MINCEP® WomanCare®
Specialized Services for Women

MINCEP's WomanCare program provides women and girls with individualized diagnosis, treatment, education, and advice about how hormonal changes affect and are affected by seizures.

Women With Epilepsy Have Special Medical Needs:

• Female reproductive hormones may affect seizure threshold and responsiveness to anti-seizure medications.
• Female reproductive hormones vary throughout the lifetime of a woman, particularly during pregnancy, menstruation, and in menopause.
• Hormone therapies, either for birth control or osteoporosis, may interact with anti-seizure medications and seizure control.
• Medicines for epilepsy present special challenges during pregnancy.

MINCEP offers a comprehensive woman's program to address these specific issues. Epileptologists with expertise in women's health provide women and adolescent girls with individualized diagnosis, treatment plans, education, and advice about how hormonal changes affect and are affected by seizures. Women who have seizures or take anti-seizure medications receive specific counseling on contraception, family planning, and pregnancy management.

Family Planning/Pre-conception Counseling

Women with epilepsy are more likely to have complications during pregnancy than healthy women. Similarly, children born to these women are more likely to have complications, particularly birth defects. Poor seizure control and the anti-seizure medication used during pregnancy are some of the main contributing factors to poor pregnancy outcome. As a consequence, it is not too surprising for women of childbearing age who have epilepsy to be told either not to get pregnant, or if they do, that they should stop all their seizure medications. Unfortunately, these are two false myths. The truth is that while there is an increased risk, women of childbearing potential with epilepsy can have a family. In fact, more than 95% of women with epilepsy are able to deliver healthy infants. However, they need counseling on the risks and how to go about decreasing them. Prenatal counseling is the most important first step in management of any woman of childbearing age with epilepsy. At MINCEP, we provide a comprehensive evaluation, management, and educational program for all women of childbearing age, and adolescent girls. We work closely with the family practitioners, internists, and obstetricians in preparing our patients for the pregnancy, and seeing them through the pregnancy.

Services provided include:

• Confirming the diagnosis of epilepsy.
• Determining if a woman needs to be on anti-seizure medications.
• Determining the most effective anti-seizure medication for the patient's condition, which at the same time will have the least risk of birth defects.
• Counseling on oral contraceptive/hormone therapy and anti-seizure medications.
• Genetic counseling for families with higher risk of birth defects.
• Counseling patients on how to decrease the risk of birth defects.

Prenatal Care

The need for specialized care for a pregnant woman with epilepsy continues after she becomes pregnant. Doctors at MINCEP maintain close correspondence with the patient's obstetrician or family practitioner throughout the pregnancy. Drug levels are followed closely, and medication doses are adjusted appropriately in order to minimize seizure activity. Counseling on prenatal diagnosis is also provided to mothers.

Postpartum Care

WomanCare continues after the mother has her baby. The objective here is to maintain good seizure control, minimize medication side effects and help the mother enjoy her newborn.

• Evaluate feasibility of breast feeding and anti-seizure medications.
• Provide education to new moms about importance of maintaining good postpartum health to avoid seizures.
• Close monitoring of anti-seizure drug levels and adjustment.

Menopause and Epilepsy

As women age, their bodies metabolize antiepileptic medications differently. We provide important ongoing evaluation to assure the effectiveness of a woman's treatment plan over time.

There is compelling evidence that men and women behave differently with respect to their seizure disorders. The biggest contributing factor for this difference is related to sex steroid hormones. The basis for the changes of life in women is alteration of estrogen. Whether this affects a woman's seizure control remains unclear. Similarly, whether hormone replacement therapy to treat osteoporosis in menopausal women affects seizure control is unknown. At MINCEP, we are interested in learning more about the effect of menopause on epilepsy. Women going through menopause are evaluated closely with monitoring of their menstrual irregularity, other related menopausal symptoms, and seizure control.

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