Men And Epilepsy

Epilepsy impacts men and women fairly equally, but the impact of having epilepsy can differ between the sexes. Not only due to biological difference but also because of the varied social roles. Here we discuss issues specific to men living with epilepsy.

• Fatherhood
• Sexual Function and Fertility
• Self-esteem
• Sports and Leisure
• Employment
• Driving
• Relationships

Whether you’re new to epilepsy or have been managing seizures for years, the more information you have the better armed you will be for any changes that occur. Review this information and make a list of your questions. Then talk to our Client Service Team to get the answers and help you need.

Special Considerations For Fathers Living With Epilepsy

Epilepsy and Inheritance

Studies show the children from men with epilepsy have a slightly higher risk of developing epilepsy which is approximately 2.4 percent risk compared t approximately 1 percent risk in the general population. That is a 97.6percent chance that your baby will not inherit epilepsy.

If both parents have epilepsy, the risk that their children will develop epilepsy increases, although estimates vary widely. Some statistics say the risk of developing epilepsy when both parents have it is about 5 percent, while others place it closer to 15 or 20 percent.

Special Considerations To Keep In Mind As A Parent

If your epilepsy is well controlled, you face very few restrictions on caring for a child. However, if your epilepsy causes impaired awareness and limited control of movement, you need to take special precautions when caring for a baby or a young child.

Sleep deprivation and new parenthood often go hand-in-hand. Not getting enough sleep is a common seizure trigger. Stress that is induced by sleep deprivation and the excitement and life changes of a new baby can aggravate seizures. Sleep deprivation and family schedule changes may also lead to missed medications.  Be aware of these potential problems and work with your GP, Client Service Team to develop a plan to reduce their impact.

Keeping Infants Safe

Tips to use when caring for an infant related to holding your baby, night time feedings, and getting sleep here

• Sit on the floor while feeding your baby. If you tend to fall on the same side during a seizure, position yourself to prevent yourself from falling on the baby.
• Dress, change, and play with the baby on the floor.
• Avoid bathing a baby in a tub while you are alone.
• Avoid carrying your baby around the house, especially up and down stairs.
• Avoid hot drinks around your baby.

When Your Children Are Older

As your children get older, they are likely to see you have a seizure. Therefore, it’s important for you to openly discuss your epilepsy with them. They will be comforted by knowing that you are not harmed by seizures. In fact, they may feel empowered if you teach them how to help you.

When discussing epilepsy with your children:

• Keep it simple. Use words that your children understand.
• Be calm and positive.
• Explain that you won’t be hurt by the seizure but may need some help during or after a seizure.
• When your children are old enough, teach them what to do, including when and how to call 000.
• Teach your children Seizure First Aid
• When you and your children are ready, add details about your condition.

Sexual Function And Fertility In Men With Epilepsy

A lot of people worry unnecessarily about whether or not it is safe to have sex when they have epilepsy or when their partner has epilepsy. Millions of people living with epilepsy either their own or that of a partner will happily attest to the fact that their sex lives are just fine. However, physical and medical conditions, such as epilepsy, can contribute to sexual dysfunction. This can be a complex disorder with medical, psychological and life circumstance all playing a part.

Why?

The following possible explanations continue to be investigated and can impact men who are trying to become fathers, as well as those who are not.

• Sexual dysfunction in men with epilepsy, including decreased interest in sex (desire/libido), decreased physical arousal (erectile dysfunction), and decreased ability to achieve orgasm
  • All of these may be impacted by changes in circulating hormones (testosterone and others) due to altered brain function related to epilepsy. This is especially true in focal (partial)epilepsy
  • Some medications used to treat epilepsy may also decrease levels of circulating testosterone, especially the older, “enzyme-inducing” medications: phenobarbital, phenytoin, carbamazepine and primidone.
• Decreased fertility in men with epilepsy due to lower sperm count or impaired sperm motility
• Comorbid depression, anxiety and lower self- -esteem in men with epilepsy
• Also, medications used to treat depression and anxiety, such as selective serotonin reuptake inhibitors (SSRIs), can decrease sexual functioning.

What Should I Do If I Am Having Problems with Sexual Function?

Talk to your GP or neurologist if you have any concerns about your sexual functioning or plans for fatherhood. Don’t stop your seizure (or other) medications if you think they are making problems worse! You will need to work with your doctor to plan a careful change if that is recommended.

Male Menopause/ Mid Life Crisis

Male menopause involves a drop of testosterone production in men who are aged 50 or older. Testosterone does more than fuel your sex drive, it also fuels changes during puberty, your mental and physical energy, maintains your muscle mass, regulates your fight-or flight response and regulates other key evolutionary features.

Male menopause differs from female menopause in several ways. Not all men experience it. It doesn’t involve a complete shutdown of your reproductive organs.

Male menopause can cause physical, sexual and psychological problems. The typically worsen as you get older. They can include:

• Low energy
• Depression or sadness
• Decreased motivation
• Lowered self confidence
• Difficulty concentrating
• Insomnia or difficulty
• Increased body fat
• Reduced muscle mass and feelings of physical weakness
• Development of breasts
• Decreased bone density
• Reduced libido
• Infertility

Low levels of testosterone is associated with male menopause has been linked to osteoporosis. This is a condition where your bones become weak and brittle. Unless male menopause is causing you severe hardship or disrupting your life, you’ll probably manage your symptoms without treatment. The biggest hurdle may be talking to your doctor about your symptoms.

