Tel: 0151 298 2666 Fax: 0151 298 2333 E-mail: mrea@epilepsymersey.co.uk Website: www.epilepsymersey.org.uk epilepsy and contraception
Women who are sexually active and taking antiepileptic medicine should be made aware that some medications can interfere with the workings of the oral contraceptive pill. Those who are seeking family planning advice should let the doctor, nurse or midwife know about the medication being taken and appropriate advice can be Antiepileptic drugs, which lessen the effect of the oral contraceptive, are the enzyme inducing drugs which increases the rate at which the liver breaks down the Pill. These include:- The effectiveness of the oral contraceptive is enhanced, when any of the above drugs are being taken, by taking a prescribed dose of oestrogen because sufficient oestrogen prevents ovulation. An increase in dosage of “The Pill” will not be effective for contraception if an enzyme inducing drug is being taken.
A tell tale sign that the dose of oestrogen is not sufficient for reliable contraception is breakthrough bleeding and such an event should be discussed with a specialist.
Non enzyme inducing antiepileptic drugs do not have any effect on the oral contraceptive pill and include:- Barrier methods of contraception such as condoms, diaphragm, cap and sponge and the newly developed Mirena coil are not affected by any of the antiepileptic drugs.
There is a small risk of having a seizure when an intrauterine device is being fitted so it is important that the person fitting the device should be aware of the epilepsy. Progestogen Injections are available to women who have epilepsy but, as with the oral contraceptive pill for those taking enzyme inducing drugs, there is the possibility of the drugs lessening the effect of the injection and resulting in an unwanted pregnancy. Those who use the injections for contraception and are taking enzyme inducing drugs should discuss the matter with the prescribing doctor with a view to slightly increasing the frequency of administering the injection. The current recommendation is for administration every 10 weeks.
The ‘rhythm’ and ‘persona’ methods of contraception rely on detection of hormonal changes relating to monthly ovulation. Since antiepileptic medication can cause hormonal changes neither of these methods is Male companions will also need to be aware of the risk of an unplanned pregnancy due to the effects of a partner’s antiepileptic medicine and should share in the decision making process as to which method of contraception to adopt having listened to advice from the experts.
The use of the ‘morning after pill’ is available for women on antiepileptic medicine and, although there is no evidence to support the view that a slightly increased dose should be given to those taking enzyme inducing drugs, it is recommend that the slightly increased dose should be taken.
Mersey Region Epilepsy Association is a Registered Charity No. 504366

Source: http://www.epilepsymersey.org.uk/docs/contraception.pdf


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