Sex and epilepsy

Many people with epilepsy have normal sex lives. But epilepsy can sometimes cause problems with sex and fertility.

Find out how epilepsy can affect both men and women and where to ask for help if you need it.

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For women

Will having epilepsy affect my sex life?

Many women with epilepsy can have a healthy sex life, but epilepsy can sometimes cause problems with sex.

More women with epilepsy have problems with their sex life than women who don’t have epilepsy. These may include problems with:

  • Becoming aroused
  • Having an orgasm
  • Having little interest in sex
  • Pain during or after sex

There are some possible causes of sexual problems that could affect you as someone with epilepsy:

Epilepsy medicines

Some epilepsy medicines might affect your interest in, or ability to have sex. This is because the medicines change the hormone levels in your body and these hormones play a role in your sex life. For example, your levels of luteinizing hormone might be lowered, which can cause you to have less interest in sex.

If you think your epilepsy medicine might be having an effect on your sex life, talk to your GP, epilepsy specialist nurse or epilepsy specialist. They will be able to talk to you about your treatment options and things that could help.

The effect of epilepsy itself

The type of seizures you have, whether or not they are controlled by medicine, and which part of the brain is affected may all make a difference to whether your sex life is affected. Many of the larger studies have not looked at whether seizures in particular parts of the brain have a higher risk for problems with your sex life. One study found an increased risk with seizures in the temporal lobe of the brain.

Worry about seizures

You might be worried about having a seizure during sex, but very few people have reported this happening. Thinking that this might happen could have an effect on your sex life. If you do notice an increase in seizures relating to sex, it’s worth talking to your doctor.

Depression and anxiety

People with epilepsy are more likely to be affected by depression and anxiety. If you’re feeling depressed or anxious, this could cause you to have less interest in sex.

 

Treating sexual problems

Problems with sex can have a big impact on your quality of life. It’s worth talking to your GP if you have any concerns about your sex life. They can do an assessment to look at the possible causes and advise you about things that could help. These might include:

  • Making lifestyle changes
  • Taking medicine to help with the problem
  • Making changes to existing medicines or contraception you are using
  • Talking therapies such as counselling or cognitive behavioural therapy (CBT)

If your GP thinks your sexual problems could be linked to your epilepsy or your epilepsy medicines, they will usually refer you to an epilepsy specialist for further advice. If it is safe to do so, your specialist may suggest making changes to your epilepsy medicine. It’s important not to make any changes to your epilepsy medicines without getting medical advice.

You can also access support and treatment for sexual health issues at a sexual health clinic. These can provide the same treatment you would get at your GP surgery. Many sexual health clinics offer a walk-in service.

You can search for sexual health clinic near you or look for information about sexual problems on the NHS website.

The Sexual Advice Association also have information and factsheets about different sexual problems.

 

Fertility

Research into epilepsy and fertility in women is currently limited. There have been some studies which have looked at whether women with epilepsy have an increased risk of fertility problems. However, these studies have often found different results.

One recent study suggests that unless you already have a known fertility problem, you should have the same chance of getting pregnant as someone without epilepsy. This study did not include women who already had a known fertility problem, such as Polycystic Ovary Syndrome (PCOS).

Other studies have found epilepsy and epilepsy medicines can cause certain health problems, which could make it harder for some women to get pregnant. For example, women with epilepsy are more likely to have problems with their periods and PCOS.

More research is needed to fully understand how epilepsy and epilepsy medicines might affect fertility.

For more information, visit our page on epilepsy and planning a baby.

For men

Many men with epilepsy have normal sex lives and father healthy children. But epilepsy can sometimes cause problems with sex and fertility. Any man might have problems with sex from time to time, but problems are more common in men with epilepsy than men without epilepsy.

