Metabolic and Menstrual Disturbances by Antiepileptic Drugs in Women with Epilepsy

Women with epilepsy(WWE) are at risk for reproductive and metabolic disorders. This study was performed to investifate whether WWE are more likely to have menstual or metabolic abnormalities, and whether some antiepileptic drugs(AEDs) more likely provoke those problems.

WWW aged 15-50 years old, taking one or more AEDs for at least 6 months, were recruited. Subjucts checked their oral temperature each morning. Body mass index(BMI : kg/m²) and waist to hip (W/H) ratio were calculated as obesity markers. Hirsutism index, as a marker of polycystic ovary syndrome, was calculated by Ferriman-Gallwey score(hirsutism if score>8). Serum tests ofr gonadotrophins, steroid hormones, sex hormone binding globulins (SHBG), lipid profiles, insulin were performed on menstrual cycle days 3 to 5.

Among 54 patients, 18 women were diagnosed as primary generalized epilepsy(PGE) and the other 36 were localoization-related epilepsy(LRE). Also, 21 women(38.9%) were treated with carbamazepine(CBZ), 14 women(25.9%) with valproate(VPA), and 19(35.2%) with lamotrigine(LTG) or topiramate(TPM). Menstrual disturbance was found in 60.0% of PGE versus 30.6% of LRE patients(p=0.050), while 64.3% of VPA and 28.6% of CBZ-treated patients(p=0.036). The W/H ratio and BMI were higher in VPA, than in CBZ-treated patients(p=0.048 and 0.018). The total and HDL-cholesterols decreased in the VPA group compared to the CBZ group(p=0.025 and 0.009).

WWE are more likely to experience menstrual and metabolic alterations. WWE with VPA tend to have abdominal obesity and alterations in lipid metabolism.