What is catamenial epilepsy?
Seizures clustering around menstruation due to estrogen withdrawal and progesterone decline — affects 30–40% of women with epilepsy.
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Pregnancy considerations
Most antiseizure medications compatible at appropriate doses — but valproate and topiramate carry risks. Folic acid supplementation essential. Drug level monitoring needed.
Contraception
Enzyme-inducing drugs reduce hormonal contraceptive effectiveness — IUD or barrier methods may be needed. Non-enzyme-inducing drugs do not interact.