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Published in: Current Obstetrics and Gynecology Reports 4/2018

01-12-2018 | Family Planning (A Burke, Section Editor)

Contraception for Women with Epilepsy

Author: Emily L. Johnson

Published in: Current Obstetrics and Gynecology Reports | Issue 4/2018

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Abstract

Purpose of Review

The purpose of this review is to summarize the current available literature on contraception for women with epilepsy, and to provide recommendations for women with epilepsy on enzyme-inducing anti-seizure drugs and on non-enzyme-inducing anti-seizure drugs.

Recent Findings

A recent study has confirmed the safety of the levonorgestrel-containing intrauterine device for women with epilepsy, with no effect on seizure control or anti-seizure drug levels. Other recent studies have found low serum etonogestrel or levonorgestrel levels in women on enzyme-inducing anti-seizure drugs and the etonogestrel or levonorgestrel implant, making this an unsuitable method for women on such drugs.

Summary

Women with epilepsy have an especially compelling need to avoid unplanned pregnancy, as some common anti-seizure medications have teratogenic or detrimental neurocognitive effects on exposed children. Women on enzyme-inducing anti-seizure drugs and their physicians must be particularly aware of drug interactions with hormonal contraceptive methods.
Literature
2.
go back to reference • Hernández-Díaz S, McElrath TF, Pennell PB, Hauser WA, Yerby M, Holmes LB. Fetal growth and premature delivery in pregnant women on antiepileptic drugs. Ann Neurol. 2017;82(3):457–65. https://doi.org/10.1002/ana.25031 Prospective study of birth/delivery outcomes in pregnant women with epilepsy. CrossRefPubMed • Hernández-Díaz S, McElrath TF, Pennell PB, Hauser WA, Yerby M, Holmes LB. Fetal growth and premature delivery in pregnant women on antiepileptic drugs. Ann Neurol. 2017;82(3):457–65. https://​doi.​org/​10.​1002/​ana.​25031 Prospective study of birth/delivery outcomes in pregnant women with epilepsy. CrossRefPubMed
36.
go back to reference Kinney MO, Morrow J, Patterson CC, Campbell E, Russell A, Smithson HW, et al. Changing antiepilepsy drug-prescribing trends in women with epilepsy in the UK and Ireland and the impact on major congenital malformations. J Neurol Neurosurg Psychiatry. 2018:jnnp-2017-317368. https://doi.org/10.1136/jnnp-2017-317368. Kinney MO, Morrow J, Patterson CC, Campbell E, Russell A, Smithson HW, et al. Changing antiepilepsy drug-prescribing trends in women with epilepsy in the UK and Ireland and the impact on major congenital malformations. J Neurol Neurosurg Psychiatry. 2018:jnnp-2017-317368. https://​doi.​org/​10.​1136/​jnnp-2017-317368.
Metadata
Title
Contraception for Women with Epilepsy
Author
Emily L. Johnson
Publication date
01-12-2018
Publisher
Springer US
Published in
Current Obstetrics and Gynecology Reports / Issue 4/2018
Electronic ISSN: 2161-3303
DOI
https://doi.org/10.1007/s13669-018-0250-6

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