The Relationship Between Epilepsy, Antiseizure Medication, and Sex Hormones

Both epilepsy itself and ASMs affect the levels of sex hormones in female patients. These steroid hormones not only affect the reproductive system, fertility, and sexual function of patients, but also have different effects on energy, desire, and mood. Among them, estradiol (E2) can result in people having lots of energy and have anti-depressant effects, but too high levels of E2 can lead to anxiety, irritability, and mood swings. Progesterone (Progediol, P) has good anti-anxiety effects, but excessive P may cause excessive sedation and depression. Testosterone (T) is also energy-inducing and stimulates fight mode and libido, but high levels of T in the body can lead to impulsive aggression. These hormones are very sensitive to the influence of the limbic system and to the regulation of liver enzyme inducers and inhibitors; their role in epileptic comorbidities such as depression, anxiety, and even interparoxysmal limbic personality will be of interest in future studies. The limbic system is extensively connected to the hypothalamus and is involved in the regulation of sexual, reproductive, and gonadal function. Interference with limbic system activity in the temporal region by epileptiform discharges may lead to chronic alterations in the release of sex steroid hormones, including gonadotrophin-releasing hormone (GnRH), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and the concentration and metabolism of their end products such as E2, T, and dehydroepiandrosterone sulfate (DHEAS).