‘Reviews of cognitive decline, particularly in executive functions, are widespread among menopausal women,’ said lead author, C. Neill Epperson, MD, professor of Obstetrics and Psychiatry and Gynecology at the Perelman School of Medication at the University of Pennsylvania, and director of the Penn Center for Women's Behavioral Wellness. ‘There are approximately 90 million post-menopausal women surviving in the US by itself, and with the common age of onset happening at 52, almost all of those women will reside in the postmenopausal state for at least one-third of their lives.Nevertheless, we don’t have information on the sort or severity of epilepsy and therefore cannot guideline out the possibility of confounding by indication. Studies evaluating the risk of general malformations after in utero contact with an antiepileptic drug in comparison without such exposure show that the chance is significantly higher with contact with valproic acid than with contact with other antiepileptic medications. Furthermore, these research have suggested increased risks of malformations in general in association with higher dosages of valproic acid as compared with lower doses.13,15-17 Since our data set does not include dose info, we were not in a position to address this question. Previous studies of valproic acid monotherapy during the initial trimester and the risk of specific malformations, apart from spina bifida,27,28 have generally been limited by relatively little samples or potential selection bias, since they have not been population-based.26 A recently available study showed that kids subjected to valproic acid in utero were much more likely to have impaired cognitive function at 3 years of age than kids exposed in utero to other antiepileptic medications.29 The American Academy of Neurology has recommended staying away from valproic acid in pregnancy, when possible, based on evidence that contact with valproic acid is associated with an increased threat of major congenital malformations and poor cognitive outcomes and confers a higher risk than that associated with contact with other antiepileptic drugs.9 For malformations seen less frequently, our study could rule out very large risks however, not smaller risks.