Polycystic-Ovarian-Syndrome in Nigerian women with epilepsy on carbamazepine/ levetiracetam Monotherapy

Objectives: The study is aimed at comparing effects of older drugs like carbamazepine(CBZ) and newer agent like Levetiracetam (LEV) on Polycystic Ovarian Syndrome (PCOS) in Women With Epilepsy(WWE).

Methods: An interviewer based questionnaire was used to obtain relevant clinical information from 50 WWE on CBZ and LEV monotherapy respectively and 50 age-matched controls. The diagnosis of epilepsy was clinical with electroencephalographic features taken into consideration and the seizures classified using the 2017 International League Against Epilepsy(ILAE) classification. The diagnosis of PCOS was based on the European Society for Human Reproduction and Embryology / American Society for Reproductive Medicine (ESHRE/ASRM)).

Result: The frequency of PCOS and its subcomponent were higher among WWE compare to controls. PCOS was present in 22(44%) of LEV group compare to 8(16%) CBZ group. The frequency its subcomponent was higher among those on LEV except for comparable effect with regards to oligomenorrhea. The levels of the sex steroid hormone were comparable in both groups of WWE except luteal phase Luteinizing Hormone (LH) which was lower among the LEV group (p0.001). The follicular phase estradiol level was lower (p0.021) and Follicle Stimulating Hormone (FSH) level was about 2-fold higher (p0.03) among WWE compare to controls. The mean value testosterone was significantly lower among controls compared to WWE CONCLUSION: The increased frequency of PCOS and its subcomponent and the unsatisfactory effect of LEV compared to CBZ on reproductive endocrine function underscores the need for routine reproductive endocrine evaluation to improve overall quality of life.