Marriage Prospects and Outcomes in Women and Men with Epilepsy: A Comprehensive Review from a Gender Perspective

Epilepsy is about more than just seizures. The physical, neuropsychological, reproductive, sexual, and social challenges associated with the condition create interconnected effects on the well-being of people with epilepsy (PWE). Marriage represents a critical intersection where these challenges converge. As marriage is a deeply gendered institution, this review examines studies on epilepsy and marriage published between 2000 and 2025 from a gender-sensitive perspective. A total of 34 papers were identified through searches on PubMed (Medline) and Web of Science, focusing on gender issues related to epilepsy and marriage. These studies address marriage and divorce rates among PWE, factors influencing marital status, and parenting-related issues. The literature consistently shows that PWE have lower marriage rates and higher divorce rates compared to the general population. However, findings on gender differences in marital prospects and outcomes remain inconsistent, likely reflecting sociocultural variations in gender roles and family dynamics. An early onset of seizures emerges as one of the strongest predictors of remaining single. For men, early onset is often associated with unemployment, which in turn negatively affects marriage prospects. In some cultural contexts, the stigma surrounding epilepsy disproportionately impacts women. Sexual dysfunction (SD) is a well-documented concern among PWE, yet its relationship with marital quality remains underexplored. Parenthood can be particularly challenging for PWE. In societies where marriage and childbearing are closely linked, perceived unfitness or reluctance to have children, especially when epilepsy begins before marriage can significantly hinder marital opportunities. While women with epilepsy may express a stronger desire for children, they also report greater discouragement and heightened concerns about parenthood compared to men. Current research tends to focus more on women regarding SD and parenting issues, with men’s experiences and concerns particularly in relation to reluctance to marry or challenges in sustaining marriage remaining under-addressed. Evidence suggests that the quality of spousal relationships is crucial for the overall well-being of PWE. Men and women experience the marital, reproductive, and parenting challenges associated with epilepsy differently. To enable a more holistic approach to epilepsy care, further research is needed that moves beyond sex-disaggregated data and critically examines the gendered dynamics of how epilepsy affects social life.