Antiepileptic Drug Effects on Reproductive Health
Summary
Epilepsy and its pharmacological management are known to intersect significantly with reproductive health across both sexes. Antiepileptic drugs (AEDs) can alter sex steroid hormone levels, influence menstrual regularity in women, and impact sperm parameters in men. Valproate, in particular, has been associated with an elevated risk of polycystic ovary syndrome (PCOS) in women, while enzyme-inducing AEDs may accelerate the metabolism of hormonal contraceptives, reducing their efficacy. In men, certain AEDs have been linked to diminished sperm motility, altered follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, and increased sexual dysfunction. Mechanistic studies point towards disruptions of the hypothalamic–pituitary–ovarian (HPO) axis, oxidative stress pathways and direct gonadal toxicity as key mediators of these effects. Understanding the balance between seizure control and reproductive wellbeing is essential for personalised therapy, with emerging evidence guiding the selection of newer, less hormonally disruptive agents. Clinicians are advised to monitor reproductive parameters, provide targeted counselling on fertility preservation, and adjust antiepileptic regimens to mitigate long-term reproductive risks.
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Antiepileptic Drug Effects on Reproductive Health publication trend
The graph below shows the total number of articles in antiepileptic drug effects on reproductive health across all publications each year (not limited to Nature Index journals).
Technical terms
Antiepileptic drug (AED): A medication used to prevent or reduce the frequency of epileptic seizures.
Hypothalamic–pituitary–ovarian (HPO) axis: The hormonal signalling network that regulates female reproductive function.
Polycystic ovary syndrome (PCOS): An endocrine disorder characterised by ovarian cysts, hyperandrogenism and menstrual irregularity.
Follicle-stimulating hormone (FSH): A pituitary hormone that promotes ovarian follicle maturation and spermatogenesis.
Luteinizing hormone (LH): A pituitary hormone that triggers ovulation in women and testosterone production in men.
Sperm motility: The ability of sperm to move actively and efficiently, an indicator of male fertility.
Sex steroid hormones: Hormones such as oestrogen, progesterone and testosterone that govern sexual development and reproductive function.
References
- Research Progress on the Effect of Epilepsy and Antiseizure Medications on PCOS Through HPO Axis. Frontiers in Endocrinology (2021).
- A Comparative Study of the Effects of Valproate and Oxcarbazepine on Sexual Function, Sperm Quality, and Sex Hormones in Males with Epilepsy. BioMed Research International (2021).
- Comparison of the probability of four anticonvulsant mood stabilizers to facilitate polycystic ovary syndrome in women with epilepsies or bipolar disorder—A systematic review and meta-analysis. Frontiers in Psychiatry (2023).
- Characteristics of menstrual disorders and reproductive hormones in women with epilepsy at an Indonesian national referral hospital. Frontiers in Neurology (2022).
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