Category: epilepsy

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Epilepsy and Sex

— How Epilepsy Can Affect Sexual Health

By Serenity Mirabito RN, OCN

Attention to sexual health in people with epilepsy is often lacking. Sexual dysfunction, however, is a side effect of epilepsy and the medications that treat it.

Although not fully understood, epilepsy can also cause endocrine disorders that negatively impact the reproductive system, leading to infertility. People with epilepsy need to talk to their healthcare providers about ways to prevent sexual problems when diagnosed with the condition.

This article addresses the cause of sexual problems in people with epilepsy and how to treat them.

What Is the Connection Between Sexual Problems and Epilepsy?

Sexual problems like decreased libido or inability to orgasm are more likely to occur in people with epilepsy compared to those who don’t have the disease. Because the brain is responsible for both epilepsy and sexual behavior, there is a connection between the two, which includes:

  • Brain excitability: Sexual dysfunction in people with epilepsy sometimes depends on the part of the brain from which the seizure originates. People with right-sided temporal lobe epilepsy have the highest rates of sexual dysfunction. People with partial epilepsy suffer from sexual dysfunction more than those with idiopathic generalized epilepsy.
  • Sex hormones: Abnormal secretion of sex hormones is common in people with epilepsy. Low testosterone and estradiol levels are associated with epilepsy and sexual dysfunction.
  • Endocrine disorders: People with epilepsy have fluctuating hormone levels that are either complicated by endocrine disorders or cause them. The hormonal instability and endocrine diseases further worsen sexual problems in men and women, including the ability to conceive.
  • Psychological effects: People with epilepsy often complain of poor self-esteem and stigma around their illness. A limited ability to work, drive, or attend school can lead to depression and anxiety. The added fear of having a seizure during sex can also inhibit the desire for intimacy.

Do Drugs That Treat Epilepsy Cause Sexual Problems?

Not only do seizures, hormones, and psychological issues diminish sexual function, but the medications that treat epilepsy also impact sexual health. Some anti-epileptic drugs (AEDs) cause elevated liver enzymes that lead to suppressed sex hormones. Other AEDs have a depressive effect on the brain that can leave people feeling sedated and uninterested in sex.

AEDs known for increasing liver enzymes and decreasing sex hormones include:

Speak to your healthcare provider about how anti-epileptic drugs could affect your sexual health.

How Are Sexual Problems Due to Antiepileptic Drugs Treated?

Some AEDs effectively treat seizures and have minimal sexual side effects. Changing medications may be an option depending on the type and severity of the seizure disorder. AEDs that have a decreased implication for sexual dysfunction are:

If switching AEDs doesn’t work, you may be able to take medications that help treat sexual dysfunctions. These include:

Reducing the dose of the AED, building up a tolerance to the medication, and taking the drug after sex may improve sexual ability. It may take various approaches to find the best solution for improved sexual health, but keeping an open dialogue with your healthcare provider is essential.

Symptoms and Gender Differences

Sexual problems in people with epilepsy can affect up to 60% of men and 50% of women. Although men and women with epilepsy may experience decreased libido, other sexual problems manifest differently in each gender.

Men

In addition to decreased testosterone levels and the side effects of AEDs, performance anxiety can cause the following sexual problems in men with epilepsy:

Women

Endocrine disorders, low levels of female hormones, menstrual irregularities, and psychiatric conditions have been linked to sexual and reproductive dysfunctions in women with epilepsy.

Epileptic women often experience the following sexual problems:

In addition, endocrine disorders that affect fertility in women with epilepsy are:

How Are Sexual Problems With Epilepsy Treated?

Treating sexual problems associated with epilepsy begins by telling your healthcare provider. Various methods can help improve sexual dysfunction in people with epilepsy. Some options that may help include:

  • Hormone replacement therapy: Replacing testosterone and estradiol may improve sexual health.
  • Medications: Drugs are available to help increase sexual desire and treat conditions like premature ejaculation.
  • Improving mental health: Treating underlying depression and anxiety can help with intimacy.
  • Lubrication: Vaginal pain and dryness during sex can be relieved with water-based lubrication.
  • Erection management: Prevent or reduce penile flaccidity by placing an elastic band at the base of the penis, using vacuum devices, or using an intracavernosal injection of vasodilators.
  • Brain surgery: Research found anterior temporal lobectomy resulted in being seizure-free in 60% of patients. Those patients also reported significant improvement in sexual function.

Summary

People with epilepsy often experience sexual problems. Hormonal abnormalities, endocrine disorders, fear, and side effects of treatment may lead to sexual dysfunctions. Depression, loneliness, and anxiety can occur if sexual health is not seriously addressed. There are various methods available for improving sexual impairments in people with epilepsy. Talk to your healthcare provider about ways to prevent sexual problems if you have been diagnosed with epilepsy.

A Word From Verywell

Sexual health plays a valuable role in the quality of life; many people feel unsatisfied and disconnected when it’s poor. If you’ve been diagnosed with epilepsy and are struggling with libido, the ability to orgasm, infertility, or depression, you are not alone. Speaking to your healthcare provider about these symptoms so they can help you feel better is essential.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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What to know about epilepsy and sex

Some people with epilepsy may find it impacts their sex life. This may be due to physical changes from the condition, medications, or emotional issues around epilepsy and sex.

by Beth Sissons

Certain types of epilepsy may cause changes in the brain that impact sexual desire and arousal.

Some epilepsy medications may affect sex drive or hormone levels which can also impact sex. Some people may find that anxiety around having a seizure during sex also affects their sex life.

This article looks at how epilepsy can affect sex and how to get help.

Epilepsy is a brain disorder that causes people to have recurring seizures.

