According to the World Health Organization, epilepsy is one of the most common neurological diseases in the world, affecting about 50 million people. The overall prevalence of epilepsy in the Russian Federation in 2020 was 2.49 patients per 1,000 people, and the total number of registered epilepsy patients in Russia was 366,134 people. About 40% of epilepsy patients are women of reproductive age. The course of epilepsy in women of reproductive age has its own characteristics, which are associated with daily and monthly cyclic rhythms. Epilepsy has a wide range of physiological consequences due to antiepileptic pharmaceutical therapy. The purpose of the review is to summarize up-to-date information on the impact of epilepsy on women's reproductive health. The authors conducted a search for publications in the electronic databases PubMed, eLibrary and Google Scholar. The search strategy included the presence of the following keywords and their combinations: "epilepsy", "reproductive health", "sex hormones", "pregnancy", "menstrual cycle", "fetal", "neonatal", "epilepsy", "reproductive health", "sex hormones", "pregnancy", "menstrual cycle", "fetal", "neonatal". The search was conducted among studies published before December 2023. Women are particularly concerned about epilepsy throughout their reproductive years. Infertility rates increase as a result of the psychological stress faced by people with epilepsy and impaired physiological processes that support reproductive health. Finally, the doctor should examine the physiological effects of antiepileptic and anticonvulsant drugs. The main goal of therapy is to provide women with epilepsy with a seizure-free life, excellent overall well-being and improved health. The current plan is achievable if the practitioner is familiar with the sexual differences in the course of epilepsy at the molecular level. The limitation is that modern treatment methods cannot be available to every woman in conditions of limited resources.