This chapter discusses some of the reproductive disturbances in women with epilepsy and points out signs and symptoms that women should report to their health-care providers. Reproductive health disturbances described in women with epilepsy include menstrual abnormalities such as amenorrhea (not menstruating), oligomenorrhea (menstrual cycle length greater than 35 days), and metrorrhagia (irregular menstrual cycle with excessive menstrual flow). Menstrual cycle abnormalities, polycystic ovaries, and disruption in pituitary and ovarian hormones may cause infertility. Women with epilepsy appear to be at risk for anovulatory cycles, polycystic ovaries, and disturbance in the hypothalamic, pituitary axis, the system that regulates the menstrual cycle and ovarian production of female sex steroid hormones. Electrical epileptic discharges in the brain may alter pituitary hormones and abnormally stimulate the ovaries. Changes in ovarian hormones caused by antiepileptic drug interactions could also cause anovulatory cycles. Finally, the antiepileptic drug valproate may specifically increase the risk.