The relationship between epilepsy and sexual dysfunction: a review of the literature

SpringerPlus, Dec 2016

Background and objectives Regardless of the disease states that people suffer from, maintaining sexual function is an important indicator of quality of life. The objective of this review was to figure out the relationship between epilepsy, antiepileptic drugs (AEDs) and sexual dysfunction. Results In various epidemiological and clinical studies, epilepsy has been correlated with a reduction in sexual function. This sexual dysfunction is not always detected in epileptic patients until systematic efforts are put in place, as part of the assessment and treatment process. Therefore, precise evaluations of the incidence of treatment related sexual dysfunction in epileptic patients is still lacking. Conclusions This literature review concluded that sexual function is influenced by the pathophysiology of epilepsy, as well as through the use of AEDs. To maximize quality of care in patients with epilepsy and those patients with other disease states who receive AEDs, it is important to address the status of the patient’s sexual function as part of the initial routine assessment and with any treatment related follow-up. Minimizing the effects of AED related sexual dysfunction can be achieved by raising awareness among patients, providing education and training for physicians regarding sexual dysfunction and obtaining a baseline sexual history from the patient so are important recommendations. In addition, systematic studies are needed to explore the risk and mechanism of such treatment related side effects on sexual function.

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The relationship between epilepsy and sexual dysfunction: a review of the literature

Atif et al. SpringerPlus The relationship between epilepsy and sexual dysfunction: a review of the literature Muhammad Atif 0 Muhammad Rehan Sarwar 0 Shane Scahill 1 0 Department of Pharmacy, The Islamia University of Bahawalpur , Bahawalpur, Punjab , Pakistan 1 School of Management, Massey University , Auckland , New Zealand Background and objectives: Regardless of the disease states that people suffer from, maintaining sexual function is an important indicator of quality of life. The objective of this review was to figure out the relationship between epilepsy, antiepileptic drugs (AEDs) and sexual dysfunction. Results: In various epidemiological and clinical studies, epilepsy has been correlated with a reduction in sexual function. This sexual dysfunction is not always detected in epileptic patients until systematic efforts are put in place, as part of the assessment and treatment process. Therefore, precise evaluations of the incidence of treatment related sexual dysfunction in epileptic patients is still lacking. Conclusions: This literature review concluded that sexual function is influenced by the pathophysiology of epilepsy, as well as through the use of AEDs. To maximize quality of care in patients with epilepsy and those patients with other disease states who receive AEDs, it is important to address the status of the patient's sexual function as part of the initial routine assessment and with any treatment related follow-up. Minimizing the effects of AED related sexual dysfunction can be achieved by raising awareness among patients, providing education and training for physicians regarding sexual dysfunction and obtaining a baseline sexual history from the patient so are important recommendations. In addition, systematic studies are needed to explore the risk and mechanism of such treatment related side effects on sexual function. Epilepsy; Sexual dysfunction; Antiepileptic drugs; Epidemiology; Relationship - Background Historically discussion around sexual practices and associated dysfunction was taboo. However, in the modern era, awareness of issues associated with sexual dysfunction has been more commonly aired. Western civilization has become more open-minded about discussing sexual dysfunction, and in particular about erectile dysfunction (ED) in men, often associated with chronic disease. With this opening up of society there has been encouragement for people to think about their sexual performance and to seek advice from health consultants (Laumann et  al. 1999; Kaufman et al. 2015). The very first orally available drug for male ED was sildenafil (Viagra) which not only treated the problem but also through marketing campaigns, increased awareness among people. These days ED is considered amongst the general public to be a “medical condition” that can be managed. In terms of etiology both physical (ED in men due to circulatory disorders) and psychological factors (inadequate interpersonal associations, psychiatric illness) are responsible for sexual dysfunction. Another cause of sexual dysfunction is the use of drugs such as anti-hypertensive (Fogari et  al. 1998), anti-psychotics (Baldwin and Birtwistle 1997), anti-depressants (Baldwin et al. 1997; Goldstein and Goodnick 1998) and antiepileptic drugs (AEDs) (Hamed et al. 2015; Kirmani et al. 2014; Lombardi et  al. 2015; Meryn 2015; Svalheim et  al. 2015; Urso et  al. 2014; Kaufman et  al. 2015; Sivaraaman © The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. and Mintzer 2011; Kaufman and Struck 2011b). The link between sexual dysfunction and drug induced as opposed to disease induced effects is complicated, and the case of epilepsy and AEDs has received less attention than one might expect. Sexual dysfunction may impact on compliance and is reported to be dose dependent with various AEDs (Kaufman and Struck 2011a). For example, case reports of gabapentin-induced sexual dysfunction suggest that the minimum total daily dose required for sexual dysfunction is 900 mg (Dalal and Zhou 2008; GRANT and OH 2002). The human sexual response and sexual dysfunction Natural sexual response of a human can be divided into four stages and disturbance can occur in any one these stages; 1. Desire typically this consists of fantasies about, and the desire to have, sexual activity. 2. Excitement the individual sense of sexual enjoyment, associated with physiological alterations, including penile tumescence and erection in men, and pelvic vasocongestion, inflamed external genitalia, and lubrication and extension of the vaginal canal in women. 3. Orgasm height of sexual enjoyment, by the discharge (...truncated)


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Muhammad Atif, Muhammad Rehan Sarwar, Shane Scahill. The relationship between epilepsy and sexual dysfunction: a review of the literature, SpringerPlus, 2016, pp. 2070, Volume 5, Issue 1, DOI: 10.1186/s40064-016-3753-5