Can Women with Mild Epilepsy Safely Use Emergency Contraceptive Pills?

Is it safe to take the emergency contraceptive pill for the first time if I have mild epilepsy?

Hello, Dr.
Chang.
I just did some research on the "Ella" emergency contraceptive pill, but I have a question that I'm not quite sure about.
The female patient has a mild history of epilepsy but has not had any seizures for a long time and lives like a normal person.
Is it appropriate for her to take this "Ella" emergency contraceptive pill?
Also, I would like to know if the first-time use of "Ella" is effective as stated in online health information, which mentions that it becomes effective after seven days.
If she starts taking "Ella" on the first day of her menstrual period and takes one pill daily for seven days, will she be close to 100% protected against pregnancy? Or how long does she need to take it to achieve complete contraceptive effectiveness? Thank you.

Niming, 20~29 year old female. Ask Date: 2018/09/25

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the groups that are not suitable for using oral contraceptives include: • Pregnancy • Breast cancer • Circulatory diseases (venous or arterial thrombosis, ischemic heart disease, cerebral hemorrhage) • Coagulation disorders with a tendency to thrombosis • Liver diseases • Systemic lupus erythematosus, hemolytic uremic syndrome • Smokers over 35 years old • Hypertension (blood pressure higher than 140/90 mmHg), diabetes If there is a history of epilepsy, it is best to consult a physician for evaluation before deciding on suitability.
For first-time users of contraceptive pills, it is recommended to start taking them on the first day of the menstrual cycle.
If starting after the second day of menstruation, it is advised to use additional contraceptive measures for the first seven days of taking the pills.
They must be taken at the same time every day; correct usage can achieve a 99% effectiveness rate in preventing pregnancy.
Wishing you peace and health, Dr.
Zhang.

Reply Date: 2018/09/25

More Info

When considering the use of emergency contraceptive pills (ECPs) like "Yueyi" (also known as "Plan B" or similar brands) in women with a history of mild epilepsy, it is essential to evaluate both the safety of the medication and its effectiveness in preventing pregnancy.

First and foremost, ECPs are generally considered safe for women with mild epilepsy, especially if they have been stable and seizure-free for an extended period. However, it is crucial for the individual to consult with their healthcare provider before starting any new medication, including ECPs. This is particularly important because some antiepileptic drugs (AEDs) can interact with hormonal contraceptives, potentially reducing their effectiveness. However, if the woman is on a stable regimen and has not experienced seizures recently, the risk of interaction is typically low.

Regarding the effectiveness of ECPs, it is important to clarify how they work. ECPs are most effective when taken as soon as possible after unprotected intercourse. They primarily work by delaying ovulation, preventing fertilization, or inhibiting implantation of a fertilized egg. The sooner they are taken, the better the chances of preventing pregnancy.

As for the specific question about the timing of taking "Yueyi," if a woman starts taking it on the first day of her menstrual cycle and continues to take it daily, it is important to note that ECPs are not intended for regular use as a primary contraceptive method. They are designed for emergency situations. If taken as directed, ECPs can be effective in preventing pregnancy after unprotected intercourse, but they do not provide ongoing contraceptive protection.

In terms of the seven-day rule mentioned in your question, it is essential to differentiate between emergency contraception and regular hormonal contraceptives. While some hormonal contraceptives may take several days to reach full effectiveness, ECPs are designed to work quickly. If a woman takes ECPs as directed after unprotected intercourse, they can be effective immediately, but they do not provide long-term protection. For ongoing contraception, it is recommended to start a regular contraceptive method, such as the pill, patch, or IUD, and follow the specific guidelines provided by the healthcare provider regarding when it becomes effective.

In summary, women with mild epilepsy can generally use emergency contraceptive pills safely, especially if they have been stable for a long time. However, it is crucial to consult with a healthcare provider for personalized advice. ECPs should be taken as soon as possible after unprotected intercourse for maximum effectiveness, and they do not provide ongoing contraceptive protection. If a woman is looking for a reliable method of contraception, she should discuss long-term options with her healthcare provider.

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