Altered ovarian function and cardiovascular risk factors in valproate-treated women

PURPOSE: Polycystic ovaries and menstrual disturbances seem to be common am ong women taking valproate for epilepsy. The purpose of the present study w as to assess the frequency of valproate-related metabolic and endocrine dis orders in different groups of women with epilepsy. SUBJECTS AND METHODS: Seventy-two women with epilepsy and 52 control subjec ts from centers in three European countries (Finland, Norway, and the Nethe rlands) participated in the study, Thirty-seven of the women with epilepsy were taking valproate monotherapy and 35 carbamazepine monotherapy. RESULTS: The frequency of polycystic ovaries or hyperandrogenism, or both, among valproate-treated women with epilepsy was 70% (26 of 37) compared wit h 19% (10 of 52) among control subjects (P <0.001). They were found in 79% (11 of 14) of obese and 65% ( 15 of 23) of lean women on valproate, and in 20% (7 of 35) of carbamazepine-treated women. The obese valproate-treated w omen with polycystic ovaries or hyperandrogenism, or both, had hyperinsulin emia and associated unfavorable changes in serum lipid levels consistent wi th insulin resistance. CONCLUSIONS: Polycystic ovaries and related hyperandrogenism are frequently encountered in both obese and lean women taking valproate for epilepsy. Th e use of valproate is associated with risk factors for cardiovascular disea se in obese women. (C) 2001 by Excerpta Medica, I tic.