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26 Apr

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Men

Epilepsy and Hormonal Effects

April 26, 2014 | By |

Epilepsy is associated with hormonal changes. For instance, experts estimate that approximately 40 percent of men with epilepsy (MWE) have low levels of testosterone, the hormone that stimulates the development of male sex organs, sexual traits and sperm. Both epilepsy itself and the antiepileptic drugs (AEDs) used to control seizures may be responsible for these hormonal changes.

How epilepsy induces hormonal changes:

  • Persistent seizures in adults may be associated with hormonal and neurological changes that contribute to sexual dysfunction.
  • Seizures can alter the release of hypothalamic and pituitary hormones.
  • Temporal lobe epilepsy, in particular, is known to have adverse effects on testicular endocrine function.

How AEDs cause hormonal changes:

Studies show that AEDs directly affect brain regions that mediate sexuality.
AEDs may cause sexual dysfunction by inducing secondary effects on reproductive hormones.
Some AEDs change the concentrations of sex steroid hormones.

Do all AEDs have the same effect on hormones?

No. Some, but not all, AEDs have been linked to adverse hormonal effects.

Research suggests that the AEDs phenytoin, carbamazepine and phenobarbital adversely affect hormone levels by reducing the level of free testosterone which, in turn, reduces sexual desire.

Some good news regarding AEDs and hormonal effects does exist: Studies show that the AED lamotrigine may not have a negative impact on sexual function. In fact, in one study, lamotrigine was shown to have a favorable effect on sexual disorders in MWE who had partial seizures and were taking other AEDs.

What is the impact of hormonal changes?

Reduced testosterone, one hormonal effect frequently seen in MWE, can adversely affect one or more of the following: energy, mood, drive, sexual function, bone density and seizure control.

A large percentage of MWE have been found to have low levels of bioavailable testosterone (BAT), the portion of total testosterone available for use. Abnormally low BAT levels have been tied to sexual dysfunction.

Getting help

Endocrine specialists can help patients sort out the complex interactions between hormones, seizures and AEDs.

Sometimes identifying hormonal influences on seizure patterns may lead to a better understanding of treatment options for seizure control.

Although it is still considered experimental and must be monitored very closely, treatment with testosterone supplements have been shown to improve low testosterone levels in males with epilepsy.