Background: Recent studies have raised the issue of an increased incidence of polycystic ovaries (PCO) and menstrual disturbances in women with epilepsy treated with valproate (VPA). It seems that antiepileptic drugs, especially valproate, may have a functional role in altering the endocrine system of child-bearing women with epilepsy. We conducted this study to investigate the association of VPA and ovarian structural/menstrual disorders in epileptic women.

Methods: In this cross-sectional study, we compared a total of 64 epileptic patients, aged 16-45 years, 32 of whom had been taking VPA alone and 32 were on other antiepileptic drugs for a minimum duration of six months. Ovarian sonography was performed and body mass index (BMI) calculated for all subjects. We also recorded the presence of menstrual disturbances in both groups.

Results: Fifteen (46%) of the VPA subjects had PCO compared to 7 (21.9%) of the other group. In the VPA group, four (12.5%) had oligomenorrhea, one (3.1%) amenorrhea and 13 (40.6%) had irregular menstrual cycles. However, from the other group, two (6.3%) subjects had oligomenorrhea and seven (21.9%) had irregular menstrual cycles; amenorrhea was not present in the non-VPA treated patients. Mean BMI was 22.5 kg/m² among the VPA subjects and 20.1 kg/m² in the non-VPA subjects.

Conclusions: This study supports the association of PCO and high BMI with VPA treatment. The frequency of menstrual disturbances did not differ significantly between the two groups.