Contraception

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Of all the individuals diagnosed with epilepsy in Ireland about 25% or 10,000 are women of childbearing potential. In today's society choice is of vital importance for women, especially those affected by epilepsy. This leaflet intends to explain the various methods of contraception available to women with epilepsy.

Women with epilepsy can choose from the standard methods of contraception. The exact choice should depend on the individual's needs but particular attention will need to be paid to some methods more than others.

Different types of planned contraception

There are three main types of planned contraception:

• Barrier methods

• Hormonal treatment

• Natural birth control (rhythm and persona)

Barrier methods

Barrier methods are used during sex to prevent the sperm reaching the egg.

These barriers include:

• Caps

• Condoms

 • The coil

• Diaphragms

• Femidoms

Hormonal contraception

Some methods of hormonal contraception use the two hormones oestrogen and progesterone, or just progesterone alone, similar to those produced by women, to control menstruation.

Hormonal contraception includes:

 • Combined oral contraceptive pill (COCP)

• Contraceptive implant • Contraceptive patch

• Depo-Provera contraceptive injection

• Mirena coil

• Contraceptive injection

• Progesterone-only pill (the mini pill)

• Vaginal ring

How can I find out more about contraception?

Talk to your family doctor, epilepsy specialist nurse, 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.

Table of Epilepsy Medications

Table of Epilepsy Medications and Recommended Contraception Please be advised that this table maybe subject to change and you should always discuss your contraception methods with your GP, neurologist or nurse specialist. (This table was completed in March 2018). If you are taking any of the following enzyme inducing anti-seizure medications then the box below will describe the most suitable method of contraception for you:

• Carbamazepine (Tegretol)

• Esclicarbazepine(Zebinix)

• Oxcarbamazepine (Trileptal)

• Perampanel (Fycompa) >12mg daily

• Phenobarbitone • Phenytoin (Epanutin)

• Primidone (Myosoline)

• Topirimate (Topamax) >200mg Daily

If you are taking any of the following non-enzyme inducing anti-seizure medications then the box below will describe the most suitable method of
contraception for you:

Biravetracetam (Briviact)
• Clobazam (Frisium)
• Clonazepam (Rivitrol)
• Ethosuximide(Zarontin)
• Gabapentin (Neurontin)
• Lacosimide (Vimpat)
• Lamotrigine (Lamictal) * -
• Levetiracetam (Keppra)
• Perampanel (Fycompa)
<12mg daily
• Rufinamide (Inovelon)
• Sodium Valproate (Epilim)**-
• Tiagabine (Gabitril)
• Topirimate (Topamax)
<200mg daily
• Vigabatrin (Sabril)
• Zonisamide (Zonegran)

Special precautions

*Lamotrigine: some research has suggested that Lamotrigine may interact with the COCP, contraceptive patch and vaginal ring reducing the effectiveness of Lamotrigine, thus increasing the risk of breakthrough seizures. You should discuss with your neurologist/ epilepsy nurse specialist if your dose of medication needs to be increased.In turn Lamotrigine may also interfere with the COCP, contraceptive patch and vaginal ring causing them to work less well. For this reason a second method of contraception should be employed.

**Sodium Valproate: Please see the section relating to
sodium valproate.

Please note: barrier methods of contraception, or having any type of coil inserted (including the intrauterine system, Mirena®), are usually the mostsuitable forms of contraception to consider if you are taking an enzyme inducing drug for your epilepsy.

How can I find out more about contraception?

Talk to your family doctor, epilepsy specialist nurse, your local family planningclinic. 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.