By: Aaliyah Ellison-McPeters
Side Effects of AEDs
Antiepileptic drugs, or AEDs, are frequently used to help control seizures caused by epilepsy and operate by altering the levels of chemicals in the brain. AEDs are the most common treatment for epilepsy. Since it is challenging to develop drugs that target solely one part of the body, medications often affect other functions, which causes side effects. Common side effects associated with using AEDS are drowsiness, nausea, mood change, irritability, blurred vision, and more. Side effects of antiepileptic drugs can also interfere with more intimate parts of a person’s life, such as their sexual health. Close to 50% of men and women with epilepsy experience sexual dysfunction, and often it is not discussed and goes unnoticed. Approximately 13% of epileptic patients have talked about sex and sexual health with their doctors. Whether this silence is fueled by fear or embarrassment, there is no shame in having these critical conversations.
Epilepsy and Female Sexuality
Women who live with epilepsy and take AEDs can experience infertility, sexual dysfunction, increased risk of congenital disabilities, osteoporosis, and more. Since antiepileptic drugs treat seizures by changing the chemical levels in the brain, AEDs can adjust hormone release and disrupt or alter the metabolism of sex hormones. Female reproductive hormones such as estrogen and progesterone affect seizures because these hormones interact with the cells in the brain. While it is still unclear how sex hormones impact brain cells, the risk of convulsions increases through the production of estrogen. Lowered estrogen production can lead to sexual dysfunction in women, primarily vaginal atrophy and dyspareunia, which are side effects of AED treatment.
Epilepsy and Male Sexuality
Epileptic men who use AED treatment commonly experience sexual dysfunction, including erectile and ejaculatory dysfunction and lowered libido. Approximately a third of epileptic men will encounter this difficulty. The sex hormone-binding globulin levels in men increase while testosterone decreases; this is believed to be associated with enzyme-inducing AEDs. Epilepsy itself may have the potential to cause disruptions in sexual health; people who are diagnosed with temporal lobe epilepsy have decreased genital blood flow in response to stimulation. The interruption between the limbic and frontal cortex caused by convulsions may be the cause. For epileptic men and women, anxiety and depression also contribute to poor sexual health. A well-rounded approach to providing symptomatic relief is imperative in these cases.
Addressing Side Effects and Protecting Sexual Health
It is best to speak with your doctor or neurologist to address any sexual or reproductive health issues caused by epilepsy or the medication used for treatment. Your neurologist can help advise you on the problems driven directly by your epilepsy. Lowering the effects of sexual dysfunction caused by AEDs can happen through spreading awareness and providing adequate education and training to care providers on sexual health. While it may be difficult for some to start conversations regarding sexual health with their providers, addressing and managing issues concerning your health is essential.
Resources:
AED Side-Effects and Interactions. (n.d.). Epilepsy Foundation Australia. Retrieved January 24, 2023, from https://epilepsyfoundation.org.au/understanding-epilepsy/treatments-and-management/anti-epileptic-drugs-aeds/aed-side-effects-and-interactions/
Atif, M., Sarwar, M.R. & Scahill, S. The relationship between epilepsy and sexual dysfunction: a review of the literature. SpringerPlus 5, 2070 (2016). https://doi.org/10.1186/s40064-016-3753-5
Epilepsy and sex. (n.d.). Epilepsy Action Australia. Retrieved January 24, 2023, from https://www.epilepsy.org.au/psychosocial-wellbeing-for-adults-living-with-epilepsy/optimal-living-with-epilepsy/epilepsy-and-sex/
Epilepsy—Treatment. (2018, October 3). Nhs.Uk. https://www.nhs.uk/conditions/epilepsy/treatment/
Harden C. L. (2006). Sexuality in men and women with epilepsy. CNS spectrums, 11(8 Suppl 9), 13–18. https://doi.org/10.1017/s1092852900026717
Laino, C. (n.d.). Women, Epilepsy, and Sexuality. WebMD. Retrieved January 24, 2023, from https://www.webmd.com/sex-relationships/features/women-epilepsy-sexuality
Rathore, C., Henning, O. J., Luef, G., & Radhakrishnan, K. (2019). Sexual dysfunction in people with epilepsy. Epilepsy & behavior : E&B, 100(Pt A), 106495. https://doi.org/10.1016/j.yebeh.2019.106495
Relationships and sex | Epilepsy Society. (n.d.). Retrieved January 24, 2023, from https://epilepsysociety.org.uk/living-epilepsy/wellbeing/relationships-and-sex
St. Louis, E. (2009). Minimizing AED Adverse Effects: Improving Quality of Life in the Interictal State in Epilepsy Care. Current Neuropharmacology, 7(2), 106–114. https://doi.org/10.2174/157015909788848857
Yang, Y., & Wang, X. (2016). Sexual dysfunction related to antiepileptic drugs in patients with epilepsy. Expert opinion on drug safety, 15(1), 31–42. https://doi.org/10.1517/14740338.2016.1112376
