Carbamazepine and Valproic Acid effects on Reproductive Hormones in Patients with Epilepsy

This study aimed to evaluate the impact of carbamazepine (CBZ) and valproic acid (VPA) on reproductive hormones in patients with epilepsy. This cross-sectional study included 41 patients with tonic-clonic generalized epilepsy (16 males and 25 females) under CBZ and/or VPA treatment for at least one year. Commercially ready enzyme-linked immune-assay (ELISA) kits were used to measure serum level of follicular stimulating hormone (FSH), luteinizing hormone (LH), progesterone, testosterone, and estradiol. The median serum level of LH in males under mixed treatment (23.86 mIU/ml) was significantly higher than those using CBZ (2.54 mIU/ml) or those using VPA (4.08 mIU/ml). While serum levels of FSH and testosterone were comparable between the different groups with no significant difference. In females, the median serum level of LH in patients using CBZ (23.96 mIU/ml) was significantly higher than those under VPA (4.74 mIU/ml) or mixed treatment (6.0 mIU/ml). Likewise, females under CBZ treatment had significant higher levels of FSH (12.49 mIU/ml) than either those under VPA (2.22 mIU/ml) or mixed treatment (4.43 mIU/ml). On the other hand, neither estradiol nor progesterone showed a significant variation between different medications. Both CBZ and VPA seem to be significantly associated with increased serum LH levels with an insignificant effect on serum levels of FSH and testosterone in males. While in females, CBZ was associated with significant elevation in serum levels of FSH and LH with an insignificant effect on estradiol and progesterone.