How the steroid hormones cause reproductive endocrine disorders in women with epilepsy?

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Zahir Hussain

Thank you Dr Zabrodskii for following and recommending my question!

Tatiyana Vaikhanskaya

Reproductive dysfunction has been reported in women with epilepsy in the absence of use of anti-epileptic drugs (AEDs) even. Thus, estrogen has been demonstrated to have proconvulsant effects via both a short latency, short-acting membrane effect and a long latency genomic effect. Conversely, progesterone has been demonstrated to have an inhibitory effect via enhancement of GABA channel function. Gonadotrophicreleasing hormone (GnRH) is released by the hypothalamus in a pulsatile manner which stimulates the release of the gonadotropins, follicle stimulating hormone (FSH) and luteinizing hormone (LH) by the pituitary gland. Epilepsy can be an endocrine disruptor and alter the levels of GnRH, LH, FSH, and prolactin with downstream effect on levels of estrogen, progesterone and testosterone in women with epilepsy (WWE).This effect is thought to result from significant connectivity of the hypothalamic pituitary axis with the limbic system. Generalized seizures and/or interictal discharges disrupt the pulsatile secretion of GnRH resulting in increases in LH and FSH in WWE. WWE have been found to have high levels of LH and altered LH to FSH ratio and elevated prolactin levels.These hormonal changes can lead to irregular menses, anovulatory cycles and premature menopause.

Certainly more research is needed into the complex interactions between epilepsy and reproductive function. Specific patients may have enhanced vulnerability to certain disorders of reproductive function based on the specific epilepsy type, the combination of AEDs used to treat her epilepsy, seizure frequency, and personal hormonal milieu.

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