Each person with epilepsy is different, yet there are some common questions and concerns among different age groups and genders. In this section, find information that may help men living with epilepsy understand and manage issues related to sexual function and fertility, fatherhood, and self-esteem.

Whether you're new to epilepsy or have been managing seizures for years, the more information you have the stronger you'll be. Review this information and make a list of your questions. Then talk to your health care team to get the answers and help you need.

People with epilepsy have lower rates of reproduction compared to the general population, but men with epilepsy seem to be impacted even more than women. A commonly cited study published in 1986 tracked birth rates in people with and without epilepsy in Rochester, Minnesota, between the years of 1935-1974. It found that reproductive rates for people with epilepsy were significantly reduced compared to controls, but more so for men with epilepsy (80% of expected) versus women with epilepsy (85% of expected).

Why Does This Occur?

The following possible explanations continue to be investigated and can impact men who are trying to become fathers, as well as those who are not.

  • Sexual dysfunction in men with epilepsy- including decreased interest in sex (desire/libido), decreased physical arousal (erectile dysfunction), and decreased ability to achieve orgasm
    • All of these may be impacted by changes in circulating hormones (testosterone and others) due to altered brain function related to epilepsy. This is especially true in focal (partial) epilepsy.
    • Some medications used to treat epilepsy may also decrease levels of circulating testosterone, especially the older, “enzyme-inducing” medications: phenobarbital, phenytoin, carbamazepine, and primidone.
  • Decreased fertility in men with epilepsy- due to lower sperm count or impaired sperm motility
  • Comorbid depression, anxiety, and lower self-esteem- in men with epilepsy
  • Also, medications used to treat depression and anxiety, such as selective serotonin reuptake inhibitors (SSRIs), can decrease sexual functioning.

What Should I Do if I Am Having Problems with Sexual Function?

Be sure to talk to your primary care doctor or neurologist if you have any concerns about your sexual functioning or plans for fatherhood. Don’t stop your seizure (or other) medications if you think they are making problems worse! You will need to work with your doctor to plan a careful change if that is recommended.

What Are The Chances That My Children Will Have Epilepsy?

As a man with epilepsy, your children are at a slightly higher risk than the general population for developing epilepsy too.

  • Studies show that children of men with epilepsy have a 2.4% risk of developing epilepsy, as opposed to children in the general population, whose risk is estimated at 1%.
  • If both parents have epilepsy, the risk that their children will develop epilepsy increases, although estimates vary widely. Some statistics say the risk of developing epilepsy when both parents have it is about 5%, while others place it closer to 15 or 20%.

What Special Considerations Do I Need To Keep In Mind As A Parent?

If your epilepsy is well controlled, you face very few restrictions on caring for a child. However, if your epilepsy causes impaired awareness and limited control of movement, you need to take special precautions when caring for a baby or a young child.

Sleep deprivation and new parenthood often go hand-in-hand. Not getting enough sleep is a common seizure trigger. Stress that is induced by sleep deprivation and the excitement and life changes of a new baby can aggravate seizures. Sleep deprivation and family schedule changes may also lead to missed medications. Be aware of these potential problems and work with your health care team to develop a plan to reduce their impact.

Find tips for managing seizure triggers here.

Keeping Infants Safe

Tips to use when caring for an infant:

  • Sit on the floor while feeding your baby. If you tend to fall on the same side during a seizure, position yourself to prevent yourself from falling on the baby.
  • Dress, change, and play with the baby on the floor.
  • Avoid bathing a baby in a tub while you are alone.
  • Avoid carrying your baby around the house, especially up and down stairs.
  • Avoid hot drinks around your baby.

When Your Children Are Older

As your children get older, they are likely to see you have a seizure. Therefore, it's important for you to openly discuss your epilepsy with them. They will be comforted by knowing that you are not harmed by seizures. In fact, they may feel empowered if you teach them how to help you.

When discussing epilepsy with your children:

  • Keep it simple. Use words that your children understand.
  • Be calm and positive.
  • Explain that you won't be hurt by the seizure but may need some help during or after a seizure.
  • When your children are old enough, teach them what to do, including when and how to call 911.
    • Seizure First Aid
    • Explaining Epilepsy to Children and Family
  • When you and your children are ready, add details about your condition.

The Connection Between Epilepsy And Low Self-Esteem

There is no evidence that epilepsy causes low self-esteem. However, some research suggests that people with epilepsy may have difficulty forming relationships with others, possibly due to damage to parts of the brain that are important in social functioning.

Experts also cite other possible reasons why people with epilepsy are prone to low self-esteem:

Low self-esteem in men living with epilepsy likely begins during adolescence, a period of heightened self-consciousness that may be made worse by having epilepsy.

Effects Of Low Self-Esteem

Low self-esteem can result in general dissatisfaction. It can also harm specific aspects of life. For instance, low self-esteem may contribute to sexual problems, such as decreased libido (sexual desire). Low self-esteem may also be partially responsible for under-employment among men living with epilepsy.

A survey published in 2000 found

  • People living with epilepsy had a lower median household income than the general population
  • Unemployment among people with epilepsy who were able to work was five times higher than the national rate

Ways To Improve Self-Esteem

Support groups – either online or in person – can help men with epilepsy realize they are not alone in the social challenges they face. This is especially true for men with poorly-controlled epilepsy, who may be socially isolated due to driving restrictions and inability to maintain employment.

Contact your local Epilepsy Foundation, call the 24/7 Helpline at 1-800-332-1000 (en Español 1-866-748-8008).

Stress management has been linked to improved self-esteem and seizure control. Men with epilepsy who suffer from low self-esteem and anxiety may benefit by learning and practicing relaxation techniques and mindfulness. Examples of these techniques include paced diaphragmatic breathing, aromatherapy, tai chi, progressive muscle relaxation, and meditation. Regular exercise also provides physical and emotional benefits for people living with epilepsy.

Seek professional help – If feelings of low self-esteem last for a long time or interfere with daily living, seek help from a trained professional, such as a clinical psychologist or a qualified counselor. Ask your primary care provider or neurologist for a referral.

Authored By:

Kristine Ziemba MD, PhD

on Tuesday, August 21, 2018

Reviewed By:

Joseph I. Sirven MD

on Tuesday, August 21, 2018

Resources

Epilepsy Centers

Epilepsy centers provide you with a team of specialists to help you diagnose your epilepsy and explore treatment options.

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Epilepsy Medication

Find in-depth information on anti-seizure medications so you know what to ask your doctor.

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Epilepsy and Seizures 24/7 Helpline

Call our Epilepsy and Seizures 24/7 Helpline and talk with an epilepsy information specialist or submit a question online.

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Tools & Resources

Get information, tips, and more to help you manage your epilepsy.

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