but the two most common are called partial seizures and generalized seizures. Partial seizures affect one hemisphere of the brain, while generalized seizures start in both sides of the brain at the same time causing an immediate loss of consciousness.

The length and severity of seizures varies from a few seconds to several minutes and includes symptoms ranging from blank stares and lip smacking to extreme jerking of the arms and legs.

What Causes Epilepsy?

There are many possible causes for epilepsy including:

  • Infections
  • Head injuries
  • Brain tumors
  • Brain injuries at birth
  • Inherited disease

However, it's important to understand approximately 65 percent of patients never discover the cause of their epilepsy.

Epilepsy and Women's Health

Women diagnosed with epilepsy face unique health issues that include reproductive problems, osteoporosis, excessive weight gain and sexual dysfunction.

Many of these issues have been linked to seizures and the side effects of certain anti-epileptic drugs (AEDs).

Some potential health risks for women with epilepsy include:

  • Increased risk of conceiving children born with birth defects
  • Ovarian cysts
  • Unwanted changes in body and facial hair
  • Obesity
  • Irregular periods
  • Absent menstruation
  • Hormone-related seizures

How Epilepsy Affects Fertility

Fertility rates for women with epilepsy are about a third lower than the general population. Although this may be partly due to the fact that women with seizure disorders may be reluctant to have children, research shows that women with epilepsy are more likely to have menstrual abnormalities, polycystic ovarian syndrome, and other reproductive problems which can interfere with normal fertility.

Epilepsy and Birth Control

Some common AEDs, such as Dilantin (phenytoin), Tegretol (carbamazepine), and barbiturates such as Phenobarb, Prominal, Mysoline and Topamax (topiramate), can interfere with the effectiveness of birth control pills. Women with epilepsy should discuss any potential drug interactions, side effects and potential reproductive health risks caused by anti-epileptic medications with their physicians.

Weight Gain and Anti-Epileptic Drugs

Women who experience weight gain while taking certain AEDs should understand that excessive weight can led to other health risks such as:

  • High blood pressure
  • Heart disease
  • Diabetes
  • Cancer

Unfortunately, many women who gain weight on seizure medications decide to stop medication, which only causes more episodes of seizures.

AEDs also are the potential cause of other problems such as:

  • Gum swelling and disfigurement
  • Acne
  • Unwanted growth of facial hair
  • Scalp hair loss

If weight gain, or other unwanted side effects, is an issue for you talk to your healthcare provider about an alternative drug choice.

Hormones and Seizures

Female hormones play a significant role in the occurrence of seizures; for example, the frequency and severity of epileptic seizures often changes during puberty, during the monthly menstrual cycle, during pregnancy, and menopause. An astonishing 30% to 50% of women with epilepsy experience menstrual cycle-related seizures.

Do Doctors Really Understand Women and Epilepsy?

Sadly, for many women who experience menstrual cycle-related epilepsy, the fact is that not many doctors are as educated as they should be about these issues.

According to a survey conducted by the Epilepsy Foundation and published in the Journal of Women's Health & Gender-Based Medicine (Vol.9 No.9, 2000), the groups of physicians who were most likely to be educated about the issues unique to women with epilepsy were neurologists, endocrinologists, and epileptologists (a subgroup of neurologists specializing in epilepsy). OB/GYNs ranked fourth in their knowledge of the effects that seizure disorders in women had on reproductive health and other women's health issues. The survey included 3,335 health care professionals, representing a wide range of specialties. who were likely to provide care to women with epilepsy.

The survey results revealed that:

  • Most of the respondents did not understand the specific effects that estrogen and progesterone have on seizure threshold.
  • Most were not educated about the menstrual-associated seizure patterns and were not able to identify which oral contraceptives interfered with anti-epileptic drugs.
  • The majority of respondents did not know that women with epilepsy have significantly more infertility, reproductive endocrine disorders, and sexual dysfunction.

Are You Seeing The Right Doctor?

The Epilepsy Foundation survey found that the respondents most likely to have correct answers were those who saw the greatest number of women with epilepsy in their practice.

If you have epilepsy and don't feel you are getting adequate treatment from your current healthcare provider, remember it's always your right to find another provider. When you are searching for a new physician, be sure to ask about the number of female epilepsy patients a physician sees before you make your choice.


Epilepsy. Accessed 08/26/09.