Reproductive endocrine functions in women with epilepsy

Abstract

Women with epilepsy (WWE) have higher incidence of hormonal disturbance in comparison to the general female population. We analyzed the reproductive endocrine functions in patients with idiopathic generalized epilepsy and compared with controls. The study was conducted in the outpatient department of Neurology at a superspeciality hospital from south India. Women of reproductive age with epilepsy were recruited for the study. Patients in post menopausal state, pregnancy, who have undergone oophorectomy, use of oral contraceptive pills, patients with systemic illness, long term medication for other diseases or progressive or degenerative diseases were excluded. Five ml of venous blood was collected from 3rd day of follicular phase in fasting condition from the women study subjects. Free T3(fT3), Free T4(fT4) and Thyroid Stimulating Hormone(TSH), Follicular Stimulating Hormone(FSH). Luteinizing Hormone(LH), Prolactin, Testosterone and Estrodiol were measured. Hormones like serum Androstenedione, dehyroepiandrosterone(DHEA) and serum17-OH Progesterone were measured. Mean age of patients (N = 100) 22.78 + 7.08 and controls (N = 75) was 24.45+ 4.52. BMI was higher in patients (23.87 + 5.18) than in controls (21.87 + 2.11) p = .05. There was no significant difference in thyroid hormone levels and prolactin. There was a lower level of progesterone(0.54 + 0.27) vs. 1.01 + 0.34 ng/ml), p = .00; higher levels of dehydroepiandrostenedione (0.69 + 0.25vs. 0.54 + 0.38μg/mL), p = .05 and luteinizing hormone-LH (6.01 + 3.90mIU/mL vs. 2.85 + 1.36mIU/mL), p = .00, higher LH/FSH ration (0.87 + 0.50 vs 0.32 + 0.16, p = .00). AED'S were Phenytoin (70%), Carbamazepine(26%), Valproate (4%). There was no significant difference between individual AED's. This study demonstrates that WWE have reproductive endocrine abnormalities. The role of epilepsy versus EIAEDS needs further evaluation.