Treatment guidelines: Women of fertile age

► Women of fertile age account for at least 25% of the population affected by epilepsy. ► Epilepsy is associated with sexual difficulties, menstrual disturbances, infertility, and premature menopause. ► Seizure exacerbation around their menstrual cycle (catameniel epilepsy) affects between 35% and 70% of women with epilepsy. ► Pharmacokinetics of antiepileptic drugs and oral contraceptive can interact bi-directionally, potentially affecting the efficacy of either drug. ► Pregnancy related complications in women with epilepsy include increased risk of congenital malformations, and risk of seizure deterioration.