Counseling and use of contraceptive methods by women with epilepsy
ESC Congress Library. Guazzelli C. 05/28/14; 50483; A-066
Prof. Dr. Cristina Guazzelli
Prof. Dr. Cristina Guazzelli
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Abstract
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  1. Objectives: This study aimed to evaluate contraceptive counseling received and the actual use of methods by epileptic women managed at a single tertiary hospital.               .

  2. Methods: This cross-sectional telephone survey involved epileptic reproductive age women (10-50 years) managed at the neurology clinic of Universidade Federal de São Paulo. All participants were using anticonvulsant medications. The study was approved by the institution´s ethics´ committee.

  3. Results: 101 women were contacted, 41 were excluded because they were post-menopausal and 60 were included in the survey.  The participants´ mean age was 32 years, mean age at menarche was 12.6 years and mean age at diagnosis of epilepsy was 11.2 years. Almost 40% of the women reported that epileptic crisis changed according to their menstrual cycle; most (78.3%) reported an increase in the number of convulsive episodes prior to menstruation (mean 1.5 days before bleeding). Only 25% of the women had started sexual activity before the diagnosis of epilepsy and 30% of the participants reported having received contraceptive counseling, although none had been informed about the possible interaction between hormonal contraceptives and anticonvulsants. The five most frequently reported contraceptive methods were: condoms 25%, tubal ligation 13.3%, monthly injectable contraceptives 6.7%, trimestral injectable contraceptives 5%, and condoms plus hormonal (oral or injectable) contraceptives 3.2%. A total of 38.3% reported they were not currently using any contraceptive method and 1.7% were pregnant. Half of the women had at least one previous pregnancy and only 16.7% of these had been planned.

  4. Conclusion: Most reproductive age female epileptic were sexually active but a significant proportion of them were not formally counseled about the need to use contraception and many did not use any birth control method. Approximately 40% of these epileptic women used either definitive methods (sterilization) or condoms, while other modern reversible contraceptive methods were much less frequently used. Health professionals involved in the management of reproductive age epileptic women need to include contraceptive counseling as part of their routine care.


 



  1. Objectives: This study aimed to evaluate contraceptive counseling received and the actual use of methods by epileptic women managed at a single tertiary hospital.               .

  2. Methods: This cross-sectional telephone survey involved epileptic reproductive age women (10-50 years) managed at the neurology clinic of Universidade Federal de São Paulo. All participants were using anticonvulsant medications. The study was approved by the institution´s ethics´ committee.

  3. Results: 101 women were contacted, 41 were excluded because they were post-menopausal and 60 were included in the survey.  The participants´ mean age was 32 years, mean age at menarche was 12.6 years and mean age at diagnosis of epilepsy was 11.2 years. Almost 40% of the women reported that epileptic crisis changed according to their menstrual cycle; most (78.3%) reported an increase in the number of convulsive episodes prior to menstruation (mean 1.5 days before bleeding). Only 25% of the women had started sexual activity before the diagnosis of epilepsy and 30% of the participants reported having received contraceptive counseling, although none had been informed about the possible interaction between hormonal contraceptives and anticonvulsants. The five most frequently reported contraceptive methods were: condoms 25%, tubal ligation 13.3%, monthly injectable contraceptives 6.7%, trimestral injectable contraceptives 5%, and condoms plus hormonal (oral or injectable) contraceptives 3.2%. A total of 38.3% reported they were not currently using any contraceptive method and 1.7% were pregnant. Half of the women had at least one previous pregnancy and only 16.7% of these had been planned.

  4. Conclusion: Most reproductive age female epileptic were sexually active but a significant proportion of them were not formally counseled about the need to use contraception and many did not use any birth control method. Approximately 40% of these epileptic women used either definitive methods (sterilization) or condoms, while other modern reversible contraceptive methods were much less frequently used. Health professionals involved in the management of reproductive age epileptic women need to include contraceptive counseling as part of their routine care.


 


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