Comparing the frequency of polycystic ovary syndrome in women with and without epilepsy

Abstract

Introduction:Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders; the impact of epilepsy and antiepileptic drugs influences the function of hypothalamic–pituitary–gonadal axis and dysfunction of the endocrine system and reproductive hormones in women with epilepsy. This study was carried out with an aim of determining and comparing the frequency and intensity of the complications of the hirsutism in women with and without epilepsy in Tehran in 2016–2017.Materials and Methods:This is a cross-sectional-comparative study which was carried out on 338 women of 18–35-year-old women with and without epilepsy who were selected by continuous sampling method. Data were collected and analyzed by Chi-square statistical test. The quantity of P was considered to be 0.05 as the level of significance.Results:The results of this study indicated that there was a statistically significant difference between the two groups with and without epilepsy in terms of the frequency of some of the clinical symptoms of the PCOS and affected by it. The results of this study showed that a higher percentage of women with epilepsy were affected PCOS. In the group of epileptic patients, some of the clinical symptoms of PCOS such as hirsutism, acanthosis nigricans, disordered menstruation, and amenorrhea were higher which as a result led to an increase in the frequency of PCOS.Conclusion:As a result, epilepsy can lead to an increase in the frequency of PCOS and some other clinical symptoms.

Research Progress on the Effect of Epilepsy and Antiseizure Medications on PCOS Through HPO Axis

“…That a certain connection may exist between epilepsy and PCOS was first proposed in 1984 (12). Recently, in a clinical study, WWE were more inclined (52.3%) to develop PCOS than women without epilepsy (18.3%) (10). In addition, a few other studies pertaining to reproductive endocrine disorders in patients with epilepsy have also confirmed that epilepsy could increase the hazards of reproductive endocrine disorders in WWE (16,38,39).…”

“…PCOS is a prominent reproductive endocrine disorder in women of childbearing age (7,10,18), affecting 6%-10% (19,20), and is related to genetic factors, environmental factors, and some other causes, such as the use of ASMs, epilepsy, and obesity; it is thus a multifactorial disease (18,21,22). This syndrome can cause HA, PCO, ovulation disorders (ODs), elevated levels of luteinizing hormone (LH), and an imbalance in the ratio of luteinizing hormone to follicle stimulating hormone (LH/FSH); some patients also have metabolic changes such as IR/ hyperinsulinemia, obesity, and dyslipidemia.…”

“…Epilepsy is a chronic and recurrent disease caused by the highly synchronized abnormal discharge of brain neurons, especially those closely related to the limbic system, such as the hippocampus and amygdala. Reproductive endocrine abnormalities are common in female patients with epilepsy, including hyperandrogenemia, ODs, PCO morphology, PCOS, and menstrual disorders (10,12,16). The brain mainly regulates and controls the HPO system and affects the release of hormones at all levels of the hypothalamus-pituitary-gonad axis through nerves and the neuroendocrine system (22).…”

“…The prevalence of PCOS varies in different studies due to the different diagnostic criteria and to ethnic differences, ranging from 8% to 13% in the general population (7), but the incidence in patients with epilepsy is approximately 3.1%-20% (8) and is sometimes as high as 26% (9). PCOS is found in approximately 10%-25% of women with epilepsy (WWE) (10) and causes infertility in those who are at the reproductive stage (11). The main clinical features include hyperandrogenemia (HA), chronic anovulation, polycystic ovary (PCO), insulin resistance (IR)/ hyperinsulinemia, obesity, dyslipidemia, and other metabolic changes.…”

“…The main clinical features include hyperandrogenemia (HA), chronic anovulation, polycystic ovary (PCO), insulin resistance (IR)/ hyperinsulinemia, obesity, dyslipidemia, and other metabolic changes. Some scholars believe that the reason women suffer from both PCOS and epilepsy is related to epilepsy (12), and some scholars believe that it at least, in part, results from the effects of anti-seizure medications (ASMs), especially valproate (VPA) (13,14); hence, most scholars believe that the emergence of PCOS in patients with epilepsy is not only related to epilepsy but also to ASMs (10,15,16), as they could affect reproductive health and secretion abnormalities through the hypothalamic-pituitary-ovarian (HPO) axis. The occurrence of epilepsy and the pharmacological action of the anti-epileptic drug VPA can target some substrates and affect hormone levels, causing disorders of the reproductive endocrine and metabolic systems, including the limbic system, liver, hypothalamus, pituitary, ovary, and adipose tissue (17).…”