Erectile Dysfunction in People with Epilepsy:
Similarities and Difference with the General Population
Phunikhom K, MD, PhD1,2, Tiamkao S, MD, MS1,2 on behalf of the Integrated Epilepsy Research Group
Affiliation :
1 Department of Pharmacology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
2 Integrated Epilepsy Research Group, Khon Kaen University, Khon Kaen, Thailand
Erectile dysfunction is a common problem in people with epilepsy(PWE). The etiology is multifactorial involving most
epilepsy, antiepileptic drugs, and co-morbidity. It is an extensive influence on the quality of life and well-being of patients and their
partners. Apart from epileptic disease and antiepileptic drugs (AEDs) use, the general medical history with the question of other
possible risk factors and the specific sexual history play the most important roles in the guideline-based diagnostics. In addition,
a thorough clinical examination and specific laboratory tests should be carried out. The appropriate treatment to be provided for
epileptic patients with erectile dysfunction (ED) requires evaluation according to patient requirements, the epileptic condition and
comorbidities and the medicines available for managing epilepsy. Various approaches might be helpful for treatment of ED in PWEs.
Contemporary treatment algorithms for ED involve the use of non-pharmacological therapies; psychotherapy, changes of AEDs
and pharmacological therapies such as phosphodiesterase type 5 (PDE5) inhibitors and intra-cavernosal injection therapy of
vasoactive agents, as well as vacuum erection devices and penile prosthesis implants in PWEs. The success rates are high in most
cases. Every neurologist, urologist, andrologist and other practitioners of sexual medicine should have detailed knowledge in this
field. This state-of- the art article evaluates current and emerging therapeutic options for ED problems in PWEs.
Keywords : Erectile dysfunction, Sexual dysfunction, People with epilepsy
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