Endocrine reproductive dysfunctions in women with epilepsy on antiepileptic therapy

Abstract

Rationale. The aim of this study is to evaluate sex hormones abnormalities and incidence of polycystic ovary syndrome among young women with epilepsy, analyzing the possible impact of antiepileptic therapy. Material and methods. In this study we included 41 women with epilepsy, aged between 18 to 40 years, not receiving hormones, with disease duration for 1 to 15 years. The assessment included clinical examination, transvaginal ultrasonography and measurement of sex hormones serum concentration (total testosterone, estradiol, SHBG, LH and FSH) from days 1 to 10 of one menstrual cycle. The patients were compared with a healthy control group. Hormonal data were correlated with the concomitant antiepileptic therapy. Results. PCO (polycystic ovaries) were found in 19 patients (46%) associated frequently with valproate treatment started before the age of 20 years. PCOS (polycystic ovary syndrome) was found in 20% of the patients, also under valproate therapy. In 22 patients (53%), a high serum testosterone level (19 patients under valproate mono- or add-on therapy). LH/FSH ratio appears bigger than 1 in 21 patients (51%) (17 patients treated with valproate mono- or add-on therapy). Conclusions. The endocrine - reproductive dysfunctions occurred more frequently in epileptic women treated with valproate; these endocrine abnormalities may have a negative impact on fertility in women with epilepsy and therefore young patients should be screened and carefully evaluated in an endocrinology service prior to start the antiepileptic treatment.