The Parameters Related to Polycystic Ovarian Syndrome in Epileptic Patients Under Valproate Treatment

OBJECTIVE: To investigate the parameters related to polycystic ovarian syndrome (PCOS) in epileptic patients under valproate (VPA) treatment. Design: Cross-sectional clinical study. Setting: Ondokuz Mayis University Teaching Hospital. Patients: 16 patients using VPA for epileptic disorders. Intervensions: Reproductive history, measurement of height and weight, hormone analyses, pelvic ultrasonography. Main outcome measures: Menstrual regularity, body mass index (BMI), early follicular phase serum total testosterone level and LH/FSH ratio, fasting insulin level, polycystic ovaries (PCO’s) at ultrasonography. RESULTS: Thirteen patients used VPA for generalized tonic-clonic seizures (81.2%) and 3 patients for focal seizures (18.8%). Mean duration of treatment was 4.9±2.9 (2-13) years. 37.5% of the patients had irregular menses in the pattern of oligomenorrhea. Mean BMI was 22.4±3.0 (17.4-27.3) kg/m2 in the group. Only 2 patients had an LH/FSH ratio of ≥ 2 (12.5%), and hyperandrogenemia was detected at a ratio of 37.5%. Insulin levels of all the patients were within the normal range. PCO’s were observed at ultrasonography at a ratio of 62.5%. Seven out of our 16 patients were diagnosed as PCOS (43.8%). Correlation analyses didn’t reveal any significant relation between the BMI, LH/FSH ratios, total testosteron and insulin levels of the patients (p>0,05). CONCLUSIONS: The relationship of epilepsy – VPA treatment – and PCOS is a controversial issue. PCOS is diagnosed at quite a high ratio in our patient group, which mostly consisted of the ones with generalized tonic-clonic seizures. Besides the epileptic disorder itself, this high ratio appears to be related to the VPA treatment as wel