Disorders of reproduction in patients with epilepsy [Reproduktionsstörungen bei Patienten mit Epilepsie]

Disorders of reproduction are unusually common among people with epilepsy. They are generally associated with and may be the consequence of reproductive endocrine disorders. Epilepsy itself and epileptic seizures have been implicated in their pathophysiology. This review focuses on how temporolimbic dysfunction in epilepsy might disrupt normal neuroendocrine regulation and promote the development of reproductive endocrine disorders. The particular nature of the dysregulation may relate to the laterality and focality of the epilepsy and some hormonal changes may develop in close temporal relation to the occurrence of epileptiform discharges. In women, reproductive endocrine disorders include polycystic ovary syndrome, hypothalamic amenorrhea, functional hyperprolactinemia, and premature menopause. In men, hypogonadism may be hypogonadotropic, hypergonadotropic or related to hyperprolactinemia. The significance of these reproductive endocrine disorders is that they may contribute not only to sexual dysfunction and infertility, but may also have an adverse impact on seizure control. This review also includes sections on special considerations in the treatment of reproductive endocrine disorders for women and men with epilepsy. © 2015, Springer-Verlag Berlin Heidelberg.