Sexual Dysfunction among Men with Epilepsy: Prevalence, Nature, and Risk Factors

Abstract Background: A definite relationship has been established between epilepsy and sexual dysfunction (SD); however, this comorbidity often goes unrecognized in clinical settings. This study aimed to assess the prevalence, nature, and risk factors for SD among men with epilepsy attending a tertiary care teaching hospital. Methods: Participants were recruited from the Epilepsy clinic of a tertiary care hospital. Sociodemographic and clinical variables were recorded. The International Index of Erectile Functioning, Chinese Index of Premature Ejaculation-5, and a structured interview for DSM-5 sexual disorders diagnosis were administered to assess sexual functioning. The Revised Clinical Interview Schedule was used to assess for common mental disorders (CMD). Serum testosterone and trough antiepileptic drug levels were measured. Factors associated with SD were analyzed using bivariate and multivariate statistics. Results: One hundred and seventy men with epilepsy were recruited. The mean age was 32.68 (sd = 10.65) years, and 48.8% were currently married. Thirty-six participants (21.2%) fulfilled criteria for an SD; seventeen were diagnosed with a CMD. Older age ( P < 0.001), substance use ( P = 0.014), low testosterone levels ( P < 0.001), and presence of CMD ( P = 0.025) were associated with SD. Conclusions: Erectile disorder and premature ejaculation were the most common types of SD among men with epilepsy. Enhanced awareness regarding the prevalence and risk factors for SD among clinicians who manage patients with epilepsy is essential for appropriate preventive and intervention strategies, which can improve patient quality of life.