Endocrine Abstracts

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting approximately 4–8% of premenopausal women. The main clinical features are clinical and/or biochemical hyperandrogenemia, oligomenorrhea and polycystic ovarian changes. It has gained a great attention during the last two decades with the realization that this syndrome affects more than the reproductive system. Epilepsy is a common neurologic disorder affecting women during the reproductive years. Seizures and some antiepileptic drugs (AEDs) can compromise reproductive health. During the last years, several reports in the literature suggest a relationship between PCOS and epilepsy. The pathophysiology of the increased prevalence of PCOS and/or hyperandrogenism is not well established in patients with epilepsy and hypothalamus-pituitary-gonadal axis is not investigated in detail.

Forty-eight women with epilepsy were recruited in order to investigate the prevalence of PCOS, glucose intolerance and ovarian functions by using a GnRH analogue buserelin. All the patients were on valproic acid or carbamazepin treatment. Fasting blood chemistry, basal hormone levels (including FSH, LH, estradiol, DHEAS, testosterone, androstenedione SHBG, 17-OHP), OGTT, buserelin test were performed and ultrasonography of the ovaries obtained. Twenty age and BMI matched healthy women served as a control group.

Serum free testosterone and SHBG levels were significantly (P<0.05) higher in patients than in the control group. Three patients (7.5%) had glucose intolerance. Glucose and insulin responses to OGTT (either peak or area under the curve: AUC) were significantly (P<0.05) higher in the patients than in the control subjects. Patients with epilepsy had sigificantly (P<0.05) higher peak and AUC 17-OHP responses to buserelin test. Overall 15 (31.2%) patients had PCOS.

Our results suggest that women with epilepsy treatment have a high prevalance of PCOS, increased insulin resistance and ovarian dysfunction.