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Seizure type, antiepileptic drugs, and reproductive endocrine dysfunction in Indian women with epilepsy: A cross‐sectional study
Author(s) -
Sahota Preeti,
Prabhakar Sudesh,
Kharbanda Parampreet S.,
Bhansali Anil,
Jain Vanita,
Das Chandi Prasad,
Modi Manish
Publication year - 2008
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2008.01676.x
Subject(s) - carbamazepine , medicine , hirsutism , phenytoin , polycystic ovary , endocrine system , epilepsy , amenorrhea , gynecology , obesity , hormone , pregnancy , insulin resistance , psychiatry , biology , genetics
Summary Background: There is paucity of data regarding occurrence of reproductive endocrine disorders in Asian women with epilepsy (WWE) on antiepileptic drug (AED) therapy. Purpose: To determine the occurrence of reproductive endocrine disorders in Indian WWE, by seizure type and the AED use. Methods: Consecutive 427 reproductive age WWE receiving various AEDs were screened for the occurrence of menstrual abnormalities, weight change, and hirsutism. Of these, 53 WWE with menstrual disturbances and/or hirsutism were further evaluated for ovarian morphology and reproductive hormonal profile. Results: Menstrual abnormalities and/or hirsutism were observed in 83 of 427 (19.4%) WWE irrespective of epileptic seizure type; of these, 50 (60.2%) received valproate, 21 (25.3%) received carbamazepine, 11 (13.3%) received phenytoin, and one (1.2%) received phenobarbitone as the primary AED. Almost half of valproate‐treated women had significant weight gain and obesity. Among 53 of 83 women evaluated further, 23.5% and 63.6% of valproate‐treated women, 25% and 58.3% of carbamazepine‐treated women, and none and 20% of phenytoin‐treated women had polycystic ovaries (PCO) and hyperandrogenemia (HA), respectively. Valproate‐treated women had significantly higher frequency of polycystic ovarian syndrome (PCOS) (11.8% vs. 2.5%, p < 0.0001) and mean serum testrosterone levels (1.78 vs. 1.36 ng/ml, p = 0.03), compared with women treated with other AEDs. Limitations: Limitations include small number of women in antiepileptic subgroups and a high drop out rate in women who underwent ultrasound and endocrinological investigations. Conclusion: Menstrual abnormalities, weight gain, obesity, and PCOS are frequent and significantly higher in WWE receiving valproate, independent of seizure type.