Contraception and Epilepsy

7th August 2018

Living with epilepsy can impact a number of areas in a person’s life, one of these that everyone should know about are the types of contraception you may or may not be able to use. It’s a complicated subject that relies on the type of treatment and medication the person is using.

Types of contraception

There are three major types of contraception available:

Barrier – As the name suggests, barrier methods prevent the sperm from reaching the egg. This type of contraception includes condoms, caps, the coil, diaphragms and femidoms.

Hormonal – These methods of contraception use oestrogen and/or progestogen similar to those the female body produces to control the menstrual cycle. This type of contraception includes the pill, implants, the patch, mirena coil, contraceptive injections and vaginal rings.

Natural – These methods rely on accurately tracking your menstrual cycle and abstaining from sex during fertile times, this includes the rhythm method and the persona method.

What’s the problem?

The main issue surrounds hormonal contraceptives, which can become less effective at preventing pregnancy when taken alongside some anti-epileptic drugs (AEDs). The type of AEDs you take can also mean that emergency contraception, such as the morning after pill could also be less effective than required. It’s less likely that your choice of contraception will affect the effectiveness of your AEDs.

Which AEDs can affect contraception?

Enzyme-inducing AEDs are very likely to reduce the effectiveness of any hormonal contraceptives. There are a number of AEDs that are enzyme-inducing, including Carbamazepine, Phenytoin, Primidone, Lamotrigine and many more. Non-enzyme-inducing AEDs, such as Sodium valproate, Clobazam and Levetiracetam, are unlikely to affect any form of contraception and those taking them should be safe.

If you’re using enzyme-inducing AEDs…

It’s important that you find a contraceptive that works for you and your epilepsy treatment plan. Unfortunately, hormonal contraceptives may not be an option if you want a solution that’s as effective as possible, but there are many other options available. It’s worth speaking to a sexual healthcare professional to discuss the options that are available to you to find one that suits your lifestyle and needs. It’s also worth talking to your neurologist to get more accurate advice that’s based on your epilepsy and the medication you’re taking.

It’s likely that barrier methods, such as condoms or a diaphragm will be a better option for you if you are taking enzyme-inducing AEDs. Natural methods are an alternative, but may be more prone to human error should you misjudge the times you are fertile.

National Epilepsy Training can help

Our expert staff can provide advice that’s more tailored to your particular situation and help you to find a contraceptive measure that works for you and your lifestyle. Call us on 01706 373075 or email admin@nationalepilepsytraining.co.uk.