The most common problems for men with epilepsy are having little or no interest in sex, and having problems with getting or keeping an erection. There are a number of possible reasons why, as a man with epilepsy, you’re more likely to have problems with sex. Possible reasons include:

  • Epilepsy medicines

Some epilepsy medicines list sexual problems as a possible side-effect. These medicines are gabapentin, pregabalin, phenobarbital, phenytoin, topiramate, carbamazepine, clobazam and clonazepam.

Some other medicines don’t list sexual problems as a side-effect. But they can reduce the level of testosterone in your body. This could affect your interest in or ability to have sex. The medicines that can cause you to have low testosterone levels include phenobarbital, phenytoin, carbamazepine and primidone. There’s also some evidence that oxcarbazepine, when taken at doses higher than 900mg per day, can have this effect.

Many men take these epilepsy medicines, but only some will have sexual problems. If you think your epilepsy medicine might be having an effect on your sex life, talk to your GP, epilepsy specialist nurse or epilepsy specialist.

  • The effect of epilepsy itself

Seizures, especially those that start in a part of the brain called the temporal lobe, can affect levels of sex hormones in the body. Studies suggest that people with temporal lobe epilepsy are more likely to have low sex drive.

  • Worry about seizures

Some men worry that they’ll have a seizure during sex. Having sex is very unlikely to trigger seizures, and most men with epilepsy don’t have seizures during sex. But if this is something that you’re worried about, the worry could have an effect on your sex life.

  • Depression and anxiety

People with epilepsy are more likely to be affected by depression and anxiety. If you’re feeling depressed or anxious, this could cause you to have less interest in sex.

Testosterone – Your body produces the hormone testosterone. Testosterone is responsible for many things that affect your sex life. These include your interest in having sex, your ability to have sex and your fertility. If you have low testosterone levels, this may cause you to have problems with your sex life.

 

Treating sexual problems

If you have any worries about your sex drive, or your ability to have sex, you are not alone. It’s really worth talking to your GP. They will look for ways to help you. For most men with sexual problems, a treatment can be found.

If you and your doctor think your sexual problems may have an emotional cause, your doctor may recommend sex therapy, psychotherapy or relationship counselling.

If it looks like there’s a physical cause for your sexual problems, your GP may suggest lifestyle changes or treatments to help.

If your GP thinks your sexual problems might be connected to your epilepsy or epilepsy medicines, they will usually refer you to an epilepsy specialist. Your epilepsy specialist might suggest making changes to your epilepsy medicines to see if this helps.

You can also access support and treatment for sexual health issues at a sexual health clinic. These can provide the same treatment you would get at your GP surgery. Many sexual health clinics offer a walk-in service. You can search for a service near you on the NHS website.

The NHS website has information about treatment for male sexual problems.

Fertility

Some research suggests that men with epilepsy may not be as fertile as men who don’t have epilepsy. This can make it more difficult to father a baby.

How epilepsy can affect your fertility

You may be taking an epilepsy medicine that can reduce the amount of sperm you produce or affect the quality of it. Carbamazepine, phenytoin and sodium valproate may all have this effect. There’s a small amount of evidence that levetiracetam may also affect the number and quality of sperm you produce.

Your epilepsy or epilepsy medicines may have caused you to have lower testosterone levels than usual. This could make you less fertile.

Treating fertility problems

If you’re trying for a baby and your partner is taking a long time to get pregnant, speak to your family doctor. They can check for common causes of fertility problems in you and your partner. They can also suggest treatments that may help.

If your family doctor thinks that your epilepsy or epilepsy medicines are a possible cause, they’ll usually refer you to an epilepsy specialist. The specialist may make changes to your epilepsy medicine, to see if that helps.

This information is due for review December 2024.

Further info

Sexual Advice Association
Tel:  020 7486 7262
Aims to help improve the sexual health and wellbeing of men and women. Their website has information on many different aspects of sexual problems.

Institute of Psychosexual Medicine (IPM)
Provides a list of IPM trained specialists, some working privately and some on the NHS.

Published: July 2022
Last modified: October 2023
To be reviewed: July 2023
Tracking: B017.08 & F074.04 (Dec 2024)
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