Many of the issues related to use of antiepileptic drugs by women also pertain to men. These include induction of enzyme that also metabolize sex steroid hormones, fertility, and teratogenicity. There is a great deal of evidence that the hypothalamic-pituitary-gonadal (testicular) axis particularly can be disrupted by enzyme-inducing drugs.
A review of epilepsy, sex hormones, and antiepileptic drugs2 described the animal and clinical studies that remain the basis for our understanding of these relationships. A later review1 expanded on our comprehension of reproductive function in people with epilepsy. The core problem addressed in many studies has been induction of hormones by enzyme-inducing antiepileptic drugs (AEDs). The clinical implications for women taking oral contraceptives were described by Mattson et al7. Several recent reports have brought new attention to male hormones both for adult men and developing boys. This article is an overview of the issues that are pertinent to clinical understanding of their needs.