Contraceptive use in women with epilepsy

• Contraceptive use in women in epilepsy is important to have a planned pregnancy
• WHO Medical Eligibility Criteria for Contraceptive Use states that all methods of contraception can be used safely in women with epilepsy
• But it is better to avoid hormonal contraceptives in them as anti epileptic drugs like phenobarbital, phenytoin and carbamazepine are enzyme inducers
• They increase the rate of degradation of these hormones and result in high risk of contraceptive failure
• This risk is greater in newer generation of oral contraceptive pills as they contain low quantities of hormones in view of better side effect profile
• So hormonal contraception is better avoided in women taking anti epileptic drugs

References:

Park’s textbook of preventive and social medicine, 20th edition, p432
Neurological Disorders and Pregnancy By Alireza Minagar
Neurologic disease in women By Peter W. Kaplan