Sexuality and Antiepileptic Drugs
April 26, 2014 | By Epilepsy Arizona |
The use of AEDs may result in one or more of the following adverse impacts on sexuality:
- Decreased libido: Some AEDs cause elevations in hormones that suppress sexual arousal and behavior.
- Sperm abnormalities: Some AEDs are associated with sperm abnormalities, including low semen volume, low sperm count and abnormal sperm motility. The following AEDs have been linked to sperm abnormalities: carbamazepine, oxcarbazepine and valproate.
- Reduced testicular volume: Some AEDs have been linked to reduced testicular volume
- Reproductive dysfunction: AEDs may cause alterations to androgens (substances that produce male characteristics and stimulate activity of male sex organs), thereby contributing to reproductive dysfunction.
Impact on sexuality varies among AEDs
When it comes to sexual function and reproductive hormone levels, not all AEDS have the same effect.
For instance, researchers have found that diminished libido and arousal are most pronounced in patients using sedating AEDs, such as barbiturates, although adverse effects on sexuality may also occur with any AED.
The AED lamotrigine appears to have a more favorable profile on sexual function and reproduction than several other AEDs. For instance, men taking enzyme-inducing AEDs have been shown to reach lower testosterone levels at an earlier age than men taking lamotrigine. Plus, a recent study found that, in men experiencing sexual disorders and taking prescribed AEDs for partial seizures, adding lamotrigine had a favorable effect on impotence.
The AED carbamazepine has been linked to significantly reduced levels of testosterone, when compared to the AED valproate. In recent studies, valproate treatment appeared to have no effect on sperm cell function in men with temporal lobe epilepsy.
If you are experiencing problems with sexual function, it is important to discuss them with your doctor. Your doctor may be able to prescribe alternative AEDs; many patients who experience sexual deficits with one medication will have normal sexual function with another. Plus, if you suffer from impotence, your doctor may prescribe medication to help you overcome it.