Some people with epilepsy, particularly those with partial seizures, experience sexual dysfunction. It can affect both men and women. Sexual dysfunction is defined as any problem that routinely interferes with the ability to achieve sexual gratification and may involve issues related to sexual arousal, the ability to achieve orgasm or feelings of discomfort or pain during intercourse.

Decreased sexual desire or arousal is the problem most often reported among people with epilepsy. For men, this may mean the inability to achieve or sustain an erection. For women, it may mean vaginal dryness, which can result in pain during intercourse.

Sexual dysfunction in people with epilepsy may be caused by numerous psychosocial and physiological factors, including:

• Side effects of some seizure medications
  
  
• Hormonal imbalances due to seizures or seizure medications
  
  
• Impairment of the parts of the brain associated with sex (such as the temporal or frontal lobes)
  
  
• Fears of having a seizure during intercourse
  
  
• Poor self-esteem or perceived sexual attractiveness
  
  
• Unpleasant sexual experiences in the past

Sexual dysfunction can sometimes lead to depression and increased levels of stress, which, in turn, may increase the risk of seizures in patients with epilepsy.

People with epilepsy who experience sexual dysfunction are encouraged to consult their physician to discuss possible treatment methods. In some cases, changing seizure medications may resolve the dysfunction, although this may not be recommended for people with a history of poor seizure control. Women who experience pain during intercourse may be advised to use lubricants.

If a physician determines that the cause of the sexual dysfunction is psychosocial rather than physical in nature, the patient may be referred to a sexual psychologist or a couple’s therapy program.