MENSTRUAL DISORDERS IN WOMEN WITH EPILEPSY RECEIVING CARBAMAZEPINE

We measured concentrations of serum sex hormones and sex hormone bindi ng globulin (SHBG) in relation to regularity of the menstrual cycles i n 8 women before carbamazepine (CBZ) treatment was initiated and after 1 and 5 years of CBZ therapy. In addition, we evaluated menstrual cyc le regularity and related endocrine changes in 56 women receiving CBZ treatment for >5 years. Serum SHBG levels increased, and serum concent rations of 17 beta-estradiol (estradiol) and estradiol/SHBG ratio decr eased during CBZ treatment. Two of the 8 patients (25%) in the prospec tive study group developed menstrual irregularities during the first 5 years of therapy. In the cross-sectional study group of patients trea ted with CBZ for >5 years, the frequency of menstrual disturbances was also 25.0% (14 of 56 patients). Concentrations of serum sex hormones and SHBG were measured in 13 women with menstrual disorders and in 11 randomly selected women with regular cycles. In most cases, menstrual disorders were associated with increased serum SHBG and decreased seru m estradiol levels and low estradiol/SHBG ratio. Long-term CBZ treatme nt results in increased serum SHBG levels and decreased estradiol effe ct, which correlate with the frequency of menstrual disorders in CBZ-t reated women with epilepsy.