Sex hormones and pituitary function in male epileptic patients with altered or normal sexuality

G. Murialdo, C. A. Galimberti, S. Fonzi, R. Manni, P. Costelli, C. Parodi, G. P. Solinas, G. Amoretti, A. Tartara

Research output: Contribution to journalArticle

Abstract

Male epileptic patients frequently complain of sexual dysfunction, particularly impotence and loss of libido. Epilepsy itself, antiepileptic drugs (AEDs), and psychosocial factors are believed to contribute to impaired sexuality. We studied luteinizing hormone (LH) pulsatile secretion, gonadotropin, and prolactin (PRL) responses to LH-releasing hormone (LHRH) and thyrotropin-releasing hormone (TRH) in 37 adult male epileptic patients receiving AED monotherapy who were seizure-free and had normal EEGs. Sexuality was assessed by psychological interview. Impotence was diagnosed in 8 patients (in 2 combined with loss of sexual desire). The occurrence of hyposexuality (~20%) was independent of epilepsy syndrome or AED. No change in total testosterone (T) level was observed. Free T (fT) and dihydrotestosterone (DHT) levels were lower and sex hormone binding globulin (SHBG) levels were higher in epileptic subjects than in healthy controls, but a statistically significant difference was not observed between hypo- and normosexual patients. In impotent epileptic patients, estradiol (E2) levels were significantly increased as compared with those of patients with preserved sexuality and of healthy controls. The unbalanced relation between androgen and E2 levels was emphasized by decreased T/E2, fT/E2, and DHT/E2 ratios obtained in hyposexual epileptic patients. In this group, LHRH induced blunted LH peaks. No changes were noted in LH pulsatility features. These findings of higher E2 levels and of decreased LH response to LHRH administration in some epileptic patients with impaired sexuality, may suggest they have subclinical hypogonadotropic hypogonadism.

Original languageEnglish
Pages (from-to)360-365
Number of pages6
JournalEpilepsia
Volume36
Issue number4
DOIs
Publication statusPublished - 1995

Fingerprint

Gonadal Steroid Hormones
Sexuality
Luteinizing Hormone
Gonadotropin-Releasing Hormone
Anticonvulsants
Dihydrotestosterone
Erectile Dysfunction
Epilepsy
Psychological Interviews
Libido
Sex Hormone-Binding Globulin
Thyrotropin-Releasing Hormone
Hypogonadism
Gonadotropins
Prolactin
Androgens
Testosterone
Electroencephalography
Estradiol
Healthy Volunteers

Keywords

  • Anticonvulsants
  • Epilepsy
  • Free testosterone
  • Gonadotropins
  • Luteinizing hormone pulsatility
  • Male sexuality
  • Prolactin
  • Sex steroids
  • Sexual function

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Sex hormones and pituitary function in male epileptic patients with altered or normal sexuality. / Murialdo, G.; Galimberti, C. A.; Fonzi, S.; Manni, R.; Costelli, P.; Parodi, C.; Solinas, G. P.; Amoretti, G.; Tartara, A.

In: Epilepsia, Vol. 36, No. 4, 1995, p. 360-365.

Research output: Contribution to journalArticle

Murialdo, G, Galimberti, CA, Fonzi, S, Manni, R, Costelli, P, Parodi, C, Solinas, GP, Amoretti, G & Tartara, A 1995, 'Sex hormones and pituitary function in male epileptic patients with altered or normal sexuality', Epilepsia, vol. 36, no. 4, pp. 360-365. https://doi.org/10.1111/j.1528-1157.1995.tb01010.x
Murialdo, G. ; Galimberti, C. A. ; Fonzi, S. ; Manni, R. ; Costelli, P. ; Parodi, C. ; Solinas, G. P. ; Amoretti, G. ; Tartara, A. / Sex hormones and pituitary function in male epileptic patients with altered or normal sexuality. In: Epilepsia. 1995 ; Vol. 36, No. 4. pp. 360-365.
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abstract = "Male epileptic patients frequently complain of sexual dysfunction, particularly impotence and loss of libido. Epilepsy itself, antiepileptic drugs (AEDs), and psychosocial factors are believed to contribute to impaired sexuality. We studied luteinizing hormone (LH) pulsatile secretion, gonadotropin, and prolactin (PRL) responses to LH-releasing hormone (LHRH) and thyrotropin-releasing hormone (TRH) in 37 adult male epileptic patients receiving AED monotherapy who were seizure-free and had normal EEGs. Sexuality was assessed by psychological interview. Impotence was diagnosed in 8 patients (in 2 combined with loss of sexual desire). The occurrence of hyposexuality (~20{\%}) was independent of epilepsy syndrome or AED. No change in total testosterone (T) level was observed. Free T (fT) and dihydrotestosterone (DHT) levels were lower and sex hormone binding globulin (SHBG) levels were higher in epileptic subjects than in healthy controls, but a statistically significant difference was not observed between hypo- and normosexual patients. In impotent epileptic patients, estradiol (E2) levels were significantly increased as compared with those of patients with preserved sexuality and of healthy controls. The unbalanced relation between androgen and E2 levels was emphasized by decreased T/E2, fT/E2, and DHT/E2 ratios obtained in hyposexual epileptic patients. In this group, LHRH induced blunted LH peaks. No changes were noted in LH pulsatility features. These findings of higher E2 levels and of decreased LH response to LHRH administration in some epileptic patients with impaired sexuality, may suggest they have subclinical hypogonadotropic hypogonadism.",
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AU - Costelli, P.

AU - Parodi, C.

AU - Solinas, G. P.

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