Epilepsy in women of childbearing age: a focused review
Neurological Research and Practice · 2025 · Europe
Source and licence
- Authors
- Jan Heckelmann, Bettina Schmitz, Yvonne G. Weber et al.
- Title
- Epilepsy in women of childbearing age: a focused review
- Journal
- Neurological Research and Practice, 2025
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC12502381
Licence statement of the original publication
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
This is a review of another guideline (Guidance on epilepsy in women of childbearing age (valproate, pregnancy), ILAE / DGN 2023). We do not reproduce that guideline's recommendations here – they belong to the original guideline.
Open the original publication →Full text on Europe PMC
Abstract
Epilepsy affects over 50 million individuals worldwide, a significant proportion of whom are women with epilepsy (WWE) of childbearing age. This population faces unique challenges related to hormonal fluctuations, e.g., during life stages such as breastfeeding or menopause. Antiseizure medications (ASMs) further complicate reproductive health by influencing menstrual function, contraception, pregnancy outcomes, bone health, and menopausal transition due to their teratogenic potential and hormonal interactive effects. Consequently, treatment strategies for WWE must consider these interactions and the risks associated with ASMs during pregnancy. This review aims to consolidate current data and guidelines for managing WWE throughout their reproductive years. These findings emphasize the importance of preconception counseling to optimize ASM regimens, ensuring both maternal well-being and fetal safety. Key recommendations from major international pregnancy registries are summarized to guide clinicians in selecting ASMs that minimize the risk of congenital malformations while maintaining effective seizure control. Additionally, this review explores the role of folic acid supplementation in preventing neural tube defects and outlines contraceptive options tailored for WWE. In conclusion, comprehensive education on the implications of epilepsy for reproductive health is crucial for WWE. By fostering informed decision-making through personalized counseling and careful medication management before, during, and after pregnancy, healthcare providers can significantly improve outcomes for both mothers and their children.
Contents of the original publication
The section headings of the original.
- Key points
- Introduction: Specific challenges in the treatment of women with epilepsy—from puberty, contraception, and pregnancy to menopause and beyond
- The teratogenic risk and safety profile of antiseizure medication
- Management and consultation of women with epilepsy before, during and after pregnancy
- Folic acid supplementation in women with epilepsy
- Contraception in women with epilepsy
- Interactions between ASM and OC
- Lamotrigine and oral contraceptives
- Optimal contraception strategies
- Summary and conclusion
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