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Lisa Zobian-Lindahl was told she should not get pregnant due to the risk of having a child with birth defects. Upon asking why she had more seizures around her menstrual cycle, she was told it was all "in her head." It is typical that many females with epilepsy and their physicians do not have up-to-date information about the specific affects of the condition and its treatments on women.

Today, more than 1,000,000 American females have epilepsy. Second to headaches, it is the neurological disorder seen most often by physicians, and one of the most-common chronic health conditions affecting women of reproductive age. Yet, until recently, limited attention has been paid to the range of problems these women must battle throughout their lives because of the illness and its treatment. Furthermore, antiepilepsy drugs (AEDs) are commonly used to treat other conditions that affect an even greater number of women, such as migraine headaches, other pain conditions, and bipolar disorder. Similar to epilepsy, little is known about the effect of this treatment relating to female-specific issues.

"Despite many treatment advances for people with epilepsy in the 1990s, the medical community has been slow to recognize the unique problems of women living with this illness," notes Martha Morrell, director of the Columbia Comprehensive Epilepsy Center of New York-Presbyterian Hospital and professor of neurology at Columbia University College of Physicians & Surgeons, New York. "What makes it more complicated is that it's often hard to distinguish the effects of the illness from the effects of the medications used to manage seizures."

According to Morrell, the seizures and some of the AEDs required to manage the illness can compromise many facets of a woman's health. Those with epilepsy experience a host of reproductive problems, sexual dysfunction, excessive weight gain, and osteoporosis. Reproductive health problems can include difficulties becoming pregnant and an increased risk of having children with birth defects, disruptions in their menstrual cycle, hormone-related seizures, infertility, and a condition called polycystic ovarian syndrome, which itself causes infertility, irregular or absent menses, ovarian cysts, obesity, and unwelcome changes in facial and body hair.

Excessive weight gain caused by some of the AEDs is of special concern to women with epilepsy because it can predispose them...