Effect of Antiepileptic Drugs on Reproductive Endocrine Function in Individuals with Epilepsy

@article{Isojrvi2005EffectOA,
  title={Effect of Antiepileptic Drugs on Reproductive Endocrine Function in Individuals with Epilepsy},
  author={Jouko Isoj{\"a}rvi and Erik Taub{\o}ll and Andrew G Herzog},
  journal={CNS Drugs},
  year={2005},
  volume={19},
  pages={207-223}
}
It is well known that epilepsy, antiepileptic drugs (AEDs), and the reproductive system have complex interactions. Fertility is lower in both men and women with epilepsy than in the general population. Moreover, reproductive endocrine disorders are more common among patients with epilepsy than among the population in general. These disorders have been attributed both to epilepsy itself and to use of AEDs.The use of the liver enzyme-inducing AEDs phenobarbital, phenytoin and carbamazepine… 
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References

SHOWING 1-10 OF 118 REFERENCES
Epilepsy, Sex Hormones, and Antiepileptic Drugs
TLDR
Data indicate seizures, especially those arising in the limbic system, may influence the hypothalamic pituitary axis, and antiepileptic drugs also influence sexual function through direct brain effects as well as through induced changes in pharmacokinetics of the sex steroid hormones.
Effect of epilepsy and antiepileptic drugs on male reproductive health
TLDR
CBZ, OXC, and VPA are associated with sperm abnormalities in men with epilepsy, in addition, VPA-treated men with generalized epilepsy who have abnormal sperm may have reduced testicular volume.
Reproductive effects of valproate, carbamazepine, and oxcarbazepine in men with epilepsy
TLDR
VPA increases serum androgen concentrations in men with epilepsy, and the endocrine effects of CBZ and OXC were different, because CBZ appears to decrease the bioactivity of androgens, whereas OxC does not.
Effects of Carbamazepine Therapy on Serum Sex Hormone Levels in Male Patients with Epilepsy
TLDR
CBZ monotherapy does not significantly change the serum balance of sex hormones; however, CBZ clearly affects the serum levels of SHBG and DHEAS.
Phenytoin‐Induced Elevation of Serum Estradiol and Reproductive Dysfunction in Men with Epilepsy
TLDR
Findings suggest that PHT may lower FT by induction of aromatase, enhancing FT conversion to estradiol, as well as SHBG synthetase, which has been suggested to play a major role in negative feedback in men as as women.
Characterization of reproductive endocrine disorders in women with epilepsy.
TLDR
The results of this study suggest that the prevalence of disordered ovulation, in particular polycystic ovary syndrome, is increased in epilepsy, independent of antiepileptic medications or type of seizure disorder.
Menstrual cycle and ovary alterations in women with epilepsy on antiepileptic therapy
TLDR
The findings reappraise the impact of ovary alterations in women mainly affected by mild to moderate epilepsy, on differing AED regimens, with the exception of more frequent ovulatory dysfunction and PCO occurrence in patients taking VPA.
Effect of Phenytoin on Semen
TLDR
The results suggests an effect of seizures on the male reproductive system, and PHT may have a slight additive (if any) influence.
Effects of Valproate, Phenobarbital, and Carbamazepine on Sex Steroid Setup in Women with Epilepsy
TLDR
Increases in testosterone and δ4-androstenedione levels and in free androgen index, along with a higher luteinizing hormone-follicle-stimulating hormone ratio in the luteal phase, were observed in women treated with VPA, although sex-hormone binding globulin levels were higher in CBZ and PB than in VPA-treated patients, the differences were not significant.
Serum hormones in male epileptic patients receiving anticonvulsant medication.
TLDR
It seems probable that accelerated hormone metabolism is responsible for the hormonal changes found in patients treated with carbamazepine and/or phenytoin, and the diverse endocrine effects of different antiepileptic drug regimens should be considered when starting antiespecific drug therapy.
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