1. ¹Department of Neurology, Assiut University Hospital, Assiut, Egypt
2. ²Department of Psychiatry, Assiut University Hospital, Assiut, Egypt
3. ³Department of Urology, Assiut University Hospital, Assiut, Egypt
4. ⁴Department of Physiology, Assiut University Hospital, Assiut, Egypt
5. ⁵Department of Clinical Pathology, Assiut University Hospital, Assiut, Egypt

Correspondence: Dr S Hamed, Department of Neuroscience, Saudi German Hospital, Aseer, PO Box 2553, Khamis Mushyt, Aseer 2553, Saudi Arabia. E-mail: hamed_herifa@yahoo.com

Received 22 June 2005; Revised 7 September 2005; Accepted 7 September 2005; Published online 27 October 2005.

Abstract

This study was specifically aimed to evaluate the sexual and reproductive health in a group of men with generalized epilepsy. In total, 44 men with generalized epilepsy were included in this study, their ages between 18 and 48 years (29.29.9) and duration of illness between 2 and 35 years (11.27.4); 34 patients were treated with conventional antiepileptic drugs (AEDs). Sexological and psychological interviews together with serum total testosterone, E₂, FSH, LH and prolactin were determined. Hyposexuality was diagnosed in 61.4%. Erectile dysfunction (ED) and premature ejaculation represented 70.4 and 66.7%, respectively. Variables such as hyposexuality, seizure duration and its poor control on AEDs were significantly associated with depressive symptoms. Compared to the normal control group, all patients reported elevated E₂ levels (P<0.001), 10 had FSH (n=4) and LH (n=6) levels exceeding that of the normal range for controls and two had hyperprolactinemia. Although the patients' mean value of total testosterone remained within the normal range, but it was significantly lower in hyposexual men compared to nonhyposexual (P<0.002), only two epileptic patients had markedly reduced level of total testosterone beyond normal control levels. This study strongly supports that: (1) The risk of hyposexuality and reproductive disturbances is high in epileptic patients with GTC convulsions despite the AEDs utilized. The risk for SD is further increased by poor seizure control and the frequently accompanied depressive manifestations. (2) It is possible that elevated E2 could increase the risk of SD by reducing active testosterone through negative feedback and the reduction of active testosterone could increase seizure intractability to antiepileptic medications.