An Examination of sex hormone levels in epilepsy patients taking antiepileptic treatment

Abstract

Aim Reproductive adverse events may be observed in patients with epilepsy associated with antiepileptic drugs. This study aimed to evaluate changes in sex hormone levels in patients receiving antiepileptic treatment as monotherapy and polytherapy. Method In this case-control study, the sex hormone levels and free androgen indexes were evaluated in 83 patients and 40 controls. In the hormone evaluations, measurements were performed for dehydroepiandrosterone sulfate, sex hormone-binding globulin, follicle-stimulating hormone, luteinizing hormone, total and free testosterone, prolactin and estradiol levels. Results A total of 83 patients (42 males, 41 females) with a mean age of 28±7.2 years and a control group of 40 healthy subjects (14 males, 26 females) with a mean age of 33±8.7 years were included. In the patient group, 45 were receiving monotherapy and 38 polytherapy, 13 (15.7%) patients had focal onset seizures, 68 (81.9%) had generalized onset seizure and 2 (2.4%) had seizure type of unknown origin. In the males of the study group, no difference was determined in the hormone levels. In the females of the study group, the free androgen index was determined to be significantly low in the carbamazepine group compared to the control group (p=0.04) and the sex hormone-binding globulin values were significantly high (p=0.01). In males, a significant positive correlation was determined between serum carbamazepine and follicle-stimulating hormone (p=0.046) and prolactin (p=0.035) and a significant negative correlation was determined with the free androgen index (p=0.032). In females, a statistically significant positive correlation was determined between carbamazepine and prolactin (p=0.036). Conclusion The use of antiepileptic drugs creates changes in the sex hormone levels in males, and associated reproductive side-effects may be seen. In the management of patients with epilepsy, an awareness of these side-effects and individual evaluation could have a positive effect on treatment compliance and patient satisfaction.