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14 - Reproductive health for women with epilepsy

from Part IV - Health challenges for women with epilepsy

Published online by Cambridge University Press:  02 November 2009

Martha J. Morrell
Affiliation:
Professor of Clinical Neurology, Columbia University; Director of the Columbia Comprehensive Epilepsy Center, New York Presbyterian Hospital
Martha J. Morrell
Affiliation:
Columbia University, New York
Kerry L. Flynn
Affiliation:
Columbia-Presbyterian Cancer Center, New York
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Summary

Women with epilepsy are less likely to have children than women without epilepsy. For many years, it was assumed this was because women with epilepsy were less likely to be married and, when married, more likely to choose to remain childless. Women with epilepsy now have marriage rates equivalent to women without epilepsy. Better prenatal care and information about the excellent outcome for more than 90% of pregnancies in women with epilepsy suggest that more women are able to choose to be mothers. However, birth rates remain lower than expected. In part, this can be explained by recent findings that women with epilepsy are less likely to ovulate and more likely to have disorders of reproductive hormones. Whether these reproductive health disturbances are caused by seizures, by antiepileptic medications, or by both, is now being debated in the medical community. This chapter discusses some of the reproductive disturbances in women with epilepsy and points out signs and symptoms that women should report to their health-care providers.

MJM

Introduction

Having epilepsy often means more than having seizures. Other areas of health may also be negatively impacted in the person with epilepsy, including reproductive health. Medical research suggests that women with epilepsy are more likely to have irregular menstrual cycles, menstrual cycles during which ovulation does not occur, and disturbances in the hormones that regulate the menstrual cycle and are needed for normal fertility.

Type
Chapter
Information
Women with Epilepsy
A Handbook of Health and Treatment Issues
, pp. 145 - 151
Publisher: Cambridge University Press
Print publication year: 2003

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References

Isojarvi, JIT, Laatikainen, TJ, Pakarinen, AJ, Juntunen, KTS, Myllyla, VV.Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Engl J Med 1993; 329:1383–8Google Scholar
Morrell, MJ.Hormones and epilepsy through the lifetime. Epilepsia 1992; 33(S4):49–61Google Scholar
Morrell, MJ.Effects of epilepsy on women's reproductive health. Epilepsia 1998; 39(S8):S32–7Google Scholar
Zahn, CA, Morrell, MJ, Collins, SD, Labiner, DM, Yerby, MS.Management issues for women with epilepsy: a review of the literature. American Academy of Neurology Practice Guidelines. Neurology 1998; 51:949–56Google Scholar
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