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Women, Epilepsy, and Sexuality

New knowledge, new drugs open new doors for people with seizure disorders.
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Epilepsy and Birth Control continued...

Like Lamictal, Neurontin has no effect on hormonal balance and thus does not interfere with the effectiveness of birth control pills.

No matter what seizure medication you are on, it's important to realize that the popular "mini-pill" has too little estrogen -- less than 35 micrograms -- to protect women with epilepsy from becoming pregnant. The reason: Many of the commonly prescribed seizure medications reduce the amount of time that hormones are in your bloodstream, Shafer says.

Her advice: "Talk to your doctor about what type of contraception is best for you." In many cases, a combination of a pill and a barrier method may be the best option.

Sexual Dysfunction

Problems with low sexual desire, difficulty with arousal, and painful intercourse are not uncommon among women with epilepsy. According to Pack, there are a variety of reasons for such problems, many of which can be helped by a doctor or therapist. Some women may experience feelings of low self-esteem, for example, while others may have vaginal dryness caused by the disease itself.

"As embarrassing as it may be, it is important to speak openly with a health-care professional you trust as many of these problems can be solved," Pack says.

Bone Health

Though bone health is of concern to all women as they age, women with epilepsy face unique challenges, Pack says.

"Some of the older medications such as phenytoin (Dilantin) and phenobarbital have been shown in studies to raise the risk of osteoporosis, which in turn can raise the risk of bone fractures," she tells WebMD. And in Pack's own trial of 70 women, those taking Dilantin had decreased bone density at the hip at one year compared with those on other drugs.

Pack notes that "we really don't have good data yet on some of the newer agents, [but] preliminary data suggests that valproate may also have a negative effect, increasing the risk of bone turnover, a precursor of osteoporosis."

Since many of the anti-epilepsy drugs increase the risk of developing the bone-thinning disease osteoporosis, women with epilepsy should ask their doctors about bone-boosting supplements and annual bone density scans, experts tells WebMD. Some seizure medications interfere with the absorption of vitamin D, the vitamin that is necessary to help build strong bones.

Be sure to get the recommended dietary allowance of both calcium and vitamin D in the diet, Pack says. The typical recommended intake of vitamin D in women of childbearing age is 200-400 IU. For calcium, the recommended intake is 1,000-1,400 mg per day.

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