Girls, Women's Health, and Valproate

This chapter covers a topic that is especially important for girls and young women, and that doctors take great care over. This information will guide you and your young person when making important health decisions in the future.

Why a Separate Chapter?

Some aspects of epilepsy treatment carry extra dimensions for girls and young women. The main reasons are that some epilepsy medications can harm a developing baby in a future pregnancy, and that some medications can interact with hormones and with birth control methods. Addressing these topics early protects the young person's future.

Valproic Acid and the Risk in Pregnancy

As we also mentioned earlier in the chapter on medications, valproic acid (sodium valproate), a strong and effective medication, increases the risk of birth defects and developmental problems in the baby when used during pregnancy. For this reason, today it is recommended to avoid this medication as much as possible in girls and young women of childbearing age and, where possible, to prefer safer alternatives. If no other medication works and valproate is unavoidable, that decision is made after a detailed conversation with the family and on the condition of effective birth control.

Important: Don't decide on your own

If your child is taking valproic acid, do not read this information, panic, and stop the medication. Stopping a medication suddenly can trigger severe seizures, and that can be more dangerous than the medication itself.

Instead, talk over your concerns about this with your doctor in a planned way. Your doctor will work with you to find the safest path based on your child's situation. Every medication change should be made carefully and gradually.

Puberty, the Menstrual Cycle, and Seizures

In some girls, seizures can increase at certain points in the menstrual cycle (especially on the days when hormonal changes are most intense); this is called a "catamenial" tendency. If you notice that the seizures are linked to the menstrual cycle, note it in your seizure diary and share it with your doctor; the treatment can be adjusted accordingly.

Birth Control and Medication Interactions

In later years, some epilepsy medications and hormonal birth control methods can change each other's effects. This can affect both the reliability of the birth control and seizure control. That's why it's important for young women to be sure to consult their neurologist when making decisions about birth control. This is one of the important pieces of information a young person should know during the transition period.

The Future: Is It Possible to Become a Mother?

This is one of families' deepest questions. The answer is encouraging: the vast majority of women with epilepsy have healthy pregnancies and give birth to healthy babies, with the right planning and follow-up. The key is that the pregnancy is planned and that the treatment is made as safe as possible beforehand. Even though this is a matter for years down the road, the steps taken today with the right medication choices help secure those days.