The impact of epilepsy surgery on sex hormones and the menstrual cycle in female patients

We investigated the impact of temporal lobe epilepsy surgery on sex hormone s and menstrual cycles. Sixteen female patients with temporal lobe epilepsy were investigated prior to surgery and 3, 6, and 12 months after surgery. The patients received carbamazepine (CBZ) as monotherapy (10 patients) or i n combination with other antiepileptic drugs (six patients). Antiepileptic drugs were maintained after surgery. During the 1-year follow-up after surg ery eight patients (50%) remained completely free of seizures, Tn another f our patients (25%) only rare disabling seizures occurred. There were no sig nificant differences between pre-surgical and post-surgical serum concentra tions of testosterone, free testosterone, prolactin, dehydroepiandrosterone sulfate, growth hormone, cortisol and sex hormone binding globulin. There was, however, a significant increase in serum androstenedione concentration 6 months post-surgically (P < 0.02). Documentation of menstrual cycles in addition to laboratory parameters revealed individual post-surgical changes of the menstrual cycle in eight patients. Four patients had a change in me nstrual periodicity: two patients with complete seizure control had regular cycles instead of oligomenorrhoea and two patients with incomplete seizure control had oligomenorrhoea instead of regular cycles. These data indicate that at least in some patients with temporal lobe epilepsy surgical treatm ent influences menstrual periodicity. (C) 2000 BEA Trading Ltd.