Epilepsy is a neurological disorder that causes frequent, spontaneous seizures. A seizure is an abrupt spike in aberrant brain activity. Contrary to popular belief, epilepsy is common in women. One million women in their reproductive years alone suffer from this illness. Epilepsy not only affects the quality of life of a woman but also affects reproductive health issues and sexual problems. 

A woman's monthly menstrual cycle involves fluctuations in hormones such as progesterone and estrogen. These hormones also permeate the brain and control its excitability. Brain excitability can be increased by estrogen and decreased by progesterone. With these hormonal imbalances, seizures or epilepsy may become more frequent after ovulation or during your periods. This is called catamenial epilepsy.

Effect of Epilepsy on Women’s Reproductive Health

Your menstrual cycle's regulating hormones may also have an impact on your seizures. Hormones are molecules found in your body that support the regulation of hunger, sleep, stress, and libido.

Your menstrual cycle is regulated by the female hormones progesterone and estrogen. Your body's concentration of these hormones varies throughout 28 days between periods. Because hormones affect how frequently seizures occur and how the endocrine system functions, women who have epilepsy confront difficulties. 

For certain women, fluctuations in the ratio of progesterone to estrogen during the menstrual cycle may have an impact on seizures. Before or after the onset of monthly flow, some women have an increase in seizures. A few weeks before each menstrual cycle, during ovulation, some women may experience an increased frequency of seizures. 

Epilepsy and Reproductive Dysfunction in Women

Sexual dysfunctions could result from hormonal imbalances, endocrine problems, fear, and side effects of antiepileptic drugs. This can further lead to depression, anxiety, and loneliness if not taken seriously. Consult a Neurologist no sooner you notice any of the symptoms. 

Women with epilepsy are at risk for reproductive health dysfunction, which includes: 

  • Fertility can be reduced by 20% to 40% when compared to women without seizures.
  • Decreased sexual desire or inability to orgasm
  • Vaginal dryness
  • Painful sex
  • Increased risk of polycystic ovarian disease
  • Ovarian cysts without any symptoms (in 21% to 23% of women)
  • Depression and anxiety
  • Irregular menstrual cycle and abnormal bleeding patterns
  • Anovulation (stopping the ovaries from releasing a mature egg)
  • Hirsutism (excess body hair)

Additional challenges Due to Antiepileptic medications?

Hormones affect how frequently seizures occur and how the endocrine system functions. Women who have epilepsy confront unique difficulties due to antiepileptic medications (AEDs), including:

1. Reduces the efficacy of contraception methods

Many anti-seizure drugs have the potential to reduce the effectiveness of oral contraceptives, which could cause unintentional births in epileptics. However, some birth control methods can make some epilepsy drugs more metabolically active, which raises the possibility of breakthrough seizures. It's crucial to consult your doctor about your current birth control regimen, potential side effects from anti-seizure drugs, and other birth control options. 

2. Affects bone density

Women on anti-seizure medications are more likely to have osteoporosis, which can lead to bone fractures. It is therefore advisable to have vitamin D supplements.

3. Risky pregnancy

Many anti-seizure drugs have the potential to cause prenatal growth restriction, preterm birth, or an increased risk of spontaneous abortion.

4. Increases the risk of fetal malformations

Pregnant women with epilepsy have a three times higher risk of congenital malformations in their children than healthy women. The risk may increase with higher doses or if more than one anti-seizure medication is taken.

Lifestyle Modification Tips to Deal Epilepsy in Women

Women need to take steps to adapt their lifestyle to accommodate epilepsy. The tips include:

  • Take adequate sleep: Sleep deprivation can increase the risk of brain misfiring, and fatigue is one of the main causes of seizures.
  • Stay away from alcohol and recreational drugs: People with epilepsy may experience seizures as a result of these substances. Seizures can occur even after one or two drinks.
  • Reduce emotional stress: By maintaining appropriate stress levels and controlling anxiety, one can lower their chance of seizures.
  • Exercise frequently: Frequent exercise has several health advantages and can also lower the chance of seizures. Before beginning a new workout regimen, you should nonetheless speak with your doctor, as some types of exercise may infrequently result in seizures.
  • Consume a balanced diet: A balanced diet with fresh fruits and vegetables keeps your brain active. Avoid skipping meals.
  • Take your medications on time: Do not miss doses of your medications.
  • Go for regular checkups with your healthcare provider: Timely checkup for a woman with epilepsy is pivotal especially if one intends to become pregnant. Discuss with your medical team the best ways to take care of both you and your unborn child.


Epilepsy is a particular worry for women during their reproductive years. Women with epilepsy experience psychological stress and anxiety. Their bodies' ability to maintain reproductive health is compromised; hence, the rates of infertility are higher. It is advisable to consult with a doctor who can consider the physiological effects of antiepileptic and seizure drugs. Early and frequent counseling regarding reproductive health and epilepsy is recommended for women who have epilepsy. When choosing antiepileptic medications, women who are or may become pregnant in the future should take contraceptive needs into account. The intention is to provide women suffering from epilepsy with exceptional general health, quality of life, and a seizure-free lifestyle. 

If you have any questions regarding epilepsy or its association with the sexual health of a woman, you can Ask a Neurologist at Ask a doctor, 24x7.

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Disclaimer: Information provided on this page is not intended to substitute for proper medical advice provided by your healthcare professional. This is only for informational purposes. 

About the Author

Dr. Shweta Khanna

Shweta Khanna is a dental surgeon who has experience in dentistry for more than 13 years. She has been writing innovative medical and healthcare content for the past eight years. She has authored various medical blogs/articles related to dentistry, orthopedics, dermatology, women's health, consumer health articles, and research articles (basic and clinical).

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