How predictable is the erectile function of patients with epilepsy?

- Erectile dysfunction (ED) is often reported by patients with epilepsy and is related to multiple factors.
- Mechanisms related to sexual changes in male with epilepsy are still not completely understood.
- Education, depressive symptoms, and prolactin levels can predict up to 41% of cases of ED.

IntroductionErectile dysfunction (ED) is often reported by patients with epilepsy and may be related to endocrine system abnormalities, side effects of antiepileptic drugs, psychiatric comorbidities, and family or social difficulties.AimsThis study aimed to identify independent predictor factors for ED in patients with epilepsy.Main outcome measuresthe five-question form of the International Index of Erectile Function (IIEF-5).MethodsIndependent predictive factors for ED evaluated by the IIEF-5 questionnaire in 36 patients (mean age: 39 years) with focal epilepsy (mean: 6 seizures/month) were identified by multiple linear regression analysis.ResultsEight (21.1%) patients were asymptomatic. Among the symptomatic patients, 11 (28.9%) had mild dysfunction, 10 (26.3%) had moderate dysfunction, and 9 (23.7%) showed severe ED. The multiple linear regression model including family income (B = 0.005; p = 0.05), education levels in years (B = 0.54; p = 0.03), depressive symptoms determined by HADS depression subscale (B = − 0.49; p = 0.03), and prolactin levels (B = − 0.45; p = 0.07) showed a moderate association (r = 0.64) with the IIEF questionnaire and explained 41% (r2 = 0.41) of its variation.ConclusionsErectile dysfunction is highly prevalent in patients with focal epilepsies. Education, depressive symptoms, and prolactin levels can predict erectile dysfunction in up to 41% of patients with epilepsy. This preliminary report justifies further efforts to make a large sample size study to identify independent biomarkers and therapeutic targets for ED treatment in patients with epilepsy.