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Characterization of Reproductive Endocrine Disorders in Women with Epilepsy

Epilepsy Center, Department of Neurosciences (L.B., R.M., S.S.), Department of Endocrinology (R.V.), and Department of Obstetrics and Gynecology (C.D.C., C.N.), Federico II University, 80131 Naples, Italy

Address all correspondence and requests for reprints to: Leonilda Bilo, M.D., Ph.D., Traversa Michele Pietravalle 54, 80131 Naples, Italy. E-mail: lbilo{at}libero.it

Abstract

An increased frequency of reproductive endocrine disorders has been reported in women with epilepsy. A possible role of the seizure disorder or, alternatively, of the use of antiepileptic drugs (AEDs) has been suggested as the pathogenic mechanism. The aim of the present study was to assess the frequency of reproductive endocrine disorders in a series of women with epilepsy, examining the possible relationships of these disturbances with different epilepsy syndromes and AED treatment.

Fifty epileptic women, all of reproductive age and none pubertal, pregnant, or lactating, were submitted to clinical endocrinological evaluation, hormonal assessment, and ovarian ultrasonography. Subjects with abnormal findings in this preliminary study underwent additional evaluations. Reproductive endocrine disorders were diagnosed in 16 (32%), consisting of polycystic ovary syndrome in 13, hypothalamic amenorrhea in 2, and luteal phase deficiency in 1. There was no significant association of these disturbances with epilepsy type or AED treatment. Patients with reproductive endocrine disorders often showed delayed ovulation with shortened luteal phase.

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.

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