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Seizures, hormones and sexuality
1Department of Psychological Medicine (Neuropsychiatry), Institute of Psychiatry and GKT School of Medicine and Dentistry, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
Seizure
|August 8, 2001
Summary
Sexual disorders are common in epilepsy patients but often unreported. Erectile dysfunction in epilepsy may have a neurophysiological basis, with multifactorial causes including neurological and endocrine factors.
Area of Science:
- Neurology
- Endocrinology
- Psychiatry
Background:
- Sexual disorders, including hyposexuality and dysfunction, affect up to two-thirds of epilepsy patients.
- These issues are frequently underreported by patients.
- Erectile dysfunction in epilepsy may have a neurophysiological basis, indicated by nocturnal penile tumescence testing.
Purpose of the Study:
- To explore the multifactorial etiology of sexual disorders in epilepsy.
- To investigate the role of epilepsy-related factors, endocrine changes, and anticonvulsant medications.
- To examine the specific issues in women, including catamenial epilepsy and polycystic ovarian syndrome.
Main Methods:
- Review of existing literature on sexual dysfunction in epilepsy.
- Analysis of potential neurological, endocrine, iatrogenic, cognitive, psychiatric, and psychosocial factors.
- Exploration of hormonal changes (e.g., sex hormone binding globulin, free testosterone) in men with epilepsy.
Main Results:
- Sexual dysfunction is prevalent and multifactorial in epilepsy.
- Epilepsy surgery may improve sexual function.
- Endocrine changes, such as elevated SHBG and reduced free testosterone, are observed, particularly with certain antiepileptic drugs.
Conclusions:
- The etiology of sexual disorders in epilepsy is complex and likely involves multiple factors.
- Further research is needed on non-hepatic enzyme-inducing anticonvulsants like lamotrigine.
- Addressing sexual health is crucial in the comprehensive management of epilepsy.