[Management of reproductive-age women with epilepsy].

Medical treatment of epilepsy is quite different for women than for men. It is known that estrogen facilitates while progesterone inhibits the generation of epileptic seizures. Due to the direct neuronal effects of estrogen, progesterone, and their metabolites, as well as the cyclical nature of sex hormone release, women are particularly susceptible to the effects of these hormones on seizure frequency and severity. Antiepileptic drugs (AEDs) may result in reproductive endocrine disorders, decreased effects of oral contraceptives, or congenital malformations. On the other hand, if AED treatment is insufficient, seizures may influence reproductive endocrine disorders or cause fetal death. Physicians should minimize these risks through preconception counseling and appropriate treatment of women with epilepsy who are of reproductive age.