Abstracts

To examine what role testosterone plays in sexual function in men with epilepsy. 60 men with epilepsy treated with monotherapy aged between 18 and 60 years were recruited. Men with seizures secondary to structural lesions were excluded.A control group of 60 men all of whom lived in the same postal code area of the study group were recruited.
Each man completed the Hospital Anxiety and Depression Scale(HADS) the World Health Organisation Brief Quality of Life Questionnaire UK (WHOQOL-BREF UK). And three validated sexual function questionnaires.
1. Sexual Desire Inventory(SDI) to assess desire for sex..
2 The Sexual Self Efficacy Scale(SSES) to assess each man[apos]s beliefs about his sexual and erectile competence in sexual situations
3.Five questions from the Pion Sexual Response Inventory asking about spontaneous morning erections, arousal during self stimulation, sexual dreams and arousal during sexual intercourse.
40mls of blood was taken for testosterone, SHBG, albumin, androstendione, DHEAS, estradiol, LH and FSH and AED levels There was no significant difference in age between the groups. Men with epilepsy were significantly more anxious and depressed . There was no significant difference in overall quality of life scores between the groups.Men with epilepsy rated their physical health and social relationships as significantly less satisfactory than controls(WHOQOL-BREF domains 1 and 3).
There was no significant differences in SDI or Pion scores. Men with epilepsy had significantly lower SSES scores suggesting that although they desired sex and had no difficulties with arousal they rated themselfs less sexually competant than controls.
There was no significant differences between in total testosterone(TT) levels. Free testosterone(FT) and biologically active testosterone(BAT) were calculated using the ISSAM formula for actual albumin. There were no significant differences Non parametric linear regression failed to show any correlation between BAT, FT and the SDI,SSES, and Pion scores. Studies of sexual function in epilepsy tend to concentrate on endocrinological explanations ignoring the psychosocial impact of epilepsy. Previous studies have made much of the finding that in some men with epilepsy testosterone is lower than in controls despite the fact there is a wide [quot]normal[quot] range of testosterone and providing an individual is within this, testostereone levels do not correlate with sexual function. In this study we have shown men with epilepsy rate their social relationships as less good than controls and although apparantly desiring sexual activity consider themselves less sexually competant than controls.As both FT and BAT are within normal range and do not differ from controls we conclude the difference between the groups is explained by the adverse social and emotional effects of epilepsy.