The most common type of treatment of symptoms is making healthier lifestyle choices. For example, your GP might advise you to:

• Eat a healthy diet
• Get regular exercise
• Get enough sleep
• Reduce your stress

These lifestyle habits can benefit all men. After adopting these habits, men who are experiencing symptoms of male menopause may see a dramatic change in their overall health.

If you’re experiencing depression, your doctor may prescribe antidepressants, therapy, and lifestyle changes.

Hormone replacement therapy is another treatment option. However, it’s very controversial. Like performance-enhancing steroids, synthetic testosterone can have damaging side effects. For example, if you have prostate cancer, it may cause your cancer cells to grow. Speak with your doctor/neurologist about hormone replacement therapy and how that can affect your anti-epileptic drugs, weigh all of the positives and negatives before making your decision.

Self-Esteem In Men With Epilepsy

The Connection Between Epilepsy and Low Self-Esteem

There is no evidence that epilepsy causes low self-esteem. However, some research suggests that people with epilepsy may have difficulty forming relationships with others, possibly due to damage to parts of the brain that are important in social functioning.

Experts also cite other possible reasons why people with epilepsy are prone to low self-esteem:

• Family over – protection, which prevents individuals from developing independence and self-esteem
• Fear and misunderstanding (stigma) that accompanies epilepsy may lead to a negative self-image
• General personal dissatisfaction, depression and anxiety

Low self-esteem in men living with epilepsy likely begins during adolescence, a period of heightened self-consciousness that may be made worse by having epilepsy.

Effects Of Low Self-Esteem

Low self-esteem can result in general dissatisfaction. It can also harm specific aspects of life. For instance, low self-esteem may contribute to sexual problems, such as decreased libido (sexual desire). Low self-esteem may also be partially responsible for under-employment among men living with epilepsy.

Ways To Improve Self-Esteem

Support groups – either online or in person – can help men with epilepsy realize they are not alone in the social challenges they face. This is especially true for men with poorly – controlled epilepsy, who may be socially isolated due to driving restrictions and inability to maintain employment.

Stress management has been linked to improved self-esteem and seizure control. Men with epilepsy who suffer from low self-esteem and anxiety may benefit by learning and practicing relaxation techniques and mindfulness. Examples of these techniques include paced breathing, aromatherapy, tai chi, progressive muscle relaxation, and meditation. Regular exercise also provides physical and emotional benefits for people living with epilepsy.

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 GP or neurologist for a referral.

Sports & Leisure

When people are busy and active, they are less likely to have seizures. When choosing a sport or leisure activity give some consideration to your type of epilepsy and your degree of seizure control. Some activities involve a greater risk than others but with appropriate safety precautions most risks can be minimised.

Cycling

When cycling take normal safety precautions such as wearing a helmet, wearing easily visible clothing and using lights at night. Use designated bike paths to avoid the traffic. If your seizures are not well controlled stick to bike paths and parks rather than cycling on public roads.

Horse Riding

Wear a riding helmet and try to ride with other people.

High risk activities

Scuba diving and boxing, are considered to be high-risk activities and should only be considered if your seizures are very well controlled. Activities such as bungy jumping are probably best avoided.

Night clubbing

If you enjoy the social atmosphere of nightclubs, being diagnosed with epilepsy does not mean you have to give up going out with your friends. Strobe lighting or flashing lights, can in some people, trigger seizures. This is known as photosensitive epilepsy. How-ever it is quite rare and affects only a very small number of people with epilepsy. Nightclubs and DJs generally display warnings if strobe lighting is used. If this is a trigger for you it would be advisable to avoid such clubs.

Swimming and other water sports

Try to always swim with someone else, making sure that your companions know you have epilepsy and how to help if you have a seizure. If you are at a public swimming pool, tell the attendant how to assist you should the need arise.

When engaging in any water sport such as boating, canoeing, windsurfing or sailing always wear a life-jacket.

Underwater swimming such as scuba diving is not recommended. In the event of a seizure, help may not be possible. Drowning is clearly something to be avoided and yet it still happens to people who think they are personally invincible. Near drowning events can be devastating to your general health and can in fact lead to death. Of course, there is an element of risk in any water activities whether or not a person has epilepsy. But a seizure in water is a critical event that all too often has a devastating outcome. Our best advice is to avoid situations such as underwater activities, where your chances of survival, should you have a seizure, are greatly reduced.

Team and contact sports

Your epilepsy should not stop you from playing team and contact sports unless the epilepsy was caused by serious head injury. Some people choose to wear head protection while playing regardless of whether or not they have epilepsy. It is always a good idea to wear protective headgear in contact sports regardless of your health status.

Television and Computer Games

Unless you have been diagnosed with photosensitive epilepsy watching television, using a computer or playing video games should not affect you. However, if your seizures are triggered by photic (light) stimuli there are things you can do to minimize the risk of seizures. Watch TV in a well-lit room and do not sit too close or directly in front of the screen. When playing computer games, sit 2.5m from the screen, again in a well-lit room and reduce the brightness of the display. If a seizure is to occur it is more likely to happen within the first 30 minutes of play. Generally, playing the game for prolonged periods doesn’t pose a risk unless it is for so long that you become sleep deprived. Sleep deprivation is a recognised seizure trigger.

Employment

Unemployment or underemployment can have a huge impact on someone’s health and mental health. Many studies have shown there is a direct link between employment status and men’s health issue can include:

• Men without trades who go from one unskilled job to another are more likely to feel upset by periods of unemployment