Men with epilepsy experience issues that are unique to their gender. These can be quite complex. They can vary with age, seizure type, severity, and overall health and lifestyle factors. This article will look at how epilepsy and its treatment may affect testosterone production, libido, and fertility in men.
It is estimated that 40% of men with epilepsy have lower levels of testosterone. This is the hormone that stimulates the development of male sex organs, sexual traits, and sperm.
Reduced testosterone can adversely affect energy, mood, sexual desire, sexual function, and bone strength.
It is thought that having epilepsy or anti-epileptic drugs (AEDs) may lower testosterone levels.
How epilepsy could cause hormonal changes:
– Seizures can alter the release of hypothalamic and pituitary hormones.
– Temporal lobe epilepsy can have adverse effects on testicular endocrine function.
How anti-epileptic drugs (AEDs) could cause hormonal changes:
– Research suggests that phenytoin, carbamazepine, and phenobarbital could reduce the level of free testosterone in the body.
Libido and Sexual Interest
All men, whether they have epilepsy or not, will experience problems with libido at some point in their lives. These problems may include losing interest in sex or having difficulty getting and/or staying aroused.
Common causes of sexual problems for men include stress, exhaustion, illness, alcohol, or having a long-term medical condition. Having epilepsy or taking AEDs could also cause problems. These can be due to:
Changes in the brain caused by seizures
Sexual desire is linked to the appropriate function of specific regions of the cerebral cortex, especially the frontal and temporal lobes. People with complex partial seizures seem to be more prone to problems with sexual desire, particularly when seizures originate in the temporal lobe. Research suggests that damage to the temporal lobe, common in people with partial epilepsy, also affects the ability to recognize subtle cues that are integral to establishing intimacy.
Exposure to anti-epileptic drugs (AEDs)
These can affect the brain regions that regulate sexuality and may also cause sexual dysfunction by secondary effects on reproductive hormones (such as testosterone). Researchers have found that diminished libido and arousal are more pronounced in men who are taking sedating AEDs, such as barbiturates, although adverse effects may also occur with any AED. In studies comparing the adverse effects of some specific AEDs on sexuality, researchers found that carbamazepine and phenytoin had more of negative effect on libido than lamotrigine.
If you are experiencing problems with libido, it is important to discuss this with a health care provider. A doctor may be able to prescribe another AED or another medication to help resolve these problems. They can also investigate other physical or psychological factors that may influence this.
Reproduction and Fertility
Research has found that men with epilepsy are at a higher risk of reproductive difficulties. This generally manifests as a lower sperm count and/or abnormal sperm characteristics.
The type of epilepsy, age of onset, and family history appear to have the biggest impact on reproductive dysfunction and infertility.
Studies have found thatmen who develop epilepsy at an earlier age (less than 10 years old) are more prone to reproductive difficulties than men who develop epilepsy at a later age. It has also been found that men with partial onset epilepsy are more prone to reproductive difficulties than those with generalized onset epilepsy.
Researchers have found that some AEDs are associated with reproductive dysfunction. Valproate has been linked to sperm tail abnormalities and reduced testicular volume. Carbamazepine and oxcarbazepine may also cause sperm abnormalities.
It is important to note that epilepsy does not necessarily cause difficulties with testosterone production, libido, and/or fertility. As well, the medications taken for epilepsy should not always be seen as the culprit. Speak to a health care provider if you have questions or concerns about these issues. They have a variety of solutions that may help. You are not alone and you don’t need to tough it out.