March 8th is International Women’s Day, and this article is dedicated to Women with Epilepsy.
Epilepsy is a neurological condition characterized by recurrent seizures, affecting individuals across all ages, genders, and socio-economic groups. However, women with epilepsy encounter unique challenges and concerns at different stages of their lives due to hormonal, reproductive, social, and psychological factors. As the Founder and Director of EPICENTTRE, I have observed these distinct issues firsthand. Our goal here is to illuminate these challenges and offer insights for women and their families to navigate epilepsy confidently and effectively.
Hormones and Epilepsy
Hormonal fluctuations significantly impact seizure patterns in women. Estrogen, a hormone predominant during the menstrual cycle’s follicular phase, tends to increase seizure risk, while progesterone, dominant in the luteal phase, generally exerts protective effects. Approximately one-third of women with epilepsy report a condition known as catamenial epilepsy, where seizures become more frequent or severe around menstrual periods.
This cyclical fluctuation can make seizure management challenging. It’s important to track seizures meticulously to identify patterns, enabling neurologists to tailor treatment strategies, including hormonal therapy or medication adjustments. Keeping a detailed seizure diary helps physicians develop individualized management plans that significantly reduce seizure frequency and improve quality of life.
Epilepsy and Contraception
Choosing appropriate contraception is crucial for women with epilepsy, as certain antiepileptic drugs (AEDs) can interact with hormonal contraceptives, reducing their efficacy. Medications such as carbamazepine, phenytoin, and phenobarbital may accelerate the metabolism of hormonal birth control, increasing the risk of unintended pregnancies. Conversely, oral contraceptives can alter AED levels, potentially triggering seizures.
Consulting a neurologist about contraceptive methods compatible with specific AEDs is essential. Options like intrauterine devices (IUDs) or barrier methods may be safer and more effective alternatives. This decision-making process should involve collaborative discussions with healthcare providers to ensure optimal seizure control and reliable contraception.
Pregnancy and Epilepsy
Pregnancy poses special considerations for women with epilepsy. While most women with epilepsy can have healthy pregnancies and healthy babies, careful planning is essential. Seizures during pregnancy can harm both mother and child by increasing the risk of injury, miscarriage, or preterm labor. Moreover, certain AEDs carry a higher risk of congenital abnormalities, necessitating pre-conception counseling and meticulous medication management.
Women planning pregnancy should ideally consult their neurologist to discuss medication adjustments to minimize risks. Folic acid supplementation before conception and throughout pregnancy significantly reduces the likelihood of neural tube defects associated with certain AEDs. Regular prenatal care, including frequent neurologist visits, is vital to ensure maternal and fetal well-being.
Motherhood and Epilepsy
Epilepsy can introduce additional challenges into motherhood, particularly in managing seizure risks while caring for a newborn. Sleep deprivation, common among new mothers, can exacerbate seizures, necessitating strong support networks and strategies to maintain adequate rest.
Safety precautions like feeding and changing the baby on low surfaces, using padded flooring, and having someone nearby during bathing times can significantly reduce potential hazards. Family education and community support play crucial roles in empowering mothers with epilepsy, enabling them to enjoy safe and fulfilling motherhood experiences.
Menopause and Epilepsy
As women approach menopause, hormonal shifts again influence seizure patterns. Menopause involves decreasing progesterone levels, often reducing seizure protection and potentially increasing seizure frequency. Additionally, menopausal symptoms like hot flashes and disrupted sleep can further complicate seizure management.
Close monitoring and adjustments to AED dosages may be necessary during this transition. Hormone replacement therapy (HRT), although helpful for menopause symptoms, must be carefully evaluated and individualized, as certain forms can potentially increase seizure risk.
Psychological and Social Challenges
Women with epilepsy frequently face psychological and social issues, including stigma, depression, anxiety, and low self-esteem. Societal misconceptions about epilepsy sometimes lead to discrimination, limiting employment opportunities, social activities, and personal relationships. Additionally, fears surrounding seizures in public settings can significantly restrict social interactions, increasing isolation.
Mental health support is essential in epilepsy management. Counseling, psychotherapy, and peer support groups can dramatically improve emotional well-being, reduce anxiety, and foster resilience. EPICENTTRE emphasizes comprehensive care, including psychological support and education, enabling women to manage epilepsy effectively and live fulfilling lives.
Bone Health and Epilepsy
Women with epilepsy must also be mindful of bone health, as AEDs can impact bone density, increasing the risk of osteoporosis and fractures. Regular bone density screenings, calcium and vitamin D supplementation, and weight-bearing exercises help mitigate these risks.
Understanding and proactive management of bone health prevent long-term complications, preserving mobility and quality of life.
Empowering Women with Epilepsy
Addressing these unique challenges requires a multidimensional approach involving neurologists, gynecologists, psychologists, family members, and support groups. Comprehensive education and advocacy play vital roles in dismantling stigma, enhancing awareness, and promoting inclusivity.
At EPICENTTRE, we focus on empowering women with epilepsy through personalized care plans, robust educational programs, and supportive resources. Our approach fosters confidence, independence, and resilience, ensuring that epilepsy does not become a barrier to achieving personal, professional, and reproductive goals.
Conclusion
Women living with epilepsy face distinct, multi-layered challenges due to the interplay of hormonal, reproductive, psychological, and social factors. However, with specialized care, informed choices, and adequate support, these challenges can be successfully managed.
Empowering women with epilepsy involves holistic care tailored to individual needs and life stages, comprehensive education, and strong support networks. By promoting understanding and proactive management strategies, we can significantly improve the lives of women with epilepsy, helping them lead empowered, vibrant, and fulfilling lives.
EPICENTTRE remains committed to this mission, offering state-of-the-art epilepsy treatment, comprehensive educational resources, and unwavering support for women navigating the complexities of epilepsy at every stage of life.
‘A FULL LIFE, WITH EVERYONE, LIKE EVERYONE, IN SPITE OF EPILEPSY’
Dr. Prithika Chary
Neurologist, Neurosurgeon, Epileptologist & Founder Director, EPICENTTRE,
Kauvery Hospital, Chennai
