Effects of carbamazepine on male reproductive hormones

Reproductive endocrine disorders and sexual dysfunction are common among men with epilepsy. We investigated sexual hormone serum levels among men with newly diagnosed epilepsy, before starting any antiepileptic drug (AED), and then after starting carbamazepine (CBZ), to determine the role and effects of epilepsy versus CBZ in creating reproductive endocrine disorders. In this prospective study, male patients 20 to 40 years of age who due to new onset seizure(s) were referred to the outpatient epilepsy clinic at Shiraz University of Medical Sciences from 2009 through 2012 were studied. A blood sample was obtained to evaluate the serum levels of follicle stimulating hormone, luteinizing hormone, prolactin, testosterone, free-testosterone, dehydroepiandrosterone sulfate and sex hormone binding globulin. CBZ was started after blood works. After at least three months of taking CBZ, another blood sample was obtained to determine the serum levels of those hormones again. Twenty patients were included. Their mean age (± standard deviation) was 28 years (± 5). The statistical analysis with paired sample tests did not show any significant changes in serum levels of sex hormones before and after CBZ therapy. Despite the fact that, sexual dysfunction and reproductive disorders are common among men with epilepsy, the exact pathophysiology of these problems is not clear yet. Further studies are required to determine the exact role of epilepsy itself, AEDs, and other possible determinants.