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Health across different life stages
Women and Epilepsy
Hormones, contraception, pregnancy, and changes across life stages can raise important questions. Clear information and individualized care can help you plan with confidence.
About this information
This webpage is subject to continuous review by Epilepsy Ontario to help keep the information current. This material is for informational purposes only and should not be used for self-diagnosis or as a substitute for professional medical advice, diagnosis, or treatment. Consult your healthcare provider about your own health and care.
Some topics on this page are also relevant to transgender and non-binary people. Care should reflect your body, treatment, circumstances, and goals.
Adolescence, relationships, and sexual health
Epilepsy does not remove a person’s right to relationships, privacy, or informed choices. Questions about sexual health, desire, fertility, and medication effects deserve respectful discussion.
Young people should receive information suited to their understanding and opportunities to speak privately with a healthcare professional.
Menstruation and seizure patterns
Some people notice changes in seizures in relation to their menstrual cycle. This pattern is sometimes described as catamenial epilepsy.
Keep a record of seizures, periods, sleep, and medication changes if your healthcare team recommends it. There is no universal cycle-day pattern that reliably predicts everyone’s seizures.
Discuss changes with the team rather than adjusting medication or hormone treatment independently.
Contraception and medication
Some anti-seizure medications can reduce the effectiveness of certain contraceptives. Some hormonal contraceptives can also change medication levels, including lamotrigine.
Ask your prescriber and pharmacist to review the exact combination before starting, stopping, or changing contraception.
If emergency contraception is needed, seek prompt pharmacy or medical advice and provide your medication list.
Planning a pregnancy
Arrange a pre-pregnancy review as early as possible. Many people with epilepsy have healthy pregnancies, but planning helps balance seizure control and treatment-related risks.
- Review every medication and supplement.
- Discuss the risks and benefits of your current treatment.
- Ask about folic acid before conception and during pregnancy.
- Agree how seizures, medication levels, and follow-up will be monitored.
- Discuss any relevant genetic or family-history questions.
The appropriate folic acid dose should be discussed with your healthcare team. Recommendations vary; more is not automatically better.
Pregnant or think you might be?
Contact your prescribing healthcare professional promptly for a review.
Do not stop or change anti-seizure medication on your own. Uncontrolled seizures can also pose serious risks. This is particularly important if you take a medication with known pregnancy risks, such as valproate.
After birth and breastfeeding
Plan support for sleep, medication routines, and caring for the baby. Ask about any medication adjustments after delivery and practical precautions during feeding, bathing, and carrying.
Breastfeeding advice depends on the medication and the baby’s circumstances. Do not assume that epilepsy or medication automatically rules it out.
Perimenopause and menopause
Report changes in seizures, sleep, mood, or medication effects. Discuss hormone treatment and other new medicines with the epilepsy team so interactions can be reviewed.
Bring these questions to your appointment
- Could hormones or contraception affect my seizures or medication?
- Is my treatment appropriate if pregnancy is possible?
- What folic acid plan is right for me?
- Who will coordinate epilepsy and pregnancy care?
- What support should I arrange after birth?
