Epilepsy syndrome, focus location, and treatment choice affect testicular function in men with epilepsy.
OBJECTIVE
To evaluate testicular function in men with epilepsy treated with different antiepileptic drugs (AED) vs no drugs.


METHODS
Two hundred men with epilepsy (mean age 36 years) were investigated. Inclusion criteria included one or no AED, no co-medication, and no endocrine co-morbidity. Findings were compared with those from 105 healthy men (mean age 33.9 years). Luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), free testosterone (free T), and inhibin B were measured.


RESULTS
One hundred seventy-eight men had focal epilepsy (117 of these had temporal lobe epilepsy [TLE]) and 22 idiopathic generalized epilepsy (IGE). Thirty-three men were not on AED; 124 men received enzyme-inducing AED. Free T was lowered in all patient subgroups, and the T/LH ratio was lowered in all groups except patients with IGE and patients receiving valproate (VPA). T was lower in patients with temporal than extratemporal focal epilepsy. Compared with TLE patients on carbamazepine (CBZ), patients treated with VPA had higher total T and lower LH values, resulting in a significantly lower T/LH ratio with CBZ.


CONCLUSIONS
Epilepsy, especially TLE, adversely affects testicular endocrine function. CBZ may increase the negative effects of epilepsy on serum levels of reproductive hormones.
Bauer
Jürgen
J
Department of Epileptology, University of Bonn, Germany. Juergen.Bauer@ukb.uni-bonn.de
Blumenthal
Sabine
S
Reuber
Markus
M
Stoffel-Wagner
Birgit
B
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D004828:Epilepsies, Partial / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D004829:Epilepsy, Generalized / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000139:chemically induced / Q000209:etiology / Q000503:physiopathology*; D007265:Inhibins / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D013737:Testis / Q000187:drug effects / Q000503:physiopathology*; D013739:Testosterone / Q000097:blood / Q000172:deficiency; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
D000927:Anticonvulsants; C422364:inhibin B; D002220:Carbamazepine; D013739:Testosterone; D007265:Inhibins; D014635:Valproic Acid; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone