Medical Education Library

Women With Epilepsy: Hormones, Contraception, and Treatment Options


A supplement to Clinical Neurology News. This supplement is jointly sponsored by the Elsevier Office of Continuing Medical Education and Clinical Neurology News. The supplement is supported by an unrestricted educational grant from UCB Pharma and is based on presentations made at a continuing medical education symposium held May 9, 2005, in San Francisco, California.

To view the supplement, click the image. To take the CME test, download and print out the PDF file, and follow the test instructions on page 12.


Advances in Epilepsy Treatment
Page B. Pennell, MD
Associate Professor of Neurology
Director, Emory Epilepsy Program
Emory University School of Medicine
Grant/Research Support: GlaxoSmithKline and Pfizer; Consultant/Speaker's Bureau: GlaxoSmithKline and UCB. She discusses the investigational use of vagus nerve stimulation for treatment of depression, topiramate for essential tremor, obesity, and pain disorders, and oxcarbazepine for neuropathy and bipolar disorder.

Hormonal Influences on Seizures: Treatment Considerations
Cynthia L. Harden, MD, Chair
Associate Professor of Neurology and Neuroscience
Comprehensive Epilepsy Center
Weill Medical College of Cornell University
New York
Grant/Research Support: GlaxoSmithKline, Ivax Corporation, Pfizer Inc., and Schwartz; Consultant: Eisai Inc., GlaxoSmithKline, and UCB Pharma, Inc.; Speaker's Bureau: Abbott Laboratories, GlaxoSmithKline, Novartis AG, OrthoNeutrogena, and UCB. She discusses the investigational use of natural progesterone and oral contraceptives for treatment of catamenial seizures.

Contraception: Making the Right Choice
Anne R. Davis, MD, MPH
Assistant Professor of Clinical Obstetrics and Gynecology
Columbia University College of Physicians and Surgeons
New York
Nothing to disclose.

Target Audience

This activity has been developed for clinicians and other health care professionals responsible for the care of women with epilepsy.

Educational Needs

Epilepsy is the most common neurologic disorder requiring continuous treatment during pregnancy, yet published surveys of clinical professionals responsible for the care of these women reveal considerable misunderstanding of the latest standards of care. Timing of pregnancy and contraception are crucial, long-term health concerns, especially for women with epilepsy. Furthermore, these women are more likely to experience reproductive disorders such as polycystic ovaries, early menopause, and irregular or no ovulation. Successful management of women with epilepsy demands an appreciation not only of hormonal influences on seizure activity but also of P-450-inducing anticonvulsants on oral contraceptives. Complex treatment issues that will be addressed for this particular patient population include catamenial seizures, perimenopausal and menopausal hormone replacement therapy, polycystic ovary syndrome (PCOS), and fetal exposure to anticonvulsants.

Learning Objectives

By reading and studying this supplement, participants should be able to:

• understand the influence of estrogen and progesterone on seizure activity.

• recommend appropriate methods of contraception for women with epilepsy.

• appreciate the causes and effects of PCOS.

• recognize and treat catamenial seizures.

• evaluate intervention benefits and risks of first-generation and newer anticonvulsants as well as of neurosurgical resection and vagus nerve stimulation.


This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Elsevier Office of Continuing Medical Education (EOCME) and Clinical Neurology News. The EOCME is accredited by the ACCME to provide continuing medical education for physicians.

The EOCME designates this educational activity for a maximum of 1.25 category 1 credits toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the educational activity.

Term of Approval: August 2005–July 31, 2006

Copyright © 2005 by Elsevier Inc.

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