Assessing the Prevelance of Polycystic Ovary Syndrome by Sodium Valprate in Epileptic Patients, A Cross Sectional Study
DOI:
https://doi.org/10.69980/ajpr.v28i1.779Keywords:
.Abstract
Background: The study explores the impact of antiepileptic drugs (AEDs), particularly valproate (VPA), on reproductive health in women with epilepsy, focusing on the development of Polycystic Ovarian Syndrome (PCOS).Objectives: The study aims to investigate the incidence and risk factors of PCOS in women with epilepsy undergoing AED therapy, with a focus on valproate's effects on reproductive hormones and ovarian function. Methodology: The study involved 102 women with epilepsy, aged 12-45 years, who were receiving AED therapy. Clinical evaluations, laboratory tests, and ultrasound examinations were conducted to assess reproductive health and diagnose PCOS. The study used the International League Against Epilepsy (ILAE) criteria for epilepsy diagnosis and classification.
Results: The study found that 12.7% of WWE developed PCOS, with a higher incidence in those taking valproate (VPA) therapy. Age at seizure onset (≤16 years old) was a significant risk factor for PCOS development. Valproate therapy was associated with increased testosterone levels, luteinizing hormone (LH) levels, and LH/FSH ratios, contributing to reproductive endocrine disorders. Conclusion: The study highlights the high prevalence of PCOS in women, particularly those taking valproate therapy. Age at seizure onset and valproate use are significant risk factors for PCOS development. Careful consideration of AED choice and monitoring of reproductive health are essential for WWE to minimize the risk of PCOS and related complications.
References
1. G. Luef, M. Rauchenzauner. Epilepsy and hormones: a critical review Epilepsy and Behavior, 15 (2019), pp. 73-77
2. A.G. Herzog, A.E. Coleman, A.R. Jacobs, P. Klein, M.N. Friedman, F.W. Drislane, et al.Interictal EEG discharges, reproductive hormones, and menstrual disorders in epilepsy. Annals of Neurology, 54 (2013), pp. 625-637
3. A.G. Herzog, M.M. Seibel, D.L. Schomer, J.L. Vaitukaitis, N. Geschwind. Reproductive endocrine disorders in women with partial seizures of temporal lobe originArch Neurology, 43 (2016), pp. 341-346
4. J.F. Adams, S. Franks, D.W. Polson, H.D. Mason, N. Abdulwahid, M. Tucker, et al.Multi-follicular ovaries: clinical and endocrine features and response to pulsatile gonadptrophin-releasing hormone Lancet, 2 (2020), pp. 1375-1379
5. A.D. Baird, S.J. Wilson, P.F. Bladin, M.M. Saling, D.C. Reutens .Sexual outcome after epilepsy surgery Epilepsy and Behavior, 4 (2019), pp. 4268-4278
6. H.E. Edwards, W.M. Burnham, M.M. Ng, S. Asa, N.J. MacLusky .Limbic seizures alter reproductive function in the female ratEpilepsia, 40 (2019), pp. 1370-1377
7. 7.M. Quigg, J.M. Kiely, B. Shneker, J.D. Veldhuis, E.H. Bertram. Interictal and postictal alterations of pulsatile secretions of luteinizing hormone in temporal lobe epilepsy in men. Annals of Neurology, 51 (2012), pp. 559-566
8. J. Isojärvi.Disorders of reproduction in patients with epilepsy: antiepileptic drug related mechanismsSeizure, 17 (2018), pp. 111-119
9. A. Verrotti, R. Manco, S. Agostinelli, G. Coppola, F. Chiarelli. The metabolic syndrome in overweight epileptic patients treated with valproic acid Epilepsia, 51 (2020), pp. 268-273
