THE EFFECT OF ANTIEPILEPTIC DRUGS ON THE DEVELOPMENT OF REPRODUCTIVE FUNCTION IN GIRLS AND WOMEN

Abstract

Epilepsy in women is caused by the hypothalamic-pituitary-ovarian system, and women with epilepsy have a higher incidence of disorders such as menstrual irregularities, polycystic ovary syndrome, and infertility. The incidence of sexual dysfunction in the group of women with epilepsy ranges from 14 to 50%.

It was found that epileptic seizures and long-term use of antiepileptic drugs (AEDs) lead to reproductive disorders of the female body, affecting the endocrine, hormonal, and sexual spheres of the female body.Objective: to study the role of hormonal changes in the course of epilepsy in women of reproductive age while taking antiepiliptic drugs and, on this basis, to develop treatment tactics

Materials and methods of research: The clinical material of the study was 15 women with epilepsy of fertile age who applied to the 4th clinical city hospital named after I.I. Irgashev and 51 family polyclinics in Tashkent, as well as 15 healthy women of fertile age who do not suffer from epilepsy.

In the course of clinical, neurological and gynecological examination, all patients underwent a thorough collection of complaints and anamnesis. Electroencephalography (EEG), clinical and laboratory research methods, hormonal profile studies (estradiol, progesterone, LH, FSH, testosterone, prolactin) were performed. Classifications of types of seizures and epilepsy and epileptic syndromes were used (ILAE 1981, 1989), as well as taking into account the requirements for the list of diagnostic measures in patients with epilepsy.

Results of the study: The study of the clinical and laboratory characteristics of patients showed that by etiology, symptomatic (50%), idiopathic (25%) and cryptogenic (25%) epilepsy (p <0,05) prevailed in women of fertile age. In general, the study of complaints and anamnesis of patients showed that by the type of epileptic seizures, primary generalized epilepsy prevailed - (39,2%) cases, secondarily generalized epilepsy - (32,3%) cases, and third - focal epilepsy - (28,5%) cases.

Analysis of the formation of the rhythm of menstruation in patients with epilepsy showed that in the overwhelming majority of cases (69%) the age of menarche was 12,5±0,3 years. However, every fourth patient had an early menarche. In patients, the menstrual cycle while taking antiepileptic drugs was normoponic in 75% of cases. The postponic nature of menstruation of the type of oligomenorrhea was detected in 25%, extremely rarely (2,3%) secondary amenorrhea was observed.

It should be emphasized that the connection between epileptic seizures and the days of menstruation was found in 14,5% of women. The above menstrual irregularities (MMC) can be interpreted as increased excitability of the hypothalamic-pituitary system caused by the underlying disease, which led to secondary disorders of the reproductive system.

According to our research data, the testosterone level against the background of monotherapy was 1,6-2,2 nmol / l, and in the polytherapy group 2,1-2,7 nmol / l (p> 0,05), an increase in testosterone levels was found in 21,7% and amounted to 3,75 ± 0,05 nmol / l.Thus, the study of the hormonal profile in women with different forms of epilepsy by menstrual cycle  MC phases made it possible to establish that hyperestrogenemia, hyperandrogenemia, hyperprolactinemia, hypoprogesteronemia were dominant in all groups of patients. The tropic hormones LH and FSH were characterized by low concentrations in both phases of the cycle in all groups, which indicates the presence of secondary hypogonadism. All these disorders require hormone replacement therapy and correction under the control of an endocrinologist, neurologist, and EEG.