The need for reliable, safe, and reversible contraception has become more evident, and the duration of their use has increased as many women opt to delay childbearing into the late third and fourth decades. Many psychosocial and economic factors will continue to affect women's contraceptive decision-making and undoubtedly will continue to influence rates of tubal sterilization. Vasectomy, like tubal sterilization, should be considered an irreversible sterilization procedure. The oral contraceptive pill is a common form of contraception in the USA. Numerous societal, biological, psychological, and legal factors must be considered when counseling women about their reproductive health. As with any physician-patient encounter, careful documentation must accompany any discussion regarding reproduction and contraceptive choices. Discussions regarding reproductive health, contraception, and sterilization must make the clear distinction between contraception and protection from sexually transmitted disease (STDs). Broad categories of assisted fertilization include hormonal assistance designed to induce ovulation and in vitro fertilization.

This chapter stresses that each woman must know whether her medical therapy can interfere with hormonal contraception. There is a variety of contraceptive methods from which to choose. These fall into two main groups: hormonal and nonhormonal methods. Epilepsy and its treatment do not alter the effectiveness of any of the nonhormonal methods of birth control. These nonhormonal methods include the intrauterine contraceptive device (IUD), barrier methods, the rhythm method and other methods of 'natural' family planning with or without spermicides, and sterilization. Hormonal methods involve taking the combined oral contraceptive pill, (which contains two hormones, an estrogen and a synthetic form of progesterone called a progestogen), or the progesterone-only pill ('mini' pill), or long-acting preparations such as medroxyprogesterone (Depo-Provera) injections or a depot hormonal implant (Norplant). Nowadays, many neurologists discuss the issue of contraception with women before starting a drug to treat their epilepsy.