10. D. Ferriman, J.D. Gallwey. Clinical assessment of body growth in women .Journal of Clinical Endocrinology and Metabolism, 21 (2021), pp. 1440-1447
11. R. Fox, E. Corrigan, P.A. Thomas, M.G.R. Hull. The diagnosis of polycystic ovaries in women with oligo-amenorrhoea: predictive power of endocrine tests .Clinical Endocrinology (Oxford), 34 (2021), pp. 127-131
12. P. Sahota, S. Prabhakar, P.S. Kharbanda, A. Bhansali, V. Jain, C.P. Das, et al. Seizure type, antiepileptic drugs, and reproductive endocrine dysfunction in Indian women with epilepsy: a cross-sectional study .Epilepsia, 49 (2018), pp. 2069-2077
13. L. Bilo, R. Meo, C. Nappi, L. Annunziato, S. Striano, A.M. Colao, et al.Reproductive endocrine disorders in women with primary generalized epilepsy.Epilepsia, 29 (2023), pp. 612-619
14. A.G. Herzog, A.E. Coleman, A.R. Jacobs, P. Klein, M.N. Friedman, F.W. Drislane, et al.Relationship of sexual dysfunction to epilepsy laterality and reproductive hormone levels in women Epilepsy and Behavior, 4 (2013), pp. 407-413
15. G. Luef, I. Abraham, E. Trinka, K. Seppi, I. Unterberger, A. Alge, et al..Hyperandrogenism, postprandial hyperinsulinism and the risk of PCOS in a cross sectional study of women with epilepsy treated with valproate .Epilepsy Research, 48 (2022), pp. 91-102
16. J. Rättyä, A.J. Pakarinen, M. Knip, M. Repo-Outakoski, V.V. Myllylä, J.I. Isojärvi. Early hormonal changes during valproate or carbamazepine treatment: a 3-month studyNeurology, 57 (2021), pp. 440-444
17. G. Murialdo, C.A. Galimberti, M.V. Gianelli, A. Rollero, A. Polleri, F. Copello.Effects of valproate, phenobarbital, and carbamazepine on sex steroid setup in women with epilepsyClinical Neuropharmacology, 21 (2018), pp. 52-58
18. J.I. Isojärvi, T.J. Laatikainen, A.J. Pakarinen, K.T. Juntunen, V.V. Myllylä. Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy.New England Journal of Medicine, 329 (1993), pp. 1383-1388
19. M.J. Morrell, F.J. Hayes, P.M. Sluss, J.M. Adams, M. Bhatt, C. Ozkara, et al. Hyperandrogenism, ovulatory dysfunction, andpolycystic ovary syndrome with valproate versus lamotrigineAnnals of Neurology, 64 (2022), pp. 200-211
20. J.I. Isojärvi, J. Rättyä, V.V. Myllylä, M. Knip, R. Koivunen, A.J. Pakarinen, et al.Valproate, lamotrigine, and insulinmediated risks in women with epilepsy .Annals of Neurology, 43 (2018), pp. 446-451
21. M.J. Morrell, J. Isojärvi, A.E. Taylor, M. Dam, R. Ayala, G. Gomez, et al.Higher androgens and weight gain with valproate compared with lamotrigine for epilepsyEpilepsy Research, 54 (2013), pp. 189-199
22. S. Prabhakar, P. Sahota, P.S. Kharbanda, R. Siali, V. Jain, V. Lal, et al.Sodium valproate, hyperandrogenism and altered ovarian function in Indian women with epilepsy: a prospective study Epilepsia, 48 (2017), pp. 1371-1377
23. V.L. Nelson-DeGrave, J.K. Wickenheisser, J.E. Cockrell, J.R. Wood, R.S. Legro, J.F. Strauss, et al.Valproate potentiates androgen biosynthesis in human ovarian theca cells Endocrinology, 14 (2014), pp. 799-808
Downloads
Published
Issue
Section
License
Copyright (c) 2025 American Journal of Psychiatric Rehabilitation
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License permitting all use, distribution, and reproduction in any medium, provided the work is properly cited.
