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Table 5 Serum sex hormone and sex hormone-binding globulin (SHBG) concentrations in various studies

From: The relationship between epilepsy and sexual dysfunction: a review of the literature

AEDs

Sex (n)

SHBG

T

FT

DHEAS

DiT

FAI

E2

A

Comments

References

Carbamazepine, valproate

M (37)

↑

↓

↓

NA

NA

NA

NA

NA

Libido and fertility are low in epileptic patients

Dana-Haeri et al. (1982)

Carbamazepine, valproate, phenobarbital

M (72)

↑

↑

↓

↓

↑

↓

NA

NA

–

Toone et al. (1983)

Carbamazepine

M (06)

↑

↑

↓

↓

NA

NA

NA

NA

Induces changes in circulating androgen concentrations

Connell et al. (1984)

Phenytoin

M (20)

NA

↑

↓

NA

NA

NA

NA

NA

Reductions in free testosterone serum levels are associated with TLE in men

Herzog et al. (1986a)

Carbamazepine

F (23)

↑

≠

≠

↓

NA

↓

≠

NA

1 year prospective data

Isojärvi (1990)

Carbamazepine

M (21)

↑

≠

≠

NA

NA

↓

↓

NA

1 year prospective study

Isojärvi et al. (1991)

Carbamazepine

F (32)

↑

≠

NA

NA

NA

≠

↓

NA

Low estradiol/SHBG ratios associated with menstrual disorders

Isojarvi et al. (1995)

Carbamazepine, phenytoin, phenobarbital

M (37)

↑

≠

↓

↓

↓

NA

NA

NA

Decreased T/E2 ratio associated with hyposexuality

Murialdo et al. (1995)

carbamazepine

M (25)

↑

≠

NA

NA

NA

↓

NA

NA

High SHBG levels associated with diminished potency

Isojärvi et al. (1995)

Valproate, carbamazepine

F (65)

↓

↑

NA

↑

NA

NA

NA

≠

T concentration is more elevated in women initiating treatment at the age <20 years

Isojärvi et al. (1996)

Carbamazepine

F (23)

≠

↓

NA

↓

NA

≠

↓

NA

–

Murialdo et al. (1998)

Valproate

F (41)

≠

↑

NA

NA

NA

↑

≠

NA

Pre-pubertal, pubertal and Post-pubertal girls aged 8–18 year

Vainionpää et al. (1999)

Valproate

F (10)

↑

↑

NA

NA

NA

≠

≠

↑

3 month prospective study

Rättyä et al. (2001)

Carbamazepine, lamotrigine, valproate, oxcarbazepine

M (70)

≠

≠

NA

≠

↑

NA

NA

NA

AEDs induce changes in circulating androgen concentrations

Mikkonen et al. (2004)

Carbamazepine

F (25)

↑

↓

NA

≠

NA

↓

≠

≠

Low E2/SHBG ratio is not associated with menstrual disorders

Löfgren et al. (2006)

Valproate, leviteracetam

M/F (20)

≠

≠

NA

≠

NA

NA

≠

↑

–

Rauchenzauner et al. (2010)

Topiramate

M (36)

NA

↑

↓

↓

NA

NA

NA

↓

Hormonal changes are associated with sexual dysfunction

Urso et al. (2014)

Primidone

M/F (20)

↑

↓

NA

NA

NA

NA

↓

NA

Leads to infertility in epilepsy patients

Luef and Madersbacher (2015)

Lacosamide

M (10)

↓

↑

NA

NA

NA

↑

NA

NA

Cause deinduction of CYP enzymes

Elger et al. (2016)

  1. AEDs anti-epileptic drugs, M male, F female, T testosterone, DHEAS dehydroepiandrosterone, DiT dihydrotestosterone, FT free testosterone, FAI free androgen index (100 × T/SHBG), E2 estradiol, A androstenedione, TLE temporal lobe epilepsy, NA not available
  2. ≠, unchanged; ↑, increased; ↓, decreased