Abstract
We thank Dr. Calabro for his interest in our paper [ [1] Henning O.J. Nakken K.O. Traeen B. Mowinckel P. Lossius M. Sexual problems in people with refractory epilepsy. Epilepsy Behav. 2016; 61: 174-179 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar ]. He further points out that the etiology of sexual problems (SP) in persons with epilepsy (PWE) is multifactorial. Epilepsy-related factors like epilepsy etiology, type of epilepsy, seizure frequency, and use of enzyme-inducing antiepileptic drugs may all contribute to the problems by influencing sexual hormones [ [2] Lossius M.I. Tauboll E. Mowinckel P. Morkrid L. Gjerstad L. Reversible effects of antiepileptic drugs on reproductive endocrine function in men and women with epilepsy—a prospective randomized double-blind withdrawal study. Epilepsia. 2007; 48: 1875-1882 Crossref PubMed Scopus (65) Google Scholar ]. While reduced testosterone levels have been found in PWE, a linear relationship between testosterone levels and sexual dysfunction has not been demonstrated [ 3 Morales A. Buvat J. Gooren L.J. Guay A.T. Kaufman J.M. Tan H.M. et al. Endocrine aspects of sexual dysfunction in men. J Sex Med. 2004; 1: 69-81 Abstract Full Text Full Text PDF PubMed Scopus (121) Google Scholar , 4 Isidori A.M. Giannetta E. Gianfrilli D. Greco E.A. Bonifacio V. Aversa A. et al. Effects of testosterone on sexual function in men: results of a meta-analysis. Clin Endocrinol (Oxf). 2005; 63: 381-394 Crossref PubMed Scopus (408) Google Scholar ]. Thus, we believe that the SP among PWE cannot merely be explained by changes in sexual hormones. We assume that psychiatric and/or psychosocial factors are also just as important. To our surprise, despite that these factors are well-known and often mentioned, there are not many studies performed to examine the impact of psychosocial factors on sexual functioning in PWE. Both Duncan and Talbot found reduced sexual desire and erectile dysfunction correlated to an increase of psychological distress, depression, and anxiety but not to changes in testosterone levels [ 5 Duncan S. Talbot A. Sheldrick R. Caswell H. Erectile function, sexual desire, and psychological well-being in men with epilepsy. Epilepsy Behav. 2009; 15: 351-357 Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar , 6 Talbot J.A. Sheldrick R. Caswell H. Duncan S. Sexual function in men with epilepsy: how important is testosterone?. Neurology. 2008; 70: 1346-1352 Crossref PubMed Scopus (50) Google Scholar ]. For sure, further studies are needed to evaluate the importance of these factors.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
