Epilepsy: Can it cause erectile dysfunction?

Yes. Sexual dysfunction — including difficulty achieving and sustaining erections (erectile dysfunction) — is more common in men with epilepsy than in the general population. Several factors likely play a role.

Epilepsy itself may cause sexual dysfunction, especially if seizures are poorly controlled. Disruptions in hormone levels and brain activity may impair sexual desire and performance. In many cases, improved seizure control alleviates sexual dysfunction.

Drugs used to treat epilepsy may also cause sexual dysfunction. Anti-seizure medications, such as phenytoin and carbamazepine, can decrease testosterone levels in men, which in turn reduces sexual desire and impairs sexual function. If a specific anti-seizure medication is the likely culprit of erectile dysfunction, your doctor may recommend an alternative medication.

In addition, psychological factors — such as depression, sexual anxiety or stigma associated with epilepsy — can contribute to sexual dysfunction in men with epilepsy.

If you have epilepsy and erectile dysfunction, consult your doctor. Your doctor may refer you to a urologist to make sure that your erectile dysfunction isn't due to an unrelated urological condition. In any case, a careful assessment is needed to determine the cause and best treatment for erectile dysfunction.