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Sexuality in Men and Women With Epilepsy

Published online by Cambridge University Press:  07 November 2014

Cynthia L. Harden
Cynthia L. Harden*
Affiliation:
Dr. Harden is associate professor in the Department of Neurology and Neuroscience at the Comprehensive Epilepsy Center at Weill Medical College of, Cornell University in New York City
*
Cynthia L. Harden, MD, Comprehensive Epilepsy Center, Room K-615, 525 East 68th St, Weill Cornell Medical Center, New York, NY; Tel: 212-746-2346; Fax:, 212-746-8845; Email:, clharden@med.cornell.edu.
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Abstract

Most people with epilepsy maintain normal reproductive and sexual lives. However, a significant minority of women with epilepsy (20% to 30%) have some degree of sexual dysfunction, including problems with libido, arousal, and orgasm. Men with epilepsy are at risk for decreased sexual functioning, including sexual interest and sexual performance, at least in part because of increased sex hormone-binding globulin levels and lower bioactive testosterone levels, particularly in association with the use of enzyme-inducing antiepileptic drugs, such as phenytoin and carbamazepine. A decrease in bioactive testosterone levels probably has a significant effect on the sexuality of women with epilepsy as well. Antiepileptic drugs may also affect sexual function in women through alterations of serotonergic neurotransmission. Epilepsy itself appears to have the potential to affect sexual function. The amygdala is emerging as a brain structure with significant involvement in sexuality in patients with epilepsy, as shown by alterations in sexual functioning after temporal lobectomy. Preliminary evidence suggests that people with temporal lobe epilepsy have reduced genital blood flow in response to erotic stimulation; the etiology of this phenomenon is not well understood, but disruption of the limbic and frontal cortex by epileptic activity may be implicated. Psychosocial factors, including sexual anxiety and stigma associated with epilepsy, can also affect the sexual life of patients with epilepsy.

Type
Research Article
Information
CNS Spectrums , Volume 11 , Issue S9 , 2006 , pp. 13 - 18
Copyright
Copyright © Cambridge University Press 2006

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