HIGH PREVALENCE OF POLYCYSTIC OVARY SYNDROME IN WOMEN WHO STARTED VALPROATE TREATMENT FOR EPILEPSY AT YOUNG AGE
Abstract number :
1.213
Submission category :
Year :
2005
Submission ID :
5298
Source :
www.aesnet.org
Presentation date :
12/3/2005 12:00:00 AM
Published date :
Dec 2, 2005, 06:00 AM
Authors :
1Kirsi Mikkonen, 3Erik Tauboll, 1Eeva Lofgren, 2Juha Tapanainen, and 1,4Jouko I.T. Isojarvi
To evaluate the effect of the start age of treatment on the prevalence of polycystic ovary syndrome (PCOS) in women with epilepsy (WWE) taking either valproate (VPA) or carbamazepine (CBZ) medication. Data on all subjects participating in the evaluation of reproductive endocrine function in three studies1,2,3 in Oulu, Finland, Oslo, Norway and Heemstede, Netherlands during the 1990s were reanalyzed according to the age at which the medication was started. New consensus criteria4 on the definition of PCOS were used according to which PCOS is diagnosed in the presence of two of the following three criteria: 1) polycystic ovaries, 2) oligo-anovulation; 3) clinical or biochemical evidence of hyperandrogenism. Menstrual disorders were used as a marker of oligo-anovulation. Sixty-seven VPA treated subjects and 93 CBZ-treated subjects participated in the analysis. Fifty-two healthy volunteers that participated in one of the studies as control subjects were used as a reference group. A greater proportion of women in the VPA group (41.5%) had PCOS when compared to CBZ treated women (10.8%) or control women (5.8%) (p[lt]0.001, both comparisons). The high prevalence of PCOS was evident in the VPA group if the medication was started at the age of 25 years or younger (47.4% VPA vs. 16.4% CBZ, p[lt]0.001), whereas the prevalence was lower in both treatment groups if the medication was started after age 25 (10%VPA vs. 2.6% CBZ, n.s.). In both treatment groups, the prevalence of PCOS was statistically significantly higher in women who started the medication before the age of 26 than later in life (VPA: p=0.037, CBZ: p=0.044). Prevalence of PCOS appears to be higher in WWE, if the medication is started before the age 26. The prevalence of PCOS is especially high in VPA treated WWE who started the medication at young age ([lt]26 years), but the prevalence of PCOS does not seem to be increased, if VPA was started later in life.
1. Isojärvi JIT, Laatikainen TJ, Pakarinen AJ, Juntunen KTS, Myllylä VV. Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Engl J Med 1993;329:1383-8.
2. Isojärvi JIT, Laatikainen TJ, Knip M, Pakarinen AJ, Juntunen KTS, Myllylä VV. Obesity and endocrine disorders in women taking valproate for epilepsy. Ann Neurol 1996;39:579-84.
3. Isojärvi JIT, Tauboll E, Pakarinen AJ, et al. Altered ovarian function and cardiovascular risk factors in valproate treated women. Am J Med 2001;111:290-6.
4. The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic and criteria and long-term health risk related to polycystic ovary syndrome (PCOS). Human Reproduction 2004;19:1-7. (Supported by Oulu University Hospital.)