Epilepsy syndrome, focus location, and treatment choice affect testicular function in men with epilepsy

Neurology. 2004 Jan 27;62(2):243-6. doi: 10.1212/01.wnl.0000091866.48962.79.


Objective: To evaluate testicular function in men with epilepsy treated with different antiepileptic drugs (AED) vs no drugs.

Methods: Two hundred men with epilepsy (mean age 36 years) were investigated. Inclusion criteria included one or no AED, no co-medication, and no endocrine co-morbidity. Findings were compared with those from 105 healthy men (mean age 33.9 years). Luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), free testosterone (free T), and inhibin B were measured.

Results: One hundred seventy-eight men had focal epilepsy (117 of these had temporal lobe epilepsy [TLE]) and 22 idiopathic generalized epilepsy (IGE). Thirty-three men were not on AED; 124 men received enzyme-inducing AED. Free T was lowered in all patient subgroups, and the T/LH ratio was lowered in all groups except patients with IGE and patients receiving valproate (VPA). T was lower in patients with temporal than extratemporal focal epilepsy. Compared with TLE patients on carbamazepine (CBZ), patients treated with VPA had higher total T and lower LH values, resulting in a significantly lower T/LH ratio with CBZ.

Conclusions: Epilepsy, especially TLE, adversely affects testicular endocrine function. CBZ may increase the negative effects of epilepsy on serum levels of reproductive hormones.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use
  • Carbamazepine / adverse effects
  • Carbamazepine / therapeutic use
  • Epilepsies, Partial / blood
  • Epilepsies, Partial / drug therapy
  • Epilepsies, Partial / physiopathology
  • Epilepsy / blood
  • Epilepsy / drug therapy
  • Epilepsy / physiopathology*
  • Epilepsy, Generalized / blood
  • Epilepsy, Generalized / drug therapy
  • Epilepsy, Generalized / physiopathology
  • Epilepsy, Temporal Lobe / blood
  • Epilepsy, Temporal Lobe / drug therapy
  • Epilepsy, Temporal Lobe / physiopathology
  • Follicle Stimulating Hormone / blood
  • Humans
  • Hypogonadism / blood
  • Hypogonadism / chemically induced
  • Hypogonadism / etiology
  • Hypogonadism / physiopathology*
  • Inhibins / blood
  • Luteinizing Hormone / blood
  • Male
  • Testis / drug effects
  • Testis / physiopathology*
  • Testosterone / blood
  • Testosterone / deficiency
  • Valproic Acid / adverse effects
  • Valproic Acid / therapeutic use


  • Anticonvulsants
  • inhibin B
  • Carbamazepine
  • Testosterone
  • Inhibins
  • Valproic Acid
  • Luteinizing Hormone
  • Follicle Stimulating Hormone