Epilepsy during the Childbearing Years

Medically reviewed by Drugs.com. Last updated on Apr 6, 2025.

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Epilepsy and epilepsy medicine can affect your ability to prevent pregnancy or to become pregnant. You may have more seizures during certain phases of your menstrual cycle. This is caused by an increase or decrease in certain female sex hormones. Changes in female sex hormones may also decrease how well epilepsy medicines work.

DISCHARGE INSTRUCTIONS:

Call your local emergency number (911 in the US) or have someone call if:

• Your seizure lasts longer than 5 minutes.
• You have trouble breathing or stop breathing.

Return to the emergency department if:

• You have a second seizure that happens within 24 hours of your first.
• You are injured during a seizure.
• After a seizure, you are confused longer than you usually are.
• You have vaginal bleeding after a seizure when you are not expecting your period.

Call your doctor if:

• Your seizures start to happen more often.
• You become depressed or have changes in your mood.
• You are planning to get pregnant or think you are pregnant.
• You have questions or concerns about your condition or care.

Drugs used to treat this and similar conditions

Birth control methods that will prevent pregnancy while you take antiseizure medicine:

Talk to your healthcare provider if you want to use birth control pills. You will need to take this medicine at the same time every day. This is important to prevent pregnancy. Some types of epilepsy medicine decrease how well hormonal birth control works. Do not stop taking your birth control medicine without talking to your healthcare provider. You will need to use a second form of birth control while you take antiseizure medicine:

• An intrauterine device or implant that releases progestin
• An injection of birth control
• Barrier methods such as condoms, diaphragms, and spermicides (also used if you miss a birth control dose)

What you need to know before you get pregnant:

Talk to your healthcare provider before you try to get pregnant. Careful planning is important to prevent harm to you or your baby.

• If you become pregnant, certain epilepsy medicines increase the risk for birth defects. The risk also increases if you use more than one epilepsy medicine.
• Your epilepsy medicine may need to be stopped or changed before you try to get pregnant.
• Epilepsy medicine may decrease the amount of folic acid in your body. Folic acid is important because it may decrease your baby's risks for birth defects. You will need to take folic acid before you get pregnant. You will need to continue for the first 3 months of your pregnancy. You may need a larger dose in the first 3 months of pregnancy.
• Epilepsy or epilepsy medicine may cause polycystic ovarian syndrome (PCOS) or early menopause. These conditions may make it more difficult to get pregnant. You may also have a decreased interest in sex. Talk to your healthcare provider if you have difficulty getting pregnant.
• Get good control of your epilepsy for 9 months before you get pregnant. This may decrease your risk for seizures during pregnancy. Manage stress and other medical conditions. Identify and avoid seizure triggers. Take your epilepsy medicine every day as directed. Ask your healthcare provider not to start any new medicine immediately before you try to get pregnant.

What you need to know about stopping your medicine:

Your healthcare provider can help you understand and make decisions about continuing or stopping antiseizure medicines. Do not stop taking your medicine until you talk to your provider. You may need to be seizure free for 18 to 24 months before you can stop your medicine. Seizures might happen again while you stop taking the medicine, or after you stop. Rarely, these seizures no longer respond to medicines. Tests such as an EEG may be useful in helping you and your provider make medicine decisions.

What else you can do to manage epilepsy during your childbearing years:

Keep track of your menstrual cycle. If you have more seizures during certain phases of your menstrual cycle, your healthcare provider may change your medicine. He or she may also tell you to take more medicine during this phase.

Follow up with your doctor as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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