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Lamotrigine and contraception

Planned contraception

Types of planned contraception that may work well for you

Barrier methods

Barrier methods are worn during sex to prevent the sperm reaching the egg. These barriers include:

  • Cap (FemCap)
  • Condom or sheath
  • Diaphragm
  • Femidom (Milex)

Hormonal contraception

The hormonal contraception that may work for you include:

  • Combined oral contraceptive pill (the pill) - but see box below
  • Contraceptive implant (Nexplanon)
  • Contraceptive injection (Depo-Provera)
  • Contraceptive injection (Noristerat) (short term method of contraception only)
  • Contraceptive patch (Ortho Evra) - but see box below
  • Hormone releasing intrauterine system (IUS) (Mirena)
  • Projestogen-only pill (the mini pill)
  • Vaginal ring (NuvaRing) - but see box below

Combined oral contraceptive pill (the pill), contraceptive patch (Ortho Evra), and vaginal ring (NuvaRing)
Research on a small group of women has shown that the pill, contraceptive patches and vaginal rings may reduce the amount of lamotrigine in the bloodstream. This would make you more at risk of having seizures. If you want to use any of these forms of contraception, talk to your doctor or epilepsy specialist. They may need to increase your dosage of lamotrigine.

Lamotrigine may make the pill, contraceptive patches and vaginal rings work less well. This would make you more at risk of an unplanned pregnancy. For this reason, your doctor might advise you to use condoms as well, until they can be sure that the pill, patch or ring would prevent you from getting pregnant. They can check if you are at risk of getting pregnant by giving you blood tests at certain times of the month. The blood tests show if you have stopped ovulating (releasing an egg) This means that you shouldn’t get pregnant. Or, the doctor may advise you to change to a different type of contraception.

Because the levels of both lamotrigine and hormonal contraception can be reduced when taken together, hormonal contraceptives may not be a good idea. This is because they can interact, leaving you with more seizures and less contraceptive cover. In the pill-free weeks, your dose of lamotrigine could be too high for you, leading to side-effects. Your doctor could advise you to use a long-acting reversible contraception (LARC) instead. The Family Planning Organisation has a guide to LARC.

Intrauterine devices

  • Copper intrauterine device (IUD) coil
  • Hormone releasing intrauterine system (IUS) (Mirena)

These are small, T-shaped birth control devices that are inserted into a woman's uterus (womb) to prevent pregnancy.

Sterilisation

  • Female sterilisation

This involves an operation to permanently prevent pregnancy. The fallopian tubes are blocked or sealed by applying a clip, ring or tying and cutting and removing a piece of each fallopian tube. This is to prevent eggs from reaching the sperm and becoming fertilised. It is usually carried out under local or general anaesthetic.

  • Male sterilisation

This involves an operation to cut or seal the tubes that carry sperm from a man’s testicles to the penis into the fluid that is ejaculated during sex. This is a permanently method of birth control and is usually carried out under local anaesthetic.

Types of planned contraception that are not recommended for you

Natural birth control

  • Persona contraception monitor
  • Rhythm method
  • Sympto-thermal method

Unplanned contraception

The following types of unplanned contraception may work well for you:

  • Copper intrauterine device (IUD) coil
  • Morning-after pill: Levonorgestrel (Levonelle) or Ulipristal acetate (EllaOne)

How can I find out more about contraception?

Talk to your family doctor, epilepsy specialist nurse or your local family planning clinic. They can help you choose a form of contraception that will work for you and suit your lifestyle.

It’s important to be happy with your choice, and to know how to use it properly, if you don’t want to become pregnant.

Further information is available from:

NHS website
Website: nhs.uk

Family Planning Association
Website: fpa.org.uk

Code: 
F058.05
Event Date: 
Friday 23 October 2015

Epilepsy Action would like to thank Beth Irwin, epilepsy nurse/midwife, The Royal Hospital, Belfast, for her help in planning this information and Kim Morley, epilepsy specialist midwife for her contribution to this information.

Beth Irwin and Kim Morley have declared no conflict of interest.

This information has been produced under the terms of Epilepsy Action's information quality standards.

  • Updated May 2019
    To be reviewed May 2022

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