Detrimental Effects of Epilepsy and Anti-Epileptic Drugs on Sexual Function and Potency of Epileptic Male Patients

Abstract

Objectives: To assess effect of epilepsy and anti-epileptic drug (AED) therapy on sexual function and potency of the epileptic male patients. Patients and Methods: This is a cross-sectional study incorporated 40 epileptic male patients with mean age of 26.8±2.9 years and 15 control men. All men underwent thorough history taking including age, duration of disease and AED therapy. All selected patients are matched in age, average Body Mass Index (BMI) 20-30. Obese patients, patients with mood disturbance or history of other medical or urological disorders that might affect sexual function were excluded from the study. Potency and erectile dysfunction was assessed by using the Arizona Sexual Experience Scale (ASEX) questionnaire. Fasting morning blood samples were obtained to measure serum level of total testosterone, estradiol and sex hormone-binding globulin (SHBG). Results: All patients were average body weight. Mean duration of disease was 7.6±2.9 years and mean number of seizure per month was 5.1±2.6 fit/month. Twenty-three of them had left, while 17 men had right temporal lobe epilepsy (TLE) and 29 patients were maintained on AED therapy. Patients had significantly higher ASEX score compared to control men and 20 patients had sexual dysfunction with score value ≥18. patients had right TLE had significantly higher ASEX score compared to both controls and to women had left TLE and 12 patients with right TLE had sexual dysfunction. Patients continue on anti-epileptic medication showed higher ASEX score with statistically significance in comparison to both controlled group and those who were not on treatment and 17 patients had sexual dysfunction were maintained on AED. Serum levels of estradiol were significantly lower, while serum levels of SHBG were significantly higher in epileptic patients compared to controls. There was a positive significant correlation between high ASEX scores identifying sexual dysfunction and high number of seizures/month, right-sided epileptic focus and maintenance on AED. Conclusion: Epilepsy has a detrimental effect on sexual functions in men and that impact might have been magnified with anti-epileptic drugs, especially for patients with right temporal lobe epilepsy.