Abstracts

RATIONALE: To determine the effests of antiepileptic drugs(AEDs) on total and calculated free estradiol levels, and sexual function in men with epilepsy. METHODS:183 consecative men attending a teaching hospital epilepsy clinic were asked to complete the Vennix and Frenken Sexuality Experience Scales (SES),at the same time blood was sampled for total testosterone, sex hormone binding globulin(SHBG), and estradiol. The men were euglycaemic with normal thyroid function. No changes had been made to AED therapy in the preceeding three months. 33 men acted as controls, 32 suffered from epilepsy but were not taking AEDs,18 took valproic acid(VPA),31 carbamazepine (CBZ),21 phenytoin (PHT)and 48 took more than one AED. RESULTS:SHBG levels were significantly raised in the groups receiving enzyme inducing drugs compared with the controls, untreated and VPA groups. Total testosterone was significantly raised in the PHT group compared with the other monotherapy groups, the controls and untreated. There was no significant difference in calculated free testosterone across the groups. There were no significant differences between the groups in total estradiol and calculated free estradiol levels.There was no correlation between total and free estradiol levels and stated preferred frequency of intercourse, enjoyment of intercourse, ability to achieve orgasm, or openness to sexual arousal CONCLUSIONS: In this the largest study of estradiol levels in men taking AEDs we have failed to demonstrate any correlation between levels of this hormone and sexual function. The role of estradiol in the human male sexual response has not been fully explored. One study in a group of male volunteers demonstrated that estradiol does not play a role in stimulating sexual activity as it appears to do in the males of other species. There is no evidence to suggest that raised levels in normal men diminish sexual interest. Further studies are required to elucidate the link, if any between, AED therapy and male reproductive function.