Interictal hyposexuality in male patients with epilepsy

Abstract

-The purpose of this study was to compare the serum levels of androgens between hyposexual and non-hyposexual patients with epilepsy. Adult male patients with epilepsy were investigated. Serum levels of testosterone (T) and free-T, estradiol, and sex hormone binding globulin (SHBG) were measured and the free androgen index (FAI) was calculated. While there were no differences between hyposexual and non-hyposexual patients in the serum levels of T, free-T, and estradiol, or to the FAI, the serum levels of SHBG were significantly higher in hyposexual patients than in non-hyposexual patients. Thus, the effects of increased SHBG upon serum levels of testosterone biologically active in patients with epilepsy and hyposexuality were not detected by the methods used in this study. Four (44%) of nine hyposexual patients who were re-evaluated after two years follow-up improved sexual performance. Thus, clinical treatment that results in good seizure control may improve sexual performance in some patients with epilepsy.KEY WORDS: epilepsy, sexual dysfunction, testosterone, and androgens.Hipossexualidade interictal em homens com epilepsia RESUMO -O objetivo deste estudo foi comparar os níveis séricos de andrógenos e estradiol entre pacientes do sexo masculino com e sem hipossexualidade. Níveis séricos de testosterona e testosterona porção livre, estradiol e globulina ligadora de hormônio sexual (SHBG) foram dosados e calculado o índice de andrógeno livre (FAI). Não houve diferença significante de testosterona, porção livre de testosterona, estradiol e de FAI nos pacientes com e sem hipossexualidade. Os níveis de SHBG foram significantemente maiores nos pacientes hipossexuais quando comparados com os pacientes sem hipossexualidade. Deste modo, os efeitos da SHBG aumentada nos níveis séricos de testosterona biologicamente ativa, em pacientes com epilepsia e hipossexualidade, não foram detectados pelo método usado neste estudo. Quatro (44%) pacientes, reavaliados após dois anos de seguimento, tiveram melhora significativa do desempenho sexual. Portanto, o tratamento medicamentoso, com melhor controle das crises epilépticas, pode melhorar o comportamento sexual de alguns pacientes com epilepsia.PALAVRAS-CHAVE: epilepsia, disfunção sexual, testosterona, andrógenos.

Association Between Neuropathic Pain, Pregabalin Treatment, and Erectile Dysfunction

“…Lastly, several studies have demonstrated that hyposexuality is one of the most frequent interictal problems diagnosed in epileptic patients. Several factors may contribute to the impairment of normal sexual function in patients with epilepsy including hormonal disorders, psychological problems, antiepileptic drugs and/or epilepsy itself [26,27]. It is generally understood that neuropathic disorders are commonly linked with sexual dysfunction either by nerve damage or by some other physiological cause.…”

Hormonal consequences of epilepsy and its treatment in men

“…The fact that SHBG appears to be more consistently associated with poor sexual quality of life in men is another piece of indirect evidence in support of the hormonal theory since SHBG binds to testosterone and avidly decreases its bioavailability [39]. However, this may not be the only mechanism for the sexual dysfunction caused by SHBG, as some investigators have shown a poor correlation with SHBG and BAT [40]. Altered levels of SHBG are predominantly associated with the use of enzyme-inducing AEDs (see below).…”

Sexuelle Lebensqualität bei Patienten mit Epilepsie

“…Bei Frauen wurde sexuelle Ängstlichkeit beobachtet, die sich auf die Häufigkeit sexueller Kontakte auswirkt, sowie eine verminderte sexuelle Erregbarkeit (Morrell et al 1994;Morrel et al 2005). Männer mit Epilepsie leiden hingegen hauptsächlich unter Potenz-und Erektionsstörungen und sexueller Unzufriedenheit (Silveira et al 2001). Beiden Geschlechtern gemeinsam ist ein Libidoverlust im Zusammenhang mit der epileptischen Erkrankung.…”