June is Men’s Health Month!

The month of June is designated Men’s Health Month! It’s a time for men of all ages to be aware of preventable health issues and get checked early to detect and treat health problems. The Epilepsy Foundation partners with the Centers for Disease Control and Prevention (CDC) to provide education and support to men living with epilepsy and presents programs to help people live their best lives by taking an active part in managing their epilepsy.

Epilepsy and Men

Each person living with epilepsy is unique; however, for some people, there can be a variety of lifestyle and health challenges. Men living with epilepsy may also experience health concerns that are unique to their gender. These specific challenges may differ depending on

• Age
• Type and frequency of seizures
• Type of treatment
• General health
• Lifestyle factors
• Social and economic factors

The Epilepsy Foundation encourages men living with epilepsy to learn about their own health issues, and to take action when needed. Critical to success will be a good relationship and open lines of communication with your loved ones and your epilepsy care team of doctors and nurses.

Learn about some of the epilepsy related health issues men should be aware of and respond to here.

Hormonal Changes: Testosterone Production

About 4 out of 10 men with epilepsy have low levels of testosterone. (Testosterone is a male sex hormone.) Low testosterone levels can affect a person’s energy, mood, sexual function, and bone strength. Testosterone levels may be lower due to

• Seizures affecting the release of hormones from the brain
• Seizures affecting testicular hormone function
• Some seizure medicines may lower testosterone levels in the bloodstream

ACTION

Review any changes in mood or sexual function with your doctor or nurse. They will determine the need for further testing to see if blood work (lab testing) or a change in seizure medication are needed.

Fertility

Most people with epilepsy do not have problems having children. But research shows that some men with epilepsy can be at higher risk for reproductive problems related to lower sperm counts or abnormal sperm function. The type of epilepsy a person has, the age when seizures started, seizure medications used, and family history have the greatest impact on fertility.

ACTION

If you are planning to start a family, talk to your epilepsy team. Your doctor can help determine if your seizures or the anti-seizure medication you are taking could contribute to problems with fertility. If fertility problems are present, ask for a referral to a specialist. Often fertility issues are treatable.

Libido and Sexual Interest

All men, whether they have epilepsy or not, can sometimes experience problems with libido (desire to have sex). Difficulties may include losing interest in sex or having problems getting or staying aroused. Common causes of sexual problems include stress, exhaustion, chronic illness, depression, anxiety, and alcohol and other substance abuse.

Having epilepsy or taking seizure medications may also cause problems, including

• Decreasing a person’s ability to recognize cues that are important for establishing intimacy
• Fear of sex causing a seizure
• Seizures from certain brain regions can affect sexual desire
• Increased difficulties because some anti-seizure medications lower libido
• Seizure medicine can cause fatigue, disrupted sleep, or feeling tense or depressed, which can all lower sexual interest

ACTION

Speak with your doctor about your concerns. Sharing your problems can help determine next steps and if any changes in your seizure treatment are needed. Some problems may even be linked to other medical conditions too. Many problems are treatable.

For most people, having a seizure during sex is no more likely than having one at any other time. Talk with your partner about what your seizures look like and what to do if you have one. Also talk about any fears – bringing feelings into the open is helpful.

Side Effects of Seizure Medications

All medications have the potential to cause side effects. Each person taking seizure medication should be aware of the potential short- and long-term side effects. Not every person taking medication experiences side effects. Some side effects may also be temporary due to the medicine dose or a medicine being new to your body. These usually go away when dosing is adjusted over time.

Common short-term side effects of some seizure medication include

• Dizziness
• Upset stomach
• Drowsiness
• Blurry or double vision
• Difficulty with speech or thinking
• Decreased energy
• Sleep disturbances
• Mood changes

Some long-term side effects to consider depend on the medication you are taking. They may include

• Thinning of the bones
• Kidney stones
• Changes in liver or blood cells
• Weight changes (weight loss or weight gain)

These side effects that could be warning signs or a serious problem should be reported to your health care team immediately:

• Fever
• Rash
• Mouth ulcers
• Easy bruising
• Swollen glands
• Increase in seizure activity
• Weakness

ACTION

Keep track of any side effects in a seizure diary and review these with your epilepsy team. They can work with you to limit any potential side effects. Ask what you can do to prevent or treat long-term side effects. For example, taking calcium and vitamin D can help strengthen bones. Report serious side effects to your health care team.

Medication Adherence and SUDEP

Medication adherence means how well a person follows a doctor’s directions about how and when to take their medicines. Studies have demonstrated that men may have more difficulty taking medicines regularly and reliably.

Medication adherence is a problem for many people with a chronic illness. For a person living with epilepsy, medication adherence could mean the difference between life and death.

• Not taking medicines regularly and missing doses is a common cause of breakthrough seizures.
• People with uncontrolled seizures are at higher risk for sudden unexpected death in epilepsy (SUDEP), than people with well controlled epilepsy. For example, people who have 3 or more generalized tonic-clonic seizures in a year have a 15-fold increased risk of SUDEP.

ACTION

Take time to think about how you are taking your seizure medicines. Talk to your doctor or nurse if your medicine schedule is hard to follow. Changing the time of day you take your medicine or taking a long-acting form may help. If you have trouble remembering doses, use an alarm on a watch or phone, write reminders on a calendar, use a pillbox, or use technology with reminder settings like Texting 4 Control or My Seizure Diary.

Ask about your risk for SUDEP and ways to lessen this risk. People who have seizures at night should consider a device that can alert others when seizures happen. This can help you to get first aid quickly if needed.

If your seizures are not well controlled, see an epilepsy specialist at an epilepsy center.

Summary

The health issues listed above are important for men with epilepsy to consider. Understanding the relationship between your gender, epilepsy, and overall general health is vital to feeling your best. Managing these issues with your epilepsy team can help improve seizure control and your quality of life.

Use this Men’s Health Month reminder to start a list about any concerns you have and share them with your primary care and epilepsy providers. It can be hard to talk about these issues, but your health care team is there for you - the whole person.