Epilepsy Talk

Sex and Epilepsy — The Ultimate Challenge | May 8, 2017

It’s the $64,000 question.

Can I have sex with epilepsy, all the AEDs, and side-effects?

The answer is yes.

If you’re willing to be flexible.

According to the EFA: “We do not yet fully understand all the complex causes for sexual problems, especially how they may be related to epilepsy.” (Cop out!)

It’s not unusual for people to have problems with sexual performance at times, and people with epilepsy are no exception.

Sexual dysfunction can be a complex disorder with medical, psychological, and life circumstances all playing a part.

The fact is, up to 43% of all women (nearly a half) and 31% of men (nearly a third) from the general population experience some difficulty maintaining a satisfactory sex life.

So if you or your partner are among them, you’re far from alone.

On the other hand, epilepsy can have effects on sex, and sex has effects on epilepsy.

It can interfere with a person’s self-confidence, body image, and mood, all of which are important when relating with others.

These can be due to the epilepsy itself, the medications used to treat the illness, or due to reactions of partners and others to the diagnosis of epilepsy.

Hormones also play an important role in sexual function and some people with epilepsy have alterations in normal hormone levels.

That may be due to anti-seizure medication-related altered testosterone metabolism and abnormal secretions due to epileptic physiology in the brain.

You may need referral to an endocrinologist to sort out the complex interactions between hormones, seizures, and medications.

Because liver metabolism of sex hormones such as testosterone or estrogen may give an impact upon diminished interest in sex.

But, needless to say, any of the antiepileptic drugs (AEDs) can cause sexual difficulties.

These drugs include:

Carbamazepine (Tegretol, Carbatrol)

Phenobarbital

Phenytoin (Dilantin)

Primidone (Mysoline)

Valproic Acid (Depakote, Depakene)

Barbiturates

However, the reaction to one medication doesn’t mean you’ll have the same experience with another.

Talk with your doctor about trying another anticonvulsant med for your seizures if you suspect this is a part of your sexual problem.

While it is not necessarily something that can be fixed instantly, it is certainly possible that some of the newer antiepileptic medications might be more helpful or that some of the newer medications available for rectifying sexual dysfunction might be of help.

Finding the right balance of seizure control and side-effect reduction is a challenge.

And stopping drugs due to frustrating side-effects might feel like a good solution in the short-term, but doesn’t help reduce seizures and can be dangerous.

And in the long run it won’t help the effects of sexual responsiveness, desire, and arousal.

For men, the main problem is erection problems. For women, lubrication problems as well as orgasmic difficulties, are the issues.

Generally, about half of men with epilepsy note decreased desire.

This is greater for men with temporal lobe epilepsy (63%), as compared to grand mal epilepsy (12%).

Urologists can often help men with sexual problems, including some medications that ease problems with erection.

Viagra (sildenafil) appears to be safe for epilepsy patients and does not interact with antiepileptic drugs.

There is less scientific literature about the effects of epilepsy on women’s sexuality, but the lack of desire is similar for women.

The problems include a low level of sexual desire, difficulty becoming sexually aroused and also intercourse can be painful for some women.

Painful intercourse can be caused by dryness of the vagina or painful vaginal spasms.

Ask your physician about creams or gels for lubricating the vagina to ease any discomfort.

Gynecologists can also do gradual dilations of the vaginal opening for women who have severe problems with pain and spasm.

For most of us sex is an important part of our lives and worrying about our sexual abilities or about our sexual performance can in itself lead to sexual problems.

And lots of people worry unnecessarily about whether or not it is safe to have sex when they have epilepsy or when their partner has epilepsy.

While sexual issues rarely threaten physical health, they can take a heavy psychological toll if they persist too long, bringing on depression, anxiety, and feelings of inadequacy.

The good news is, in most situations, treatment may lead to resumption of normal sexual functioning.

And sex can release anxiety and stress, helping people to relax, and reduce seizure frequency!

Millions of people living with epilepsy, either their own or that of a partner, will happily attest to the fact that their sex lives are just fine.

And having a supportive partner who provides emotional closeness, as well as sexual intimacy, is perhaps the greatest asset in helping people with epilepsy feel positive about themselves, which in turn improves seizure control.

 

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An article of interest:

Testosterone Tx Needs Clinical Trials   http://www.medpagetoday.com/Endocrinology/GeneralEndocrinology/45500?xid=nl_mpt_DHE_2014-05-01&utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g678262d0r&userid=678262&email=pfjohnson@comcast.net&mu_id=5845719

Resources:

http://www.ncbi.nlm.nih.gov/pubmed/12609320

https://www.epilepsy.org.au/sites/default/files/PDFS/E360/Sep_2010/360_Sep10_P8-11.pdf

https://www.epilepsysociety.org.uk/relationships-and-sex#.WMhAF_nyvtU

https://www.ncbi.nlm.nih.gov/pubmed/16871133

https://www.epilepsy.org.uk/info/men

https://www.epilepsy.org.uk/info/women/sex-life

On orgasms, epilepsy and the lack of sexual neuroscience

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