Fertility, periods and epilepsy

Your menstrual cycle starts on the first day of your period and ends on the day before your next period. Most women have a menstrual cycle length of between 25 and 35 days. However, it’s not unusual for someone to have a cycle of less than 25 days or more than 35 days.

The hormones that control your menstrual cycle can be affected by anti-epileptic drugs, or by seizure activity in a certain area of your brain. This may occasionally cause your period to arrive earlier or later than expected. However, in more serious cases, women may find that their periods are irregular or happen very rarely. This can make it harder to become pregnant. For this reason, if your periods are irregular or happen rarely, you may want to talk to your doctor about it.

Polycystic ovary syndrome and the menstrual cycle

Polycystic ovary syndrome (PCOS) is another possible cause of irregular periods. If you have PCOS, you have cysts on your ovaries and unusual hormone levels. This may stop you from ovulating (releasing an egg) every month. This would make it more difficult for you to become pregnant.

PCOS can affect any woman. But studies suggest that it is more common in women with temporal lobe epilepsy and women who take the anti-epileptic drug sodium valproate (Epilim). The risk of developing PCOS is further increased if you have taken sodium valproate from a young age.  However, the syndrome often improves once a woman stops taking sodium valproate. If you are concerned about PCOS, it is very important that you do not stop taking your anti-epileptic drugs without advice from your doctor. This could cause you to have more seizures.

Fertility

Any woman can have reduced fertility. This means it may take them longer to get pregnant. Women with epilepsy have a slightly higher risk of being less fertile than other women. This may be due to having epilepsy itself or taking some anti-epileptic drugs (AEDs). It could also be due to another reason that’s not connected to epilepsy.

If your periods are not regular, or if you have been trying to get pregnant and it has not happened, it’s worth talking to your doctor. They can look into the possible causes for your problem and, if necessary, suggest treatment.

Your doctor may suggest making changes to your AEDs. Having fewer seizures or changing your AEDs may make your periods more regular. This could improve your fertility. If you have [polycystic ovary syndrome] (PCOS), your doctor may advise you to take the contraceptive pill. Taking the contraceptive pill can reduce the effects of PCOS and you may begin to have regular periods. This may help you to get pregnant, once you stop taking the contraceptive pill.

Your doctor may suggest you use hormone-based fertility drugs to help you become pregnant. Some women with epilepsy have said that they had more seizures while taking these. However, you should not be stopped from taking hormone-based fertility drugs, just because you have epilepsy or take AEDs.