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Martha Morrell, M.D., is the Director of the Columbia Comprehensive Epilepsy Center at New York-Presbyterian Hospital, as well as a Professor of Clinical Neurology at Columbia University. Dr. Morrell's research has focused on female reproductive health risks associated with epilepsy. She is the lead author in a published report entitled, "Health Issues for Women with Epilepsy: A Descriptive Survey to Assess Knowledge and Awareness Among Health Care Providers," published in the November 2000 issue of the Journal of Women's Health and Gender-based Medicine. She is the senior author of the Expert Consensus Guideline Series: Treatment of Epilepsy, published as a supplement in November/December 2001 issue of Epilepsy & Behavior. Dr. Morrell has served as an epilepsy advisor to the National Institutes of Health (NIH), Centers of Disease Control and Prevention (CDC) and as a member of the Board of Directors of the American Epilepsy Society.  She is the immediate past chair of the Epilepsy Foundation.

What Some Women Need To Know About Reproductive Health And Certain Medications

Epilepsy has long been misunderstood, often causing people with the disorder to be stigmatized or to receive inadequate health care.  Although we no longer think that people with epilepsy are possessed by demons as people did in ancient times, much of the public and many health care providers still don't understand epilepsy, especially when it comes to the unique way in which it affects women.

More than two million Americans live with epilepsy, about half of whom are women and girls. Second to headaches, epilepsy is the neurological disorder seen most often by physicians and one of the most common chronic health conditions affecting women of reproductive age. Many other women also use anti-epilepsy drugs (AEDs) to treat conditions such as migraines, pain conditions, and bipolar disorder. However, little is known about the effect of this treatment as it relates to females.

Epilepsy is a seizure disorder caused by brief, abnormal discharge of electrical activity in one's brain. Epilepsy is diagnosed through a combination of medical tests, a thorough medical history plus discussion with a doctor. Most doctors diagnose patients as having epilepsy if they have two or more seizures. Among the many causes are infections, head injuries, brain tumors, brain injuries at birth, and genetic predisposition. In the majority of people, a cause is never discovered. Seizures can last a few seconds or several minutes, and symptoms range from a blank stare to a jerking motion in arms and legs. Because of the variety of seizure symptoms, epilepsy is often confused with and misdiagnosed as fainting, migraine, or panic attacks.

Epilepsy in women can be very complicated because it's often hard to distinguish the effects of the illness from the effects of the medications used to manage seizures. Women with epilepsy can experience a host of reproductive and sexual problems, excessive weight gain, and osteoporosis when compared to women in the general population. Reproductive problems with epilepsy can include difficulties becoming pregnant and an increased risk of having children with birth defects, menstrual irregularity, infertility and a condition called polycystic ovarian syndrome (PCOS), which itself causes infertility, irregular or absent menses, ovarian cysts, obesity and unwelcome changes in facial and body hair. Further complicating matters is the fact that the majority of health care professionals who responded to a recent survey are unaware of the impact of epilepsy and its treatment on women.

The good news is that recent studies are showing that certain anti-epilepsy drugs are less likely than others to be related to some of these female-specific effects.  Furthermore, new treatment guidelines have been issued, recognizing the need for special treatment strategies for groups such as women. These consensus guidelines, based on the clinical practices of leading epilepsy experts from around the country, outline a separate treatment strategy for women in their childbearing years, relying on anti-epilepsy drugs (AEDs) that appear to be less likely to cause these problems for women.

If you are prescribed AEDs for the treatment of epilepsy or for other reasons, make sure you and your physician are aware of potential concerns relating to the use of these medications in females. One source of information is the Epilepsy Foundation's Women and Epilepsy Initiative launched in 1997 to help women manage the effects of epilepsy and its treatment in their daily lives.

For more information about epilepsy, click here.

Created: 1/6/2002  -  Martha Morrell, M.D.

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