Objectives: To explore the relationship between epilepsy and anti-epileptic drug (AED) and sexual, reproductive and psychological functions of epileptic women.
Patients & Methods: The study included 60 women with partial seizures of temporal lobe origin (TLE) and 20 control age-matched women. All women underwent full history taking and sexual interest and function during the preceding week, measured using the Arizona Sexual Experience Scale (ASEX) questionnaire and were evaluated in terms of possible presence of depression using the Beck Depression Inventory (BDI). Fasting, morning blood samples were obtained for estimation of hormonal profile including serum total testosterone, estradiol (E2), sex hormone-binding globulin (SHBG), leutinizing hormone (LH) and follicle stimulating hormone (FSH).
Results: Epileptic women were overweight to obese; 23 were infertile and 47 women had irregular menstrual cycle. Epileptic women had significantly higher serum testosterone and SHBG with significantly lower serum E2 compared to control women. Twenty-three women had right TLE and 16 patients had stopped AED at least 3 months before testing. Mean ASEX score in epileptics was significantly higher compared to controls with significantly higher mean ASEX score in epileptics who had right TLE compared to those who had left TLE and in those on AED compared to those who stopped treatment. Mean BDI score in epileptics was significantly higher compared to controls, with significantly higher mean BDI score in epileptics who had right TLE compared to those who had left TLE, but patients maintained on AED showed non-significantly higher BDI score compared to those who stopped AED. There was a positive significant correlation between presence of TLE and high ASEX scores, BDI scores, serum testosterone and serum SHBG, but showed a negative significant correlation with serum E2. Regression analysis showed low serum E2 and presence of epilepsy as the significant predictors for high ASEX score which was the most significant predictor for high BDI score.
Conclusion: Epilepsy has deleterious effects on psychological, sexual and reproductive functions in women and such effect was magnified with AED and with lesions on the right side and showed a close relationship to disturbed sex hormone levels. |
