Serum Sex Hormones Are Altered in Patients with Chronic Temporal Lobe Epilepsy Receiving Anticonvulsant Medication

Stoffel‐Wagner, Birgit; Bauer, J.; Flügel, Dominique; Brennemann, W.; Klingmüller, Dietrich; Elger, Christian E.

doi:10.1111/j.1528-1157.1998.tb01307.x

Cited by 111 publications

(96 citation statements)

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“…The epilepsy etiology, the epilepsy duration, and type of AED used and duration of drug treatment are all likely to affect hormonal cycles and the metabolism of sex hormones, and thus sexual function, including libido (Schupf and Ottman 1996; Stoffel‐Wagner et al. 1998; Klein et al. 2001; Harden and Pennell 2013).…”

Section: Discussionmentioning

confidence: 99%

Age‐specific birth rates in women with epilepsy: a population‐based study

et al. 2016

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ObjectiveThe aim of this study was to investigate birth rates and use of hormonal contraception in different age groups among women with epilepsy (WWE) in comparison to women without epilepsy.Materials and MethodsDemographic data and medical information on more than 25,000 pregnant women (40,000 births), representing 95% of all pregnancies in Oppland County, Norway, were registered in the Oppland Perinatal Database in the period 1989–2011. Data were analyzed with respect to epilepsy diagnoses, and 176 women with a validated epilepsy diagnosis (303 pregnancies) were identified. Age‐specific birth rates in these women were estimated and compared with age‐specific birth rates in women without epilepsy in the same county.ResultsIn WWE over 25 years of age, birth rates were significantly lower than in those of the same age group without epilepsy. In women below 20 years of age, birth rates were similar in those with and without epilepsy. The use of hormonal contraceptives prior to pregnancy was lower among WWE under 25 years than in the corresponding age group without epilepsy.ConclusionsHealth professionals who counsel WWE who are of fertile age should be aware of the strongly reduced birth rates in WWE over 25 years of age, and the lower rates of use of contraceptives among young WWE.

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Section: Discussionmentioning

confidence: 99%

Age‐specific birth rates in women with epilepsy: a population‐based study

et al. 2016

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“…Moreover, all patients were taking long-term AEDs. AEDs may contribute to alterations in hormonal balances (31). All patients investigated in this study were treated with CBZ monotherapy or CBZ in combination with on additional AED.…”

Section: Discussionmentioning

confidence: 99%

Expression of 5α‐Reductase and 3α‐Hydroxisteroid Oxidoreductase in the Hippocampus of Patients with Chronic Temporal Lobe Epilepsy

et al. 2000

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Summary: Purpose:The hippocampus is one of the principal target areas for neurosteroidal action, and the major neuroendocrine conversion of progesterone appears to be Sa-reduction and 301-hydroxysteroid oxidoreduction, leading to the potent neurosteroid 3~~,5~~-tetrahydroxyprogesterone. To investigate whether the human hippocampus is equipped with the enzymes 5a-reductase and 3a-hydroxysteroid oxidoreductase (301-HSOR), we studied the expression of 5a-reductase types 1 and 2 and 3a-HSOR types 1 and 2 in the resected hippocampi of patients with medically intractable chronic temporal lobe epilepsy.Methods: We studied tissue specimens from the hippocampi of 13 women, 25 men, and four children. Quantification of different mRNAs was achieved by competitive reverse transcription-polymerase chain reaction (RT-PCR).Results: Sa-Reductase 1 mRNA and 301-HSOR 2 mRNA were expressed in hippocampi of children and adults, whereas 5a-reductase 2 mRNA and 3a-HSOR 1 mRNA were not expressed. Neither Sa-reductase 1 mRNA nor 3a-HSOR 2 mRNA concentrations in hippocampal tissue showed any statistically significant differences between women and men or between children and adults.Conclusions: This study demonstrates for the first time mRNA expression of the type 1 isozyme of 501-reductase and the type 2 isozyme of 3a-HSOR in the human hippocampus. The finding that both 5a-reductase and 3a-HSOR are present in the hippocampus leads us to assume the synthesis of neuroactive steroids in this human brain area. Key Words: 5a-Reductase-3a-Hydroxysteroid oxidoreductase-Hippocampus-Neurosteroid-Epilepsy .From animal studies, it is known that sex steroid hormones may influence neuronal cerebral excitability, possibly by different modes of action (1,2). Sex steroid hormone metabolism, including aromatization, Sol-reduction and 17P-reduction, and 17P-oxidation has been proven to occur in the human temporal lobe (3-5). The major active products, estrogens and Sol-androstanes are responsible for many behavioral and physiologic effects of the parent steroid (6).Moreover, numerous animal studies have shown that in the central nervous system progesterone is rapidly metabolized to , which is subsequently further reduced to 3qSa-tetraAccepted September 23, 1999. Drs. Stoffel-Wagner and Beyenburg contributed equally to this work.

