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Sexual dysfunction in people with epilepsy.

Chaturbhuj Rathore1, Oliver J Henning2, Gerhard Luef3

  • 1Department of Neurology, B. K. Shah Medical Institute and Research Center, Sumandeep Vidyapeeth, Vadodara, Gujarat, India.

Epilepsy & Behavior : E&B
|October 3, 2019
PubMed
Summary
This summary is machine-generated.

Sexual dysfunction affects nearly half of people with epilepsy (PWE), often unnoticed. Factors like uncontrolled epilepsy, seizure frequency, and antiseizure drugs (ASDs) contribute, necessitating a multidisciplinary approach for management.

Keywords:
Antiseizure drugsEpilepsy surgeryErectile dysfunctionHypersexualityHyposexuality

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Area of Science:

  • Neurology
  • Endocrinology
  • Psychiatry

Background:

  • Sexual dysfunction is a frequent comorbidity in people with epilepsy (PWE), significantly impacting their quality of life.
  • Prevalence estimates vary widely due to heterogeneity in study populations, epilepsy characteristics, antiseizure drug (ASD) regimens, and assessment tools.
  • Nearly 50% of individuals with epilepsy experience sexual dysfunction, yet it often remains undiagnosed.

Purpose of the Study:

  • To review the prevalence, contributing factors, and potential mechanisms of sexual dysfunction in people with epilepsy.
  • To highlight the impact of epilepsy type, seizure control, and antiseizure medications on sexual health.
  • To discuss the role of psychosocial factors and propose management strategies for sexual dysfunction in PWE.

Main Methods:

  • Systematic review of existing literature on sexual dysfunction in people with epilepsy.
  • Analysis of factors associated with increased risk, including epilepsy duration, seizure frequency, and specific antiseizure drugs (ASDs).
  • Examination of proposed pathophysiological mechanisms, encompassing direct neurological effects, ASD-induced hormonal changes, and psychosocial influences.

Main Results:

  • Uncontrolled epilepsy, longer duration, focal epilepsy, higher seizure frequency, and use of enzyme-inducing or multiple ASDs are linked to higher rates of sexual dysfunction.
  • Women commonly experience desire issues, while men often face arousal disorders like erectile dysfunction.
  • Newer ASDs like oxcarbazepine, lamotrigine, and levetiracetam appear to have minimal impact on sexual function.

Conclusions:

  • Sexual dysfunction in PWE is multifactorial, involving epilepsy itself, ASDs, and psychosocial elements like depression and anxiety.
  • A comprehensive, multidisciplinary approach is crucial for managing sexual dysfunction, focusing on treating reversible causes and providing symptomatic relief.
  • Further large-scale, prospective research is needed to elucidate the precise prevalence and underlying mechanisms of sexual dysfunction in epilepsy.