Prevalence of Polycystic Ovarian Syndrome in epileptic Kashmiri women on sodium valproate and phenytoin.

Abstract

Background

: Polycystic ovarian syndrome (PCOS) is a common cause of infertility in women of reproductive age group. Antiepileptic drugs, notably Sodium valproate,  has been linked to PCOS in various studies. Such an association has significant implications given rampant use of sodium valproate, particularly in such women .

Objectives:

to determine the prevalence of PCOS in women taking valproate or phenytoin monotherapy.

Material & Methods:

35 women on Valproate monotherapy and 28 women on phenytoin were compared with 43 healthy women.

Results:

Mean BMI was 24.46 kg/m

²

(SD 4.19) in Valproate group, 23.37 kg/m

²

(SD 3.67)in phenytoin group and 22.12 kg/m

²

(SD 3.29) in Control group. Menstrual dysfunction was seen in 40% patients in Valproate group which was significant  as compared to Phenytoin group (14%) and Control group (12%). Polycystic ovaries were seen on ultrasonography in 37% patients in valproate group, 18% in Phenytoin group and  14% in Control group.Serum testosterone, prolactin, LH and LS/FSH ratio were significantly higher in Valproate group as compared to Control group (p value < 0.05). 26% patients in Valproate group had PCOD while as 14% in the Phenytoin group and 7% in Control group were diagnosed as PCOD.

Conclusion:

Women with epilepsy taking sodium valproate for seizure control have higher prevalence of menstrual dysfunction and PCOS and hence need closer follow up and health advice for same