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Women, Epilepsy, and Sexuality

New knowledge, new drugs open new doors for people with seizure disorders.

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.

Combating Birth Defects

Though women with epilepsy were once discouraged from having babies due to the health risks of mother and fetus alike, more than nine in 10 of such women now have healthy babies. Nevertheless, there are special concerns to be faced.

Though some women say they would rather go off their medication during pregnancy than risk hurting their fetus, doctors generally advise against this.

"It really depends on the individual," Pack says. "Some women must continue to take their drugs or they will have a seizure, and that could be worse to both the mother and the fetus than not taking the drug. There's a risk of preterm delivery, miscarriage, and decreased oxygen to the brain that can result in permanent brain damage, even death."

On the flip side, there is a chance that some anti-seizure drugs can cause birth defects in the newborn. And it's not a concern to be taken lightly: The anti-epileptic drug phenobarbital went on the market in 1912, but it was not until the 1990s that articles about its harmful effects on the fetus began to appear, says Lewis Holmes, MD, professor of pediatrics at Harvard Medical School and chief of the pediatric and teratology unit at Massachusetts General Hospital in Boston.

Because some seizure medications are known to lower levels of folate, which is associated with birth defects, women of childbearing age should take folate supplements (400 mg per day) as part of a healthy diet.

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