title: Altered ovarian function and cardiovascular risk factors in valproate-treated women.
abstract: OBJECTIVE
  Polycystic ovaries and menstrual disturbances seem to be common among women taking valproate for epilepsy. The purpose of the present study was to assess the frequency of valproate-related metabolic and endocrine disorders in different groups of women with epilepsy.
  
  
  METHODS
  Seventy-two women with epilepsy and 52 control subjects from centers in three European countries (Finland, Norway, and the Netherlands) participated in the study. Thirty-seven of the women with epilepsy were taking valproate monotherapy and 35 carbamazepine monotherapy.
  
  
  RESULTS
  The frequency of polycystic ovaries or hyperandrogenism, or both, among valproate-treated women with epilepsy was 70% (26 of 37) compared with 19% (10 of 52) among control subjects (P <0.001). They were found in 79% (11 of 14) of obese and 65% (15 of 23) of lean women on valproate, and in 20% (7 of 35) of carbamazepine-treated women. The obese valproate-treated women with polycystic ovaries or hyperandrogenism, or both, had hyperinsulinemia and associated unfavorable changes in serum lipid levels consistent with insulin resistance.
  
  
  CONCLUSIONS
  Polycystic ovaries and related hyperandrogenism are frequently encountered in both obese and lean women taking valproate for epilepsy. The use of valproate is associated with risk factors for cardiovascular disease in obese women.
authors.affiliation: Department of Neurology, University of Oulu, FIN-90220 Oulu, Finland.
authors.forename: J I
authors.initials: JI
authors.lastname: Isojärvi
authors.forename: E
authors.initials: E
authors.lastname: Taubøll
authors.forename: A J
authors.initials: AJ
authors.lastname: Pakarinen
authors.forename: J
authors.initials: J
authors.lastname: van Parys
authors.forename: J
authors.initials: J
authors.lastname: Rättyä
authors.forename: H F
authors.initials: HF
authors.lastname: Harbo
authors.forename: P O
authors.initials: PO
authors.lastname: Dale
authors.forename: B C
authors.initials: BC
authors.lastname: Fauser
authors.forename: L
authors.initials: L
authors.lastname: Gjerstad
authors.forename: R
authors.initials: R
authors.lastname: Koivunen
authors.forename: M
authors.initials: M
authors.lastname: Knip
authors.forename: J S
authors.initials: JS
authors.lastname: Tapanainen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000139:chemically induced; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000139:chemically induced*; D008599:Menstruation Disturbances / Q000097:blood / Q000139:chemically induced; D009765:Obesity / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000139:chemically induced*; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D014635:Valproic Acid