Objectives:

We evaluated the polycystic ovarian syndrome (PCOS) in female epileptic patients within reproductive age; the role of epilepsy in pathogenesis of PCOS; the relation between antiepileptic drugs (AED) and PCOS.

Patients and Methods:

79 female epileptic patients (mean age 23.4; range 16 to 32 years) receiving valproate (VPA) monotherapy (n=28), carbamazepine (CBZ) monotherapy (n=30) and no antiepileptic medication (n= 21) were clinically examined; their hormones were measured and had transabdominal ultrasonography. The results were compared with those of 30 healthy age-matched controls (mean age 25.3; range 21 to 37 years).

Results:

PCOS were found in 22.7% of 79 epileptic female patients. Statistically significant difference in PCOS was determined in the group with cryptogenic partial epilepsy (p=0.02), but not in the group of idiopathic generalized epilepsy (p=0.19). Patients with CBZ monotherapy had significantly higher PCOS than the control group (26.7% p=0.038), but there was no significant difference in the group receiving VPA (25% p=0.075) and in the group receiving no antiepileptic medication (14.3% p=0.637). PCOS in the patients groups did not show any significant relationship with the age of menarche, initiation of epilepsy pre-menarche, the duration of epilepsy, the duration of drug treatment, seizures during menstrual period, the frequency of seizures and weight gain. However, increase in total testosterone level was statistically significant in the group with VPA monotherapy.

Conclusion:

Our findings corroborate the concept that increased possibility of PCOS in female epileptic patients within reproductive age and hormonal changes as a result of AED.

Keywords: Anticonvulsants/adverse effects, epilepsy/drug therapy, female, gonadal steroid hormones, polycystic ovary syndrome, reproduction/drug effects