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Infertility and Menstrual Disorders: Seizure Medications vs. Seizures

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Controversies in Caring for Women with Epilepsy

Abstract

A 30-year-old woman has a long standing history of generalized tonic-clonic seizures since age 15. During an inpatient epilepsy monitoring, her seizures were found to originate from dominant hemisphere frontal lobe. She has declined epilepsy surgery due to potential risks for complications. In the past, she was treated with multiple seizure medications including phenytoin, carbamazepine, topiramate, valproic acid, and lamotrigine. Currently, she is treated on a combination of lacosamide and levetiracetam and experiences at least one break through seizure per month. She is married and has been trying to become pregnant in the past 4 years with no success. During her office visit, she mentions that her menstrual periods are irregular and her gynecologist has determined that she has anovulatory cycles and decreased chance for becoming pregnant. She also has noticed weight gain and thinning of her hair, acne, and excess facial hair. She is wondering whether her condition is a result of her seizure disorder or her medications and if there is anything she can do to improve her condition.

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References

  1. Herzog AG. Menstrual disorders in women with epilepsy. Neurology. 2006;66 Suppl 3:S23–8.

    Article  PubMed  Google Scholar 

  2. Wallace H, Shorvon S, Tallis R. Age-specific incidence and prevalence rates of treated epilepsy in an unselected population of 2,052,922 and age-specific fertility rates of women with epilepsy. Lancet. 1998;352:1970–3.

    Article  CAS  PubMed  Google Scholar 

  3. Herzog AG, Friedman MN. Menstrual cycle interval and ovulation in women with localization-related epilepsy. Neurology. 2001;57:2133–5.

    Article  CAS  PubMed  Google Scholar 

  4. Herzog AG. Disorders of reproduction in patients with epilepsy: primary neurological mechanisms. Seizure. 2008;17:101–10.

    Article  PubMed  Google Scholar 

  5. Thomas SV, Sarma PS, Nirmala C, et al. Women with epilepsy and infertility have different reproductive hormone profile than others. Ann Indian Acad Neurol. 2013;16(4):544–8.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Dansky LV, Andermann E, Andermann F. Marriage and fertility in epileptic patients. Epilepsia. 1980;21:261–71.

    Article  CAS  PubMed  Google Scholar 

  7. Weber MO, Hauser WA, Ottman R, Annegers JF. Fertility in persons with epilepsy: 1935-1974. Epilepsia. 1986;27(6):746–52.

    Article  Google Scholar 

  8. Schupf N, Ottman R. Reproduction among individuals with idiopathic/cryptogenic epilepsy: risk factors for reduced fertility in marriage. Epilepsia. 1996;37(9):833–40.

    Article  CAS  PubMed  Google Scholar 

  9. Morrell MJ, Flynn KL, Doñe S, et al. Sexual dysfunction, sex steroid hormone abnormalities, and depression in women with epilepsy treated with antiepileptic drugs. Epilepsy Behav. 2005;6(3):360–5.

    Article  PubMed  Google Scholar 

  10. Bauer J. Epilepsy and prolactin in adults: a clinical review. Epilepsy Res. 1996;24:1–7.

    Article  CAS  PubMed  Google Scholar 

  11. Bilo L, Meo R, Valentino R, et al. Characterization of reproductive endocrine disorders in women with epilepsy. J Clin Endocrinol Metab. 2001;86:2950–6.

    Article  CAS  PubMed  Google Scholar 

  12. Mahesh VB, Brann DW. Regulation of the pre-ovulatory gonadotropin surge by endogenous steroids. Steroids. 1998;63:616–29.

    Article  CAS  PubMed  Google Scholar 

  13. Herzog AG. A relationship between particular reproductive endocrine disorders and the laterality of epileptiform discharges in women with epilepsy. Neurology. 1993;43:1907–10.

    Article  CAS  PubMed  Google Scholar 

  14. Baird AD, Wilson SJ, Bladin PF, et al. Sexual outcome after epilepsy surgery. Epilepsy Behav. 2003;4:268–78.

    Article  PubMed  Google Scholar 

  15. Sukumaran SC, Sarma PS, Thomas SV. Polytherapy increases the risk of infertility in women with epilepsy. Neurology. 2010;75(15):1351–5.

