Epilepsy in Women: Unique Challenges & Considerations

  •   Wed, Mar 20 2024
  •   By Dr Shivananda Pai

March 20, 2024

Women with epilepsy face distinct challenges, particularly in the spheres of reproductive health, hormonal fluctuations, and social considerations. Understanding these challenges is essential for effective management and support.

Hormonal Fluctuations: Women's lives are punctuated by hormonal changes, such as those occurring during puberty, menstruation, pregnancy, and menopause. These fluctuations can significantly impact epilepsy. In particular, some women may notice an increase in seizure activity during their menstrual cycle, a phenomenon likely tied to hormonal imbalances.

Catamenial Epilepsy: This specific type of epilepsy is characterized by a doubling in the frequency of seizures during or just before menstruation. The condition is thought to be driven by fluctuations in estrogen and progesterone levels, with increased estrogen or reduced progesterone potentially heightening seizure risk.

Pregnancy and Epilepsy: Pregnancy management is paramount for women with epilepsy. Given the potential risks posed by antiepileptic drugs (AEDs) to the developing fetus, it is critical for affected women to closely collaborate with healthcare professionals to tailor a safe treatment strategy. Additionally, the occurrence of seizures during pregnancy could endanger both mother and child, underscoring the importance of stringent seizure control during this period.

Bone Health:Women with epilepsy face a higher risk of falls, fractures, osteoporosis, and osteopenia compared to the general population, highlighting the importance of monitoring and managing bone health in these individuals. 

Preparation for Pregnancy with Epilepsy:

Before attempting pregnancy, it's crucial to consult with your healthcare provider, ideally one experienced in managing high-risk pregnancies. This consultation should extend to your broader healthcare team, including your primary care provider and neurologist, to assess how well your epilepsy is managed and discuss any necessary adjustments to your treatment prior to becoming pregnant. Women experiencing frequent seizures may be advised to postpone pregnancy until their condition is better controlled.

Strict adherence to your prescribed anti-seizure medication regimen is vital, as uncontrolled seizures can pose a significant risk to your baby. It's imperative not to adjust your medication dose or discontinue use without professional guidance.

Moreover, embracing healthy lifestyle choices plays a crucial role in managing epilepsy during pregnancy. This includes consuming a balanced diet, taking prenatal vitamins, ensuring adequate sleep, and avoiding caffeine, cigarettes, alcohol, and illegal substances. These measures not only support general health but also contribute to minimizing potential risks during pregnancy for women with epilepsy, fostering safer outcomes for both mother and baby.

 

 

 
By Dr Shivananda Pai
Dr Shivananda Pai is a consultant of neurology at KMC Hospital, Dr B R Ambedkar Circle Mangaluru.
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