Sexual dysfunction in patients with epilepsy

Luef, Gerhard; Madersbacher, H.

doi:10.1016/b978-0-444-63247-0.00022-5

Cited by 29 publications

(21 citation statements)

References 98 publications

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“…The clinical manifestations of the impairment on sexual function in PWE seemed to depend on the site of the origin of seizures. Among the PWE, the occurrence of SD is distinctly higher in people with temporal lobe epilepsy (particularly on the right side) than those with extratemporal and primary generalized epilepsies [34][35][36]. A previous study [37] reported that anterior temporal lobectomy would result in postoperative seizure freedom in over 60% AED-resistant patients.…”

Section: Discussionmentioning

confidence: 94%

Association between epilepsy and risk of sexual dysfunction: A meta-analysis

Zhao

Tang

Xie

et al. 2019

Seizure

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A B S T R A C TPurpose: Sexual functioning is an important factor influencing quality of life. Mounting evidence suggests that both male and female patients with epilepsy (PWE) have an increased risk of developing sexual dysfunction (SD). The aim of this meta-analysis was to quantify the association between epilepsy and the risk of SD. Methods: PubMed, Embase, and Cochrane Library database were systematically searched to identify the pertinent studies focusing on the association between epilepsy and SD. Relative risk (RR) for SD with 95% confidence interval (CI) was calculated. The overall quality of the evidence was generated by applying the GRADE-profiler. This meta-analysis was registered on the PROSPERO (ID: CRD42018103572, http://www.crd.york.ac.uk/ PROSPERO). Results: Nine studies (3 cross-sectional, 5 case-control, and 1 cohort) were included in this meta-analysis, for a total of 1556 subjects and 599 cases of epilepsy. Synthetic results demonstrated that epilepsy was associated with an increased risk of female SD (6 studies, pooled RR = 2.69, 95%CI: 1.48-4.89, P = 0.001; heterogeneity: I 2 = 88.9%, P < 0.001) as well as male SD (3 studies, pooled RR = 4.85, 95%CI: 2.01-11.7, P < 0.001; heterogeneity: I 2 = 74.2%, P = 0.021). The GRADE-profiler showed that the rate of events of SD on average in the PWE and the controls were 383/659 (58.1%) and 168/1017 (16.5%), respectively. The quality of evidence across outcomes was MODERATE. Conclusions: Epilepsy is significantly associated with an increased risk of SD in both sexes. These findings suggest that both clinicians and patients should recognize that epilepsy has a potential hazardous effect on sexual functioning.

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Section: Discussionmentioning

confidence: 94%

Association between epilepsy and risk of sexual dysfunction: A meta-analysis

Zhao

Tang

Xie

et al. 2019

Seizure

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“…We found that there was no association between seizure control or use of AEDs (including enzyme‐inducing AEDs) or the degree of adverse effects and the frequency of reporting different types of sexual dysfunction. Enzyme‐inducing AEDs may reduce free testosterone by increasing sex‐hormone–binding globulin and thus lower libido . However, the relationship between libido and testosterone levels is not linear, and therefore some patients using these drugs might experience compromised sexual function, whereas others might not .…”

Section: Discussionmentioning

confidence: 99%

“…Enzyme-inducing AEDs may reduce free testosterone by increasing sex-hormone-binding globulin and thus lower libido. 22 However, the relationship between libido and testosterone levels is not linear, and therefore some patients using these drugs might experience compromised sexual function, whereas others might not. 23 This may explain the lack of correlation between sexual problems and use of enzyme-inducing AEDs in our study.…”

Section: Discussionmentioning

confidence: 99%

Sexual function in people with epilepsy: Similarities and differences with the general population

et al. 2019

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Objective The potential impact of epilepsy on sexual function is important for patient welfare, but often neglected. This study explored the occurrences of different sexual problems in patients with both well‐controlled and mostly refractory epilepsy, and compared these with equivalent information from the general population. Methods Between 2015 and 2017, a total of 221 adult inpatients and outpatients, mostly with intractable epilepsy, at the National Centre for Epilepsy in Norway, and 78 outpatients with well‐controlled epilepsy at Lillehammer hospital participated in a questionnaire survey on sexual function. Information on the individual patient's epilepsy was collected. The results were compared with equivalent data on sexual function from 1671 adult Norwegians in the general population. Results Patients with epilepsy reported a significantly higher frequency of problems with orgasm, dyspareunia, erectile dysfunction, and feelings of sexual deviance. However, reduced sexual desire, premature ejaculation/climax, and vaginal dryness occurred at similar frequencies in the general population. After controlling for gender, we found no significant association between sexual problems and seizure control or use of enzyme‐inducing antiepileptic drugs. In both genders, feelings of sexual deviance were associated with lower quality of life. Fewer patients with epilepsy were satisfied with their sex lives. The perception of sex as an important part of daily life was similar among women with epilepsy and women from the general population, whereas significantly fewer men with epilepsy than men in the general population reported that sex was an important part of their daily lives. Women with mostly refractory epilepsy reported asking for help with their sexual problems significantly more often than women in the other groups. Significance Some sexual problems occur significantly more often in patients with epilepsy than in the general population and feelings of sexual deviancy occur more frequently. No epilepsy‐related factors could be identified as specific predictors.

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“…The aetiology is still unclear with genetic as well as environmental causality (Lew‐Starowicz & Gianotten, ). Patients with MS suffer fatigue, depression, spasticity and incontinence leading to SD (Luef & Madersbacher, ).…”

Section: Introductionmentioning

confidence: 99%