Sexual Dysfunction and Associated Psychiatric Comorbidities Impacting Quality of Life in Epilepsy: A Review of Literature

Abstract

Introduction: Epilepsy is caused by dysfunction in the brain, which is characterized by an enduring disposition for unprovoked seizures that reoccur often, along with the neurological, cognitive, psychological, and social effects of the condition, which are often managed with prolonged and sometimes lifelong medications that involve antiepileptic drugs (AEDs). To confirm the diagnosis of epilepsy, at least two unprovoked seizures occurring greater than 24 hours apart should be reported. This illness affects both children and adults. Patients with epilepsy are more likely to experience sexual dysfunction compared to the general population, which often leads to a poor quality of life. The pathophysiology involved consists of the impact of epilepsy and AEDs on the control of the hypothalamic-pituitary-gonadal axis, consequently resulting in a high risk of developing testicular or ovarian dysfunction, leading to sexual dysfunction in epilepsy patients. Aim: This review aims to highlight various studies focusing on the association of developing the risk of sexual dysfunction with psychiatric comorbidities, mainly depression and anxiety, that impact the quality of life in epilepsy patients. Methodology: The search methodology involved articles from the Google Scholar and PubMed databases published between 2018 and 2023. "Sexual dysfunction", "epilepsy", "depression", "anxiety", and "quality of life" were the keywords used to search the articles. The Boolean operator "AND" and "OR" were used in between the keywords used. Following this, a total of 15 articles were included in the review based on the inclusion and exclusion criteria. Conclusion: The review concluded that epilepsy patients are often affected by sexual dysfunction along with associated psychiatric comorbidities that mainly involve depression and anxiety, consequently impacting their quality of life, as demonstrated by various studies. Sexual dysfunction is a common yet underdiagnosed condition in epilepsy patients due to the stigma attached to it. Hence, neurologists must keep a high index of suspicion for this problem. Furthermore, screening and monitoring for sexual dysfunction should be added to the usual epilepsy work-up.