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Question:
I was born with spinabifida and developed epilepsy at the age of 10. I am now in my late thirties. Browsing the web I discovered that Phenytoin can lower sexual libido. I have been taking Phenytoin for the last 15 years. for the previous 10 years I took Tegretol. My question is how can I confirm this? Is there a way of testing libido? Just being able to know this for sure would increase my confidence greatly in relating to the opposite sex.
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Answer:
by Annette Owens: (06/24/2004)
Thank you for contacting The Sexual Health Network with your request. From your additional information I learned that you are a male and that you feel very conscious of the fact that you have little interest in sex and therefore are reluctant to start relationships.
The book “Sexual Pharmacology. Drugs That Affect Sexual Function” by Theresa Crenshaw and James Goldberg (see the link on the right hand side of this page) has a detailed section on the effects of epilepsy drugs on sexual function. Maybe you can get a library to copy the section on anticonvulsants (pages 357 to360) for you. The references to detailed articles are on pages 459 to 552.
I will give you the main points here: Seizure disorders are associated with both hypersexuality (high sexual desire) and hyposexuality (low sexual desire). However, hyposexuality is far more characteristic of epileptics, especially those on medication. Studies show that patients with epilepsy show hyposexuality as well as reduced fertility more than the control population, regardless of whether they are being treated with anticonvulsant medication. In cases of temporal lobe epilepsy (such as in your case) specific structures in the brain called the limbic structures may be affected. These structures include an area in the brain called amygdala, which prominently affects sexual desire. Abnormalities of sperm morphology (structure) and motility (ability of movement) that may occur in epileptic men may be due to hormonal imbalances and chemical deficiencies that occur during long term treatment with epilepsy drugs.
You asked whether there is a way of testing your libido. You can translate this term to “appetite.” Do you have an appetite for sex? Do you regularly masturbate, think about sex, or initiate sexual contact with others? You already gave me most of the answer, and I am not surprised that your sexual desire is low, given the fact that you have had epilepsy and been on anticonvulsant drugs for over 25 years. The important point to stress here is that your sexual desire might not be improved if you were not taking any medication. You most likely need your medication in order to avoid seizures, and I would encourage you to think about the medication as a positive tool to control your epilepsy. I also would encourage you to discus this topic with your neurologist. He or she is probably interested in knowing how your epilepsy affects your personal as well as social life.
I hope this answered your question. Please do not hesitate to contact me again if you have any further questions.
All the best to you,
Annette Owens, MD PhD
Reviewed by Sexual Health Editorial Team
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