Epilepsy in men: The effect of the disease and its therapy on reproductive endocrine functions

Abstract

Epilepsy in men:The effect of the disease and its therapy on reproductive endocrine functions " Abstract In men with epilepsy, the disorder itself as well as its treatment may lead to hormonal changes. Focal seizures and especially temporal lobe epilepsy (TLE) have an impact on the hypothalamic-pituitary axis. Whereas seizures cause a shortlasting increase in serum levels of pituitary hormones, the impact of interictal focal epileptic activity is long lasting. In TLE a decrease of serum levels of free testosterone and the testosterone/luteotrophic hormone ratio is observed, indicating a testicular malfunction. Following successful epilepsy surgery in men with TLE, a significant increase in serum androgen levels is observed within a 12-month follow-up. The supprimation of epileptic acitivity by successful epilepsy surgery is followed by normalization of preoperatively decreased serum concentrations of androgens.

Oxcarbazepine treatment in male epilepsy patients improves pre-existing sexual dysfunction

“…A sizeable number of studies in men taking AEDs consistently detected an increase in SHBG levels and in consequence a decrease in bioactive androgens, mainly testosterone. As, however, most patients were receiving polytherapy, the specific effects of particular AEDs on reproductive endocrine function were difficult to differentiate (14). The results of studies with single AED treatment as summarized in an overview by Isojärvi et al.…”

“…The increase in SHBG leads over time to reduced free (bioactive) testosterone (BAT), which may result in diminished libido and sexual function in men. (12–14). Moreover, these alterations may contribute to reduced fertility as well.…”