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“…By comparison, in their study on the effect of CBZ on DHEAS, Stoffel-Wagner et al (33) and Rättyä et al (34) reported that the serum concentration of DHEAS was significantly lower with the use of enzyme-inducing AEDs. Several mechanisms may lead to this effect: AEDs (CBZ or phenobarbitone) may induce liver enzymes that metabolize steroids or may stimulate the synthesis of binding proteins and alter the steroid metabolic pathway (35).…”

Section: Discussionmentioning

confidence: 99%

Physical Growth and Endocrinal Disorders during Pubertal Maturation in Girls with Epilepsy

et al. 2004

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Summary:Purpose: This study investigated the effect of epilepsy and/or antiepileptic drugs (AEDs) on the physical growth, pubertal development, and androgenic status of girls with epilepsy between ages 8 and 18 years.Methods: Sixty-six female patients with epilepsy, their mean ages 13.47 ± 3.5 years, were included. Anthropometric measurements, staging of pubertal maturation, and clinical manifestations of hyperandrogenism were assessed, as well as measurement of serum levels of testosterone, dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), and free androgen index (FAI). Of the included patients, 44 had transabdominal ultrasonic examination of the ovaries and fasting serum insulin levels were measured. Forty healthy age-matched females served as a control group.Results: Patients showed reduced mean height percentile compared with controls (z = 2.07; p = 0.04), which was negatively correlated with the duration of their epilepsy. Patients showed increased frequency of obesity, especially postpubertal girls taking valproate (VPA; 67%), who also showed higher insulin levels (t = 8.01; p = 0.0003). Patients showed increased frequency of clinical hyperandrogenemia in the different stages of puberty. High levels of testosterone and DHEAS were found in female patients with epilepsy, especially pubertal and postpubertal girls. Hyperandrogenism (clinical and/or laboratory) was most affected by the types of AEDs, with higher incidence in patients taking VPA compared with those taking enzymeinducing AEDs (χ 2 = 9.16; p = 0.01). Eighteen percent of the patients were diagnosed as having polycystic ovary syndrome (PCOS). No difference was found in the types of seizures, degree of seizure control, type of AEDs, or insulin levels between patients with and those without PCOS.Conclusions: Longer duration of the disease has a negative impact on the stature of female patients with epilepsy. Postpubertal girls taking VPA are more liable to obesity, which is associated with increased incidence of hyperinsulinemia. Clinical and/or laboratory evidence of hyperandrogenism is seen at a high frequency in patients, especially with the use of VPA. Furthermore, female patients with epilepsy especially in the postpubertal stage of sexual maturation, have a high prevalence of PCOS, independent of the type of AED or the characteristics of the epilepsy disorder. Key Words: Epilepsy-FemaleAndrogenic hormones-PCOS-Endocrine functions.Reproductive and endocrine functions are of major concerns for clinicians who treat patients with epilepsy. An increased frequency of reproductive endocrine disorders has been reported in women with epilepsy (1). Considerable data pertaining to changes in the hormonal milieu of women with epilepsy and suggest that these individuals are more likely to have derangements of the menstrual cycles and polycystic ovary syndrome (PCOS) (2).A possible role of the seizure disorder or, alternatively, of the use of antiepileptic drugs (AEDs) has been sug-

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Serum Sex Hormones Are Altered in Patients with Chronic Temporal Lobe Epilepsy Receiving Anticonvulsant Medication

Cited by 111 publications

References 40 publications

Age‐specific birth rates in women with epilepsy: a population‐based study

Age‐specific birth rates in women with epilepsy: a population‐based study

Expression of 5α‐Reductase and 3α‐Hydroxisteroid Oxidoreductase in the Hippocampus of Patients with Chronic Temporal Lobe Epilepsy

Physical Growth and Endocrinal Disorders during Pubertal Maturation in Girls with Epilepsy

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