Men's Issues and Epilepsy

Seizures and anti-seizure medication can also have effects on the general health both women and men.  There are some impacts though which are unique to men.

Causes and consequences of Epilepsy
• Certain causes of epilepsy are more common in men than in women.  For example, post-traumatic epilepsy, which is epilepsy caused by an injury to the brain, is more common in men because they are more likely to engage in potentially self-injurious activity than women
• Overall there is no difference between the sexes in the likelihood of successful treatment of epilepsy

Effects of epilepsy and seizure medication on men’s sexual health
• Both seizures and seizure medications can have negative effects on male reproductive hormones.  This can lead to higher rates of sexual dysfunction, decreased libido (sex drive), and fertility.  Older medications in particular, like phenobarbital, phenytoin, and carbamazepine, can lower the levels and availability of hormones like testosterone, which is important for male sexual health.  Valproate can also have negative effects on male reproductive hormones.

Sex
• Impotence
• The majority of men with epilepsy will be able have a healthy sex life.  Older seizure medications, because of their hormone affects described above, especially phenobarbital and primidone, may make it difficult to achieve an erection.  This side effect can be temporary if the individual is switched to another medication.  

Libido
• Men with epilepsy are more likely to have decreased libido (sexual desire).  A referral to an endocrinologist for testing and possible hormonal replacement therapy with testosterone may be helpful for this.  In addition, testosterone replacement may be helpful for mood in men with epilepsy
• Peyronie’s Disease
• Phenytoin and phenobarbital has been associated with a painful, curved erection (Peyronie’s Disease), but it is not definite that these medication cause this condition.

Fertility
• Although the majority of men with epilepsy are able to have children, fertility rates are slightly decreased.  Men with epilepsy are more likely to have lower sperm counts, abnormally shaped sperm, and sperm motility.  Men with epilepsy who are finding it difficult to have a child should consider seeing a fertility specialist.