Seizures, hormones and sexuality

Abstract

Sexual disorders (both hyposexuality and sexual dysfunction) are common in people with epilepsy, occurring in up to two-thirds of patients. However, characteristically, patients do not spontaneously report these problems. Nocturnal penile tumescence testing suggests that the erectile dysfunction has a neurophysiological component. The aetiology remains uncertain but is likely to be multifactorial, involving neurological, endocrine, iatrogenic, cognitive, psychiatric and psychosocial factors. Epilepsy-related factors include the age of onset/duration of epilepsy along with the seizure type and focus. In addition, seizure frequency might be relevant as successful epilepsy surgery can result in an improvement in sexual functioning despite remaining on anticonvulsant medication. Endocrine changes (raised sex hormone binding globulin and reduced free testosterone) have been reported in men with epilepsy, especially when treated with hepatic-enzyme inducing antiepileptic drugs. Studies have not been performed evaluating anticonvulsants that do not induce hepatic enzymes such as lamotrigine. The association between these endocrine changes and hyposexuality is not known. The relationship between seizures, hormones and anticonvulsant medication in women is explored, focusing on issues such as catamenial epilepsy, the menopause, hormone replacement therapy and the polycystic ovarian syndrome. Suggestions for future research and treatment issues are discussed.

Sexuality in psychosis: dysfunction, risk and mental capacity

“…The enzyme-inducing anti-epileptics that are used as mood stabilisers (sodium valproate, carbamazepine) are associated with sexual dysfunction, and this is thought to be a hormonal effect, via suppression of the hypothalamicpituitary-gonadal axis. Lamotrigine, however, appears to be far less likely to cause sexual dysfunction (Lambert 2001).…”

Sex and Estrus Cycle Differences in the Modulatory Effects of Morphine on Seizure Susceptibility in Mice

“…Sex-dependent differences in seizure susceptibility pose important clinical and experimental problems (1)(2)(3). Such sex-specific differences in seizure threshold have been reported in several seizure paradigms, and it is believed that sex hormones may play a role in these differences (4)(5)(6)(7)(8).…”

Lamotrigin bei Frauen mit Epilepsie

“…Grundsätzlich kommen ätiologisch mehrere Faktoren in Betracht: die epileptischen Anfälle und ihre zerebralen Ursachen, psychiatrische Begleiterkrankungen, insbesondere depressive Syndrome, aber auch hormonelle Störungen durch AED.Bei Männern wurden unter enzyminduzierenden AED erhöhte Werte für das sexualhormonbindende Globulin und freies Testosteron für eine Hyposexualität verantwortlich gemacht (Übersicht bei [23]). Sexuelle Funktionsstörungen bei Frauen haben wissenschaftlich bisher wenig Beachtung gefunden.Allerdings konnte in einer Studie, in der 116 Frauen systematisch nach sexuellen Funktionsstörun-gen befragt wurden, gezeigt werden, dass weniger das sexuelle Bedürfnis als sexuelle Funktionen wie Erregbarkeit und Orgasmusfähigkeit beeinträchtigt sind [27].…”