Epilepsy in women comes with many potential effects on fertility, reproduction, menstrual cycle and sexual development. Both the disease, and the medications prescribed can have negative effects on a woman’s menstrual cycle and fertility; antiepileptic drugs increase the risk of major congenital malformations (MCMs) in the offspring of women with epilepsy. Author Crawford P. from the Department of Neurology, York District Hospital, York, UK, wrote an article titled “Best practice guidelines for the management of women with epilepsy”, where it is stated that “Preconception counseling should be available to all women with epilepsy who are considering pregnancy. Women with epilepsy should be aware of a number of issues relating to future pregnancy, including methods and consequences of prenatal screening, genetics of their seizure disorder, teratogenicity of AEDs, folic acid and vitamin K supplements, labor, breast feeding, and childcare.”
Many doctors believe that pregnant women with epilepsy should aim to be on the lowest AED dose possible to control their epilepsy, but this may not always be realistic if an individual has epilepsy that is difficult to control. Epileptic episodes during pregnancy may cause harm to the fetus, therefore controlling the mothers seizures is very important.
Author Crawford P. further explains that “Recent pregnancy databases have suggested that valproate is significantly more teratogenic than carbamazepine, and the combination of valproate sodium and lamotrigine is particularly teratogenic. Most pregnancies are uneventful in women with epilepsy, and most babies are delivered healthy with no increased risk of obstetric complications in women.” Breastfeeding is encouraged for with epilepsy since the total amount of drug transferred to the child through breast milk is very low and is significantly lower than the amount transferred to the child during pregnancy. Severity of a woman’s epilepsy may change throughout her life: roughly 40 percent of women report worsening of their seizure disorder during menopause, however 27 percent report improvement.
Due to the fact that an AEDs containing sodium valproate (the active ingredient in Depacon Depakene, and Depakote) have been associated with a dramatically-increased risk for birth defects, and the manufacturer of these products (Abbott Industries) has time and again failed to warn users of these risks, a number of Depacon lawsuits have been filed.
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