Seizure frequency and sex steroids in women with partial epilepsy on antiepileptic therapy.
OBJECTIVE
Neuroactive sex steroids influence neuron excitability, which is enhanced by estradiol (E2) and decreased by progesterone (Pg). In epilepsy, the production, metabolism, biologic availability, and activity of sex hormones may be affected by seizures themselves or by antiepileptic drugs (AEDs). This cross-sectional observational study was aimed at evaluating the relationships between sex steroids, seizure frequency, and other clinical parameters in women with partial epilepsy (PE) on AED treatments.


METHODS
Serum E2, Pg, sex hormone binding globulin (SHBG) levels, free E2 (fE2), and E2/Pg ratios were determined during the follicular and luteal phases in 72 adult women with PE, and in 30 healthy controls. Hormonal data were correlated with seizure frequency, age, body weight, body mass index (BMI), disease onset and duration, and AED therapies.


RESULTS
In patients, E2, fE2, and Pg levels were lower in both ovarian phases, whereas those of SHBG were higher than in controls. No significant changes in hormone levels and in prevalence of anovulatory cycles were observed between patients grouped according to their seizure frequency. However, when compared with those in healthy controls, luteal fE2 and Pg levels were chiefly impaired in women with more frequent seizures, mostly undergoing AED polytherapies, but not in those with absent or rarer seizures.


CONCLUSIONS
The actual changes in sex steroid levels and E2/Pg ratios did not explain an increased seizure frequency in adult women with AED-treated PE, but patients with more severe disease showed more relevant changes in their sex hormone profile and impaired Pg levels during the luteal phase.
Murialdo
Giovanni
G
Department of Endocrine and Medical Sciences, University of Genova, Italy. gmurialdo@unige.it
Magri
Flavia
F
Tamagno
Gianluca
G
Ameri
Pietro
P
Camera
Antonella
A
Colnaghi
Silvia
S
Perucca
Piero
P
Ravera
Giambattista
G
Galimberti
Carlo Andrea
CA
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000627:therapeutic use*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004828:Epilepsies, Partial / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D011374:Progesterone / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013223:Statistics as Topic; D013256:Steroids / Q000097:blood*; D055815:Young Adult
D000927:Anticonvulsants; D012738:Sex Hormone-Binding Globulin; D013256:Steroids; D011374:Progesterone; D004958:Estradiol