Men and epilepsy

The impact of epilepsy varies from person to person, and each person’s experience of epilepsy is unique. However, there are often issues and concerns that are specific to age groups and gender.

Below, find information that may help men with epilepsy understand and manage issues related to:

• Mood 
• Self-esteem
• Sexual Function and Fertility

Living with epilepsy can be challenging. Sometimes you may feel anxious, irritable or angry, tired, or depressed. It’s normal to feel this way sometimes, but it’s important not to ignore these feelings if they are intense or go on for a prolonged period. If this occurs, you may experience:

• Low motivation
• Negative feelings such as sadness, shame, anger or anxiety
• Lack of interest in usual activities
• Self-neglect- not looking after your diet, sleep and body
• Relationship difficulties
• Thoughts of helplessness or self-harm

For some people, living with epilepsy may negatively impact their self-image and contribute to low self-esteem. While epilepsy does not directly cause low-self esteem, some or all of the below may be contributing factors:

• Being overprotected- preventing the person with epilepsy from developing self-esteem 
• Fear of misunderstanding or judgement from others
• Feeling embarrassed or worried about having a seizure in public
• Loss of independence
• Depression and/or anxiety, feeling dissatisfied

Low-self esteem can lead to a loss of confidence, difficulty with relationships, lower levels of social and workforce participation and sexual problems, such as decreased libido.

If you are experiencing poor self-image or self-esteem related to epilepsy, it is important to remember that avenues of support are available and there are strategies you can employ to help improve your situation.

• Consider joining a support group. You can find information about Epilepsy Queensland support groups here
• Connect with your local epilepsy organisation – our helpline is available on 1300 852 853 or follow us on Facebook, Instagram, Twitter and LinkedIn 
• Stress management- Relaxation techniques such as meditation and practicing mindfulness may help manage stress. Regular exercise can also provide physical and emotional benefits for people living with epilepsy.
• Being  educated and learning how to live well with epilepsy may help improve your confidence. 
• Seek professional help- If feelings of low self-esteem last for a long time or interfere with daily living, seek help from a trained professional, such as a clinical psychologist or a qualified counsellor. Ask your general practitioner or neurologist for a referral.

People living with epilepsy have a lower rate of reproduction when compared to the general population, with men more adversely impacted than women.

Investigations continue into the possible causes for this disparity. Some possible explanations include:

Sexual dysfunction:

Some men living with epilepsy may have decreased interest in sex, decreased physical arousal and decreased ability to achieve orgasm. This may be affected by hormonal changes (testosterone and others) due to altered brain function related to epilepsy. Research suggests this is particularly evident in focal epilepsy.

Epilepsy medications:

Some epilepsy medications may also decrease circulating testosterone. Especially “enzyme-inducing” medications such as phenobarbital, phenytoin, carbamazepine, and primidone.

Decreased fertility:

Men living with epilepsy may experience reduced fertility due to lower sperm count or impaired sperm motility.

Mood and/or anxiety disorders and poor self-esteem:

Medications to treat depression and anxiety can impair sexual function in men living with epilepsy.

If you have concerns about your sexual functioning or fertility, it is important to discuss this with your general practitioner or neurologist. DO NOT stop taking epilepsy or other prescribed medications until a review is made by your treating doctor- they can best guide you how to make a monitored  and careful change if that is deemed to be necessary.

*This information has been abstracted from the Epilepsy Foundation US.