Women with epilepsy: Evidence-based counseling across the lifespan - PubMed

7 hours ago

Women with epilepsy (WWE) face unique challenges across different life stages, requiring care beyond seizure control.
Key life stages include adolescence, reproductive health, pregnancy, lactation, menopause, and bone health.
Hormonal changes and antiseizure medications (ASMs) interact with reproductive physiology, affecting seizure patterns and treatment efficacy.
Special attention is needed for teratogenic and neurodevelopmental risks associated with certain ASMs during pregnancy.
Effective care involves continuous, individualized counseling, structured transition processes, and evidence-based advice on contraception and pregnancy.
Therapeutic drug monitoring during pregnancy and transparent communication about fetal risks of ASMs are crucial.
Post-reproductive years require monitoring of seizure changes during menopause and long-term ASM effects on bone health.
Despite advances, participation in pregnancy registries is low, and evidence outside pregnancy remains limited.
Awareness of sex-specific epilepsy issues is insufficient among both WWE and healthcare professionals.
Improving education, multidisciplinary care, and research is essential for patient-centered, lifelong care for WWE.

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