Women with epilepsy taking anti-epileptic drugs may have difficulty in preventing pregnancy using some contraception methods. This usually happens because some anti-epileptic drugs especially enzyme-inducing anti-epileptic drugs may interact with the methods of contraception used. While non-enzyme inducing anti-epileptic drugs do not interact or affect contraception methods.
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Enzyme-Inducing AEDs
Enzyme-inducing anti-epileptic drugs such as topiramate, carbamazepine, phenytoin, primidone, perampanel may interact or disturb contraception methods that have hormones, such as contraceptive implants or the Pill. This is because AEDs increase the number of enzymes that accelerates the breaking down of hormones in the body. This simply means that the hormones from the contraceptives are broken down more rapidly than normally, so they do not stay in the body for longer time and becomes ineffective to prevent pregnancy.
If you are taking enzyme-induced anti-epileptic drugs, your doctor may advise you to use those methods of contraception that do not interact with your epilepsy medication. For instance he/she may advise you to use more than a single contraceptive method or a barrier method to prevent pregnancy.
Which Contraception Method is best for you?
The best way to decide on which contraceptive method will work for you is consult your neurologist about the combination of contraception and AEDs that’s best suited for you. In this article we have covered some methods of contraception and their overall affect when taken alongside anti-epileptic drugs. These methods may or may not work to prevent pregnancy, and for more information on contraception it is advised that you contact FPA (Family Planning Association).
Types of Contraception Methods
Barrier Method – It is a contraception method that forms a physical barrier to help prevent pregnancy. These barriers methods usually include: femidoms, condoms, diaphragms and caps. These contraceptive methods are not affected by anti-epileptic drugs. However, these barrier methods when used alone may not be so effective to prevent pregnancy. It is advised to take another contraceptive method along with barrier method to be effective in preventing pregnancy.
IUSs or Intrauterine systems – These contraceptive devices are fitted inside your womb (uterus). Unlike intrauterine devices that do not contain hormones, these devices contain progestogen (sex hormone). One example of intrauterine systems is the Mirena coil, which releases levonorgestrel.
Though, intrauterine systems have progestogen, they are not affected by anti-epileptic drugs as the hormone (progestogen) is not released in the body but directly into the womb. This prevents the enzyme-inducing AEDs to break down hormone more rapidly as it would have when a hormone travels around the body.
There is a possibility that when the intrauterine system is inserted inside your womb woman could have a seizure attack. But it is very rare.
Contraceptive injections – These are also effective in preventing pregnancy and are not affected by anti-epileptic drugs as the hormone contained in these injections is released in the blood than in the liver. Injection such as Depo Provera can be given at regular interval that contains female sex hormone progestone.
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