Celebrating women: Frequently asked questions around epilepsy awareness

Women with epilepsy (WWE) face a myriad of challenges. Most of them are due to the effects of seizures and anti-epileptic drugs on hormonal function, potentially affecting both sexual and reproductive health.

As the World celebrated International Women’s Day yesterday, we talked to a number of women and sampled the most commonly asked questions of practical relevance to clinicians treating Women with Epilepsy.

Is it safe to get pregnant if you are living epilepsy?

Yes. With proper care, more than 90% of women with epilepsy give birth to normal babies.

Even though there is a 25% risk of worsening seizures in pregnancy, with proper management this can be controlled.

However, convulsive seizures can be harmful to the fetus and more so the medications, so it is important to have them under control.

Will the baby inherit epilepsy?

Generally a baby does not inherit epilepsy from the mother. Epilepsy is mostly not genetic. However, there are cases of genetic epilepsy but even so; it is uncommon for a baby to inherit epilepsy. 

What precaution should a woman with epilepsy take before conception to avoid birth defects?

Along with being on appropriate anti-seizure medications, women who are planning for pregnancy should be on folic acid prior to conception. They should consult with their doctors and get advice on how to handle their pregnancies. 

I seem to have more seizures just before my period. What can I do?

Among women with epilepsy, about half say that they have more seizures around the time of their menstrual period, especially just before it.

Some others report seizures at the time of ovulation. This occurs about halfway between periods.

Seizures that are linked to the menstrual cycle are called catamenial epilepsy. Controlling these seizures can be challenging as there is no clear effective hormonal therapy. Some women take slightly higher doses of their seizure medicine at these times, or they add another medicine. However, the best thing to do is to talk to your health care team on how to best manage your epilepsy.

Not all doctors are familiar with treatments for catamenial epilepsy, and you may benefit from seeing a specialist in epilepsy and women's health.

Tests to look at hormonal function as well as seizures may be needed before knowing what options may work for you.

- The writer is the national secretary – National Epilepsy Coordination Committee (NECC)