    Article  PubMed  Google Scholar 

  16. Isojarvi JL, Tauboll E, Pakarinen AJ. Altered ovarian function and cardiovascular risk factors in valproate-treated women. Am J Med. 2001;111(4):290–6.

    Article  CAS  PubMed  Google Scholar 

  17. Hamed SA, Hamed EA, Shokry M, et al. The reproductive conditions and lipid profile in females with epilepsy. Acta Neurol Scand. 2007;115:12–22.

    Article  CAS  PubMed  Google Scholar 

  18. Isojarvi JI. Serum steroid hormones and pituitary function in female epileptic patients during carbamazepine therapy. Epilepsia. 1990;31(4):438–45.

    Article  CAS  PubMed  Google Scholar 

  19. Morrell MJ, Hayes FJ, Sluss PM, et al. Hyperandrogenism, ovulatory dysfunction, and polycystic ovary syndrome with valproate versus lamotrigine. Ann Neurol. 2008;64(2):200–11.

    Article  CAS  PubMed  Google Scholar 

  20. Kumar S, Kaur G. Second generation anti-epileptic drugs adversely affect reproductive functions in young non-epileptic female rats. Eur Neuropsychopharmacol. 2014;24(10):1709–18.

    Article  CAS  PubMed  Google Scholar 

  21. Pennell PB. Hormonal aspects of epilepsy. Neurol Clin. 2009;27(4):941–65.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Klein P, Serje A, Pezzullo JC. Premature ovarian failure in women with epilepsy. Epilepsia. 2001;42:1584–9.

    Article  CAS  PubMed  Google Scholar 

  23. Harden CL, Koppel BS, Herzog AG, et al. Seizure frequency is associated with age of menopause in women with epilepsy. Neurology. 2003;61:451–5.

    Article  CAS  PubMed  Google Scholar 

  24. Bauer J, Isojarvi JI, Herzog AG, et al. Reproductive dysfunction in women with epilepsy: recommendations for evaluation and management. J Neurol Neurosurg Psychiatry. 2002;73(2):121–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Löfgren EL, Pouta A, von Wendt L, Tapanainen J, Isojärvi JI, Järvelin MR. Epilepsy in the northern Finland birth cohort 1966 with special reference to fertility. Epilepsy Behav. 2009;14(1):102–7.

    Article  PubMed  Google Scholar 

  26. Zhou JQ, Zhou LM, Chen LJ, Han JD, Wang Q, Fang ZY, Chen ZY, Ling S. Polycystic ovary syndrome in patients with epilepsy: a study in 102 Chinese women. Seizure. 2012;21(9):729–33.

    Article  PubMed  Google Scholar 

  27. Hu X, Wang J, Dong W, Fang Q, Hu L, Liu C. A meta-analysis of polycystic ovary syndrome in women taking valproate for epilepsy. Epilepsy Res. 2011;97(1–2):73–82.

    Article  CAS  PubMed  Google Scholar 

  28. Lossius MI, Taubøll E, Mowinckel P, Mørkrid L, Gjerstad L. Reversible effects of antiepileptic drugs on reproductive endocrine function in men and women with epilepsy—a prospective randomized double-blind withdrawal study. Epilepsia. 2007;48(10):1875–82.

    Article  PubMed  Google Scholar 

  29. Tietze C. Reproductive span and the rate of conception among Hutterite women. Fertil Steril. 1957;8:89–97.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to M. Sazgar M.D. .

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Bui, E., Harden, C.L., Sazgar, M. (2016). Infertility and Menstrual Disorders: Seizure Medications vs. Seizures. In: Sazgar, M., Harden, C. (eds) Controversies in Caring for Women with Epilepsy. Springer, Cham. https://doi.org/10.1007/978-3-319-29170-3_11

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  • DOI: https://doi.org/10.1007/978-3-319-29170-3_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29168-0

  • Online ISBN: 978-3-319-29170-3

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