EPILEPSY, SEXUAL RELATIONSHIPS, AND HAVING CHILDREN

by Epilepsy Association of Scotland

Relationships

It is quite understandable for anybody with a history of epilepsy to be concerned about establishing a relationship with a member of the opposite sex and having children, but many people do form satisfying and stable relationships. To achieve such a relationship, it is important that both of you are open and frank with each other, and that you discuss your epilepsy and its implications for your life together.

Sex drive

People with epilepsy sometimes express concern that their sex drive may be affected by their condition, or by the medication they take to control their seizures. Research in this area has been limited, but there is some evidence to suggest that both epilepsy and anti-epileptic medication can lower sex drive in a few cases. If you are concerned that you may be affected, seek the advice of your doctor or consultant.

Fertility

Many people with epilepsy establish happy relationships and produce healthy children. However, the effect of epilepsy on fertility has been the subject of limited research, and results have shown that there are some women who do experience reduced fertility. To date, there has been no evidence to suggest that anti-epileptic medication affects fertility.

Contraception

Many couples use contraceptives for a while before starting a family. If the woman has epilepsy, it is important for her to discuss appropriate birth control methods with her doctor. Some anti-epileptic medication interferes with the effectiveness of oral contraceptives, and will affect the choice of the pill. The doctor may recommend an alternative method of birth control or may change the medication, or alter the dosage.

Heredity

It is quite understandable for people with epilepsy to be concerned about "passing on" their epilepsy to their children. The question of heredity is a complex one. Any child has a one in 200 chance of developing epilepsy. If one parent has a history of epilepsy, then the odds may rise depending on the type of epilepsy. If both parents are affected the odds may be even higher. What can be inherited is a low seizure threshold, which may result in the child having a tendency to take seizures. This does not necessarily mean that the child will have them.

If there is an established hereditary condition in your family and you yourself have epilepsy, discuss these facts with your doctor, who may advise you to seek the guidance of a genetic counsellor.

During pregnancy

See also "Guidelines for women with epilepsy".

Anti-epileptic medication

Taking any medication during pregnancy can be worrying for a mother-to-be. Some medication can affect the growing foetus. Therefore very important to get medical advice as early as possible so that the best drug treatment can be started before the pregnancy begins.

It is unlikely that the doctor will withdraw drug treatment completely, because any sudden change in medication can result in increased seizures. In most cases the drug treatment can be adapted, so that the risk to the unborn child is very small. If the foetus does absorb some of the medication, it will pass out of the baby's system over the first few days after birth.

Seizure pattern

The changes which take place in a woman's body during pregnancy may lead to alterations in the seizure pattern. There may be an increase in seizures during this period, or they may become less frequent, perhaps stopping altogether.

Effects of seizures

If seizures do occur in pregnancy, a woman may worry about the baby being harmed. Although this anxiety is very real, mothers-to-be should be encouraged to know that many women with epilepsy have a trouble-free pregnancy, and produce normal healthy children. If your are at all anxious on this score, discuss your worries with your local health visitor.

Vitamin deficiency

Some anti-epileptic medications are responsible for reducing vitamin K in the bloodstream, which can affect the clotting mechanism of the blood. In some cases, the doctor may recommend that vitamin K is taken by the mother before the delivery, and by the baby for a short while after birth.

Medical checks

It is especially important to take your medication for epilepsy as prescribed during pregnancy, and to attend your doctor or the clinic as required for drug-level monitoring, so as to reduce to a minimum the risk of seizures occurring. Keep your doctor informed about any seizures you have during pregnancy. Although it is most unlikely that your baby will be injured if you have a fall during a seizure, you should have a medical check as soon as possible, should one occur, to ensure that all is well.

After the birth
Breastfeeding

The new mother may wish to breastfeed, but might be worried about her milk being affected by the medication she is taking. The likelihood of this depends on the particular medication she uses, and again advice should be sought from the doctor. In the majority of cases very little, if any, of the medication is passed on to the child in the milk, and any small amount which is, passes through the liver and out of the baby's system.

Child rearing

Anxieties may arise for a parent with epilepsy who experiences unpredictable seizures with loss of consciousness. For suggestions about safety procedures for bathing, changing, carrying the baby, etc., see "Parents With Epilepsy".