Patterns and predictors of sexual dysfunction in women with epilepsy

Salsabil Abo Al-Azayem; Nirmeen A Kishk; Reham Shamloul; Abeer Attia; Radwa M Elsayed; Rehab Magdy

doi:10.1016/j.yebeh.2023.109421

Patterns and predictors of sexual dysfunction in women with epilepsy

Epilepsy Behav. 2023 Oct:147:109421. doi: 10.1016/j.yebeh.2023.109421. Epub 2023 Sep 6.

Authors

Salsabil Abo Al-Azayem¹, Nirmeen A Kishk¹, Reham Shamloul¹, Abeer Attia², Radwa M Elsayed³, Rehab Magdy⁴

Affiliations

¹ Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt.
² Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
³ Department of Family Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
⁴ Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: rehab.m.hassan@kasralainy.edu.eg.

PMID: 37677900
DOI: 10.1016/j.yebeh.2023.109421

Abstract

Objectives: Available data about sexual-related problems among Egyptian women with epilepsy (WWE) are scarce. Hence, this work aimed to study the pattern and predictors of sexual dysfunction in a sample of Egyptian WWE.

Methods: In this cross-sectional study, sexually active WWE and age and years of marriage-matched healthy controls were included. The Female Sexual Function Index questionnaire (FSFI) was used to assess sexual function in both groups.

Results: In the patient group (n = 142), the median age was 33 (28-39), whereas the median age of the control group (n = 142) was 33.5 (28-36). Women with epilepsy had significantly lower desire, arousal, pain, and FSFI-total scores than the control group (P = 0.001, 0.001, 0.023, 0.008, respectively). There was a significant difference between the FSFI-total score of women on polytherapy and those on monotherapy (P = 0.042), as well as between those on enzyme-inducing ASMs and those on ASMs that did not affect P450 (P = 0.032). Seizure frequency in the last three months was negatively correlated with scores of desire, arousal, lubrication, orgasm, and satisfaction (P 0.047, 0.02, 0.009, 0.013, 0.046, respectively). By multiple backward linear regression models, age, and seizure frequency were the significant predictors of the FSFI-total score (B -0.219, -0.33, respectively).

Conclusion: The pattern of sexual dysfunction among Egyptian WWE is characterized by reduced sexual desire, arousal deficits, and sexual-related pain. Seizure frequency, epilepsy duration, enzyme-inducing medications, and multiple anti-seizure medications (ASMs) may adversely affect WWE's sexual health. The only factor that could predict higher sexual dysfunction in WWE was higher seizure frequency.

Keywords: Anti-seizure medications; Enzyme-inducing; Seizure frequency; Sexual function; Women with epilepsy.