Reproductive Dysfunction in Women with Epilepsy

The document from 2008 examines the relationship between epilepsy, antiepileptic drugs (AEDs), and reproductive dysfunction in women, including conditions like polycystic ovary syndrome (PCOS), hypothalamic amenorrhea (HA), and functional hyperprolactinemia (HPRL). It suggests that epilepsy and AEDs, particularly valproate (VPA), can affect the hypothalamic-pituitary axis, hormone metabolism, and insulin sensitivity, leading to menstrual irregularities, sexual dysfunction, and reduced fertility. A small study of 12 women indicated that seizure frequency could be significantly reduced by converting anovulatory cycles to ovulatory cycles. The document also notes that women with epilepsy have a higher prevalence of PCOS compared to the general population and that VPA treatment is associated with menstrual cycle irregularities and elevated testosterone levels. However, switching from VPA to lamotrigine may normalize these conditions. The document emphasizes the need for neurologists to work with endocrinologists or gynecologists to manage these reproductive issues in women with epilepsy.