Epilepsy is a brain condition that affects around 3.4 million U.S. Americans. Epilepsy often causes repeated seizures from random disruptions in the brain. Often, this starts in childhood and progresses throughout adulthood, or it may start later in life from a brain injury or infections.
People with epilepsy may struggle with sexual health issues, which can contribute to a lower quality of life. Antiepileptic and anticonvulsant drugs can affect sex hormones (estrogen and testosterone), which could cause sexual dysfunction as a side effect.
Furthermore, men with epilepsy may experience erectile dysfunction (ED), anorgasmia (lack of orgasm with sexual activity), delayed ejaculation (when it takes too long to ejaculate), premature ejaculation (ejaculation happens too early), sexual pain, and low libido (sex drive).
Women with epilepsy may also experience anorgasmia in addition to vaginal dryness, dyspareunia (pain with penetrative sex), delayed orgasm, and low libido. Additionally, the medications that epileptics take may interfere with hormonal birth control options, which can lead to unwanted pregnancy.
Issues such as anorgasmia and problems with ejaculation might be due to psychological reasons. People with epilepsy may hesitate to fully “let go” during sex for fear of having a seizure. This might delay or stop orgasm, resulting in lower sexual satisfaction.
Low self-esteem, fatigue (extreme tiredness), and fear of seizing or peeing during sex may also lead to low libido. If a person doesn’t feel ready to have sex (is not aroused enough), this can sometimes lead to pain during sex, especially when there is not enough lubrication.
Options for Treatment
Because of the complicated interplay between hormones and epilepsy medications, doctors might try a multi-level approach that addresses the patient’s main concerns.
This may include trying different doses of anti-seizure drugs, or different doses of drugs related to sexual functioning like sildenafil, vaginal estrogen, and others. Doctors may also try medicines that specifically treat low libido, like flibanserin for women’s hypoactive sexual desire disorder.
Some non-drug-related options may be recommended as well. This could include vacuum erection devices, lubricants, sex therapy, pelvic floor muscle therapy (for sexual pain), and cognitive behavioral therapy.
Key Takeaways
- People with epilepsy have often managed the condition throughout their entire lives. Managing sexual dysfunction alongside it may become an issue that reduces quality of life in adulthood.
- Epilepsy medications may cause differences in sex hormone levels (estrogen and testosterone), which can cause erectile dysfunction and vaginal dryness.
- Epilepsy-related mental health concerns may cause issues with orgasm and ejaculation, often resulting from fears surrounding seizures and lack of bladder control (incontinence).
- Options for treating sexual dysfunction and epilepsy at the same time may involve medication changes, therapy, or sexual aids.
- If sexual dysfunction and epilepsy are distressing or preventing satisfactory sex, it may be beneficial to speak with a sexual health professional.
Resources
Atif, M., Sarwar, M. R., & Scahill, S. (2016). The relationship between epilepsy and sexual dysfunction: A review of the literature. SpringerPlus, 5(2070). https://doi.org/10.1186/s40064-016-3753-5
Bóné, B., & Janszky, J. (2006). Az epilepszia es a férfi nemi muködes zavara: okok, diagnózis es terápia [Epilepsy and male sexual dysfunction: etiology, diagnosis and therapy]. Ideggyogyaszati szemle, 59(5-6), 148–152.
Calabrò, R. S., Marino, S., & Bramanti, P. (2011). Sexual and reproductive dysfunction associated with antiepileptic drug use in men with epilepsy. Expert Review of Neurotherapeutics, 11(6), 887–895. https://doi.org/10.1586/ern.11.58
Paulsen, O., Rutkowski, A., Nguyen, K., Kohut-jackson, A., Banton, J., Primuth, H., & Rubin, R. (2023). (112) treatment options for female sexual dysfunction in patients with epilepsy: A systematic review. The Journal of Sexual Medicine, 20(Supplement_2). https://doi.org/10.1093/jsxmed/qdad061.108
Petersen, M., Kristensen, E., Giraldi, L., & Giraldi, A. (2020). Sexual dysfunction and mental health in patients with multiple sclerosis and epilepsy. BMC Neurology, 20(1). https://doi.org/10.1186/s12883-020-1625-7
Sathyanarayana Rao, T., Karan, V., Harsha, S., Keshava, B., Pradeep, R., & Andrade, C. (2015). Sexual dysfunction in women with epilepsy. Indian Journal of Psychiatry, 57(3), 301. https://doi.org/10.4103/0019-5545.166616
Talbot, J. A., Sheldrick, R., Caswell, H., & Duncan, S. (2008). Sexual function in men with epilepsy. Neurology, 70(16), 1346–1352. https://doi.org/10.1212/01.wnl.0000311242.51618.b7
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