Abnormal electrical activity in the brain can cause involuntary movements, unusual sensations, and sometimes a loss of consciousness.

There are two Trusted Source main types of seizures:

  • focal or partial seizures, which affect one area of the brain
  • generalized seizures, which affect both sides of the brain

Many people with epilepsy will find it has no impact on their sex life.

However, other people may find that epilepsy does affect their sex life, which may be due to:

  • side effects of epilepsy medications
  • changes in the brain that may affect sexual arousal and desire
  • changes in hormone levels, which may be due to medications or brain changes
  • fear or anxiety around epilepsy and sex, such as concern about having a seizure during sex

Epilepsy medications, physical changes in the brain, and hormone levels may all impact sex.

Worrying about epilepsy could also impact a person’s sex life.

Medication

Some antiepileptic drugs may alter hormone levels and change how the body processes them.

Side effects of antiepileptic drugs that may impact sex include:

  • less interest in sex
  • difficulty becoming aroused
  • tiredness
  • disrupted sleep
  • feeling tense or depressed

Some medications may lower testosterone, which could lead to sexual problems in males.

Fear and anxiety

Emotional factors can impact how people feel about sex. If epilepsy is causing emotional issues, such as making people feel low, anxious, or vulnerable, it may impact a person’s sex life.

People may also worry about having a seizure during sex. Having a seizure during sex is unlikely, but discussing any worries with a partner may help to ease fears.

Letting a partner know about seizure first aid and preparing them for the possibility of a seizure may alleviate some anxiety.

A seizure can also impact someone emotionally — they may feel upset, fragile, or tired after experiencing a seizure.

Changes in the brain

Certain areas of the cerebral cortex, particularly the frontal and temporal lobes, affect sexual desire.

People with complex partial seizures may be more likely to experience problems with sexual desire, especially if the seizures begin in the temporal lobe.

Seizures that begin in the temporal lobe may also affect sex hormones and reduce sex drive.

Physical changes

Physical changes that can occur due to epilepsy may include:

  • disruption to areas of the brain controlling sexual function
  • temporal lobe epilepsy may make it more difficult for people to get and maintain an erection
  • changes in hormone levels that relate to sexual desire and arousal

People may find talking about any concerns with a partner helps ease any anxiety or fears and helps each person know what to do in case of a seizure.

Talking with a healthcare professional may also help — people can discuss any side effects of medications and any emotional issues.

Talking with a doctor

People can discuss any medications they are taking with a doctor, and whether they are causing any side effects that could be impacting sex.

A doctor may be able to alter dosages or suggest an alternative medication to combat side effects.

Finding a therapist

People may find it helpful to talk with a counselor or therapist about any concerns they have around epilepsy and sex. People may want to do this individually or with a partner.

Cognitive behavior therapy (CBT) may help reduce feelings of anxiety, anger, or depression in people with epilepsy.

People can ask their doctor for CBT recommendations or search via the National Association of Cognitive-Behavioral Therapists.

Talking with partners

Some people may worry about having sexual activity alone or with partners in case they have a seizure.

Although people may find it difficult to talk about, discussing any concerns with a sexual partner or partners may help.

If people need help talking with partners about epilepsy, they may want to consider relationship or couples counseling.

It may help a person to know seizure first aid if their partner has epilepsy.

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, not all seizures require medical attention.

A person should only call 911 if:

  • the person has not had a seizure before
  • the person has a health condition such as diabetes
  • the person is pregnant
  • the seizure lasts for more than 5 minutes
  • the person sustains an injury during a seizure
  • the seizure happens in water
  • another seizure happens soon after the first
  • the person has difficulty walking or breathing after the seizure

If the above instances do not apply, a person can help a person having a seizure by:

  • checking the person for any medical bracelets or other emergency information
  • staying with the person during the seizure until it ends and they are fully conscious
  • keeping themselves and everyone else calm
  • easing them to the floor gently
  • placing something soft under their head, such as a pillow or folded jacket
  • removing any eyeglasses and loosening anything around their neck
  • not placing anything in their mouth, as a person cannot swallow their tongue during a seizure

When the seizure has stopped, a person should take them to a safe and comfortable place.

Once the person is awake and conscious, someone should explain in calm and simple terms what has happened.

This section answers some common questions about epilepsy and sex.

Can I masturbate if I have epilepsy?

There is no evidence to suggest that masturbation will cause seizures unless it is a personal trigger for people.

Can having sex trigger seizures?

According to the Epilepsy Foundation, few people with epilepsy report having a seizure during sex.

If physical activity, fast breathing, or excitement trigger seizures in people, they may have concerns about having seizures during sex.

However, sex is unlikely to trigger a seizure for most people.

Are orgasms good for epilepsy?

According to an older 2015 studyTrusted Source, it is uncommon for orgasms to trigger seizures. In rare cases, orgasm may trigger seizures in people with reflex epilepsy.

Stress can be a trigger for seizures in some people with epilepsy. Anxiety and depression can also worsen stress and may lead to further seizures.

Sexual activity may help to reduce anxiety and depression and may have a protective effect against mood disorders and relationship issues.

What to do if your partner has epilepsy?

If a person’s partner has epilepsy, it may help both people to talk about epilepsy and how it may impact sex.

This may help to ease any fears a person might have.

People can also make sure they know how to practice seizure first aid.

Some people with epilepsy may find the condition impacts their sex life. This may be due to medications, changes in the brain, or anxiety around epilepsy and sex.

Many people will find that sex does not trigger seizures, but if people have any concerns, they may want to talk with their partner. Therapy or counseling may also help.

People can discuss any medications they are taking with their doctor to check if that could be impacting sex in any way.

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