Return to COPE
Taking measures for Birth Control enables you to prevent unwanted pregnancies. It allows you the opportunity to act responsibly in planning and spacing your family according to your personal needs and preferences. Some questions may arise in choosing a method of birth control. This leaflet is designed to answer your questions and guide you in a choice of birth control most suitable for you while you take antiepileptic drugs (AED's). Please refer to it for answers to many of your questions. Other questions not answered in this leaflet may be addressed at your next clinic visit.
QUESTION: Should I decide to become pregnant, what should I do?
ANSWER: It is most important for you to consult your physician before beginning your family. Your physician will provide genetic counseling and guidance with regard to your epilepsy, use of AED's, and family planning.
METHODS OF CONTRACEPTION
QUESTION: Are there effective contraceptive methods which I can use to prevent pregnancy?
ANSWER: There are many contraceptive methods available for protection against pregnancy. These methods include: not having sex, the rhythm method, barrier methods (cervical cap, sponge, diaphragm), condoms, intrauterine devices (lUD's), and the pill.
ORAL CONTRACEPTIVES - THE PILL
Choosing oral contraceptives as a method of birth control is a workable option for you. Questions which may arise when choosing oral contraceptives as a method of birth control are addressed below.
QUESTION: Will my seizures increase in frequency or severity while taking an oral contraceptive?
ANSWER: Oral contraceptives have not been found to increase or decrease the frequency or severity of seizures in women who are taking AED's.
QUESTION: Will taking oral contraceptives prevent me from becoming pregnant?
ANSWER: Oral contraceptives are very effective in preventing pregnancy in a sexually active woman.* In a sexually active epileptic woman, taking birth control pills and AED's, the risk of pregnancy is greater.** The greater risk of pregnancy in epileptic women taking birth control pills and AED's is thought to be related to the effects of AED's on the metabolism of oral contraceptives. AED's increase the metabolism and elimination of estrogen from the body. The effects of increased metabolism of estrogen and decreased availability of progestin in the body decreases the effectiveness of oral contraceptives in preventing pregnancy in some women. Therefore, your physician may need to provide an oral contraceptive which contains a higher amount of estrogen than you might otherwise need to protect you against pregnancy.
* Only 0.7 pregnancies occur per 100 women years of birth control coverage in women taking birth control pills consistently.
** Pregnancies occur at a rate of 3.1 per 100 women years of birth control coverage in female epileptics taking birth control pills consistently.
QUESTION: What if I experience breakthrough bleeding between my menstrual periods?
ANSWER: Breakthrough bleeding between menstrual periods indicates a need for a higher dose of estrogen in your oral contraceptive. At these times, the protective effect of your oral contraceptive against pregnancy is decreased. Call your physician and notify him of the breakthrough bleeding so that he can adjust the estrogen level in your oral contraceptive accordingly. Further, use other barrier methods to protect against pregnancy (while continuing your birth control pills) for the remainder of the month.
QUESTION: Will my Obstetrician/Gynecologist or Neurologist decide on the amount of hormones to be combined in my oral contraceptive?
ANSWER: Titration of your estrogen hormone level (to prevent breakthrough bleeding) will be done by your Obstetrician/Gynecologist, NOT your Neurologist.
QUESTION: What are the advantages of using oral contraceptives as a method of birth control?
ANSWER: Using oral contraceptives as a method of birth control will allow you to plan your family and space your children via a relatively effective, inexpensive, and simple-to-use method.
OTHER TYPES OF BIRTH CONTROL
Conscientious and proper use of one of these methods during intercourse provides the best protection against pregnancy at that time. Failure of these methods in preventing pregnancy relates to their inconsistent use, improper size, improper insertion, displacement of the appliance during intercourse, or a defect in the appliance itself.
QUESTION: What effect will these contraceptive methods have on the frequency of my seizures?
ANSWER: The use of these contraceptive methods will have no effect on the number of seizures that you may experience at this time.
QUESTION: Will my epilepsy or AED's have any effect on the effectiveness of the above contraceptive methods in preventing pregnancy?
ANSWER: The effectiveness of the contraceptive methods described above will not be affected by your epilepsy or by the AED's which you are taking to control your seizures except the pill. Their effectiveness in preventing pregnancy depends upon your conscientiousness in using the methods, as directed, and the integrity of the appliance itself.
Questions not addressed here on birth control in epilepsy should be asked at your clinic visits. We look forward to having you plan your family through responsible use of AED's, and information relating to epilepsy, while using oral or other contraceptive methods to prevent pregnancy.
Return to COPE