Menstrual pattern characteristics in female adolescents with epilepsy
Main Article Content
Keywords
Menstruation disturbances, Epilepsy, Adolescent
Abstract
Background: There are multiple adverse effects from anti-epileptic drugs, including menstrual irregularities such as amenorrhea, oligomenorrhea, gynecomastia, galactorrhea and polycystic ovary syndrome. In view of the paucity of information, the purpose of this study was to determine the frequency of menstrual disorders in female adolescents with epilepsy in a tertiary care pediatric hospital.
Methods: Female adolescents with epilepsy, older than 9 years and with more than 1 year with epilepsy were included. Initially, pubertal stage was identified. During 6 months, menstrual patterns were assessed. Among those with detected menstrual disorders, a hormonal profile and gynecological ultrasound were performed. Statistical analysis was descriptive.
Results: 24 patients with a median of 13 years of age; 40 % with overweight or obesity. Most received more than two anti-epileptic drugs. Sixteen patients (66.6 %) had one or more menstrual disorders: 10 had menorrhagia, 6 polymenorrhea, 6 dysmenorrhea, 4 opsomenorrhea; 4 had primary amenorrhea and 1 secondary amenorrhea. There were four patients with hyperprolactinemia and three with hypothyroidism. Evolution time and treatment of epilepsy, as well as the number of anti-epileptic drugs were higher among those with menstrual disorders.
Conclusions: The high frequency of menstrual disorders in female adolescents with epilepsy should be taken into account as part of the comprehensive treatment of these patients.
References
Hauser WA, Beghi E. First seizure definitions and worldwide incidence and mortality. Epilepsia. 2008; 49(Suppl 1):8-12.
Adelöw C, Andell E, Amark P, Andersson T, Hellebro E, Ahlbom A, et al. Newly diagnosed single unprovoked seizures and epilepsy in Stockholm, Sweden: First report from the Stockholm Incidence Registry of Epilepsy (SIRE). Epilepsia. 2009;50(5):1094-101.
Wiebe S, Camfield P, Jetté N, Burneo JG. Epidemiology of epilepsy: Prevalence, impact, comorbidity and disparities. Can J Neurol Sci. 2009;36(Suppl 2):S7-16.
David P. Impacto de los nuevos fármacos antiepilépticos en la epilepsia. Rev Chil Epilepsia. 2010;10(1):41-6.
Sánchez-Álvarez JC, Galán-Barranco JM, Camino-León R, Pita-Calandre E, Ramos-Lizana J, et al. Guía terapéutica en epilepsia de la Sociedad Andaluza de Epilepsia 2005 II. Terapéutica antiepiléptica crónica en adulto y en el niño. Rev Neurol. 2005; 0(10):619-26.
Herzog AG. Menstrual disorders in women with epilepsy. Neurology. 2006;66(6 Suppl 3):S23-8.
Herzog AG. Disorders of reproduction in patients with epilepsy: Primary neurological mechanisms. Seizure. 2008;17(2):101-10.
Bilo L, Meo R, Valentino R, Di Carlo C, et al. Characterization of reproductive endocrine disorders in woman with epilepsy. J Clin Endocrinol Metab. 2001;86(7):2950-6.
Martínez-Ferri M. Atención integrada a la mujer epiléptica. Rev Neurol. 2002;34(5):471-5.
Foldvary-Schaefer N, Falcone T. Catamenial epilepsy: Pathophysiology, diagnosis, and management. Neurology. 2003;61(6 Suppl 2):S2-15.
Zupanc ML. Antiepileptic drugs and hormonal contraceptives in adolescent women with epilepsy. Neurology. 2006;66(6 Suppl 3):S37-45.
Reddy DS. The role of neurosteroids in the pathophysiology and treatment of catamenial epilepsy. Epilepsy Res. 2009;85(1):1-30.
Reddy DS. Neuroendocrine aspects of catamenial epilepsy. Horm Behav. 2013;63(2):254-66.
Serret-Montoya J, Hernández-Cabezza A, Mendoza-Rojas O, Cárdenas-Navarrete R, Villasis-Keever MA. Alteraciones menstruales en adolescentes. Bol Med Hosp Infant Mex. 2012;69(1):63-76.
Hickey M, Balen A. Menstrual disorders in adolescence investigation and management. Hum Reprod. 2003;9(5):493-503.
Svalheim S, Tauboll E, Bjornenak T, Roste LS, Morland T, Saetre ER, et al. Do women with epilepsy have increased frequency of menstrual disturbances? Seizure. 2003;12(8):529-33.
Hu X, Wang J, Dong W, Fang Q, Hu L, Liu C. A meta-analysis of polycystic ovary syndrome in women taking valproate for epilepsy. Epilepsy Res. 2011; 97(1-2):73-82.
Löfgren E, Tapanainen JS, Koivunen R, Pakarinen A, Isojärvi JI. Effects of carbamazepine and oxcarbazepine on the reproductive endocrine function in women with epilepsy. Epilepsia. 2006;47(9):1441-6.
Verotti A, Laus M, Coppola E, Parisi P, Mohn A, Chiarelli F. Catamenial epilepsy: Hormonal aspects. Ginecol Endocrinol. 2010;26(11):783-90.
Murialdo G, Galimberti CA, Magri F, Sampaolo P, Copello F, Gianelli MV, et al. Menstrual cycle and ovary alterations, in women with epilepsy on antiepileptic therapy. J Endocrinol Invest 1997;20(9):519-26.
Löfgren E, Mikkonen K, Tolonen U, Pakarinen A, Koivunen R, Myllyla VV, et al. Reproductive endocrine function in women with epilepsy: The role of epilepsy type and medication. Epilepsy Behav. 2007; 10(1):77-83.
Aggarwal A, Rastogi N, Mittal H, Chillar N, Patil R. Thyroid hormone levels in children receiving carbamazepine or valproate. Pediatr Neurol. 2011;45(3):159-62.
Herzog AG. Catamenial epilepsy: Definition, prevalence, pathophysiology and treatment. Seizure. 2008; 17(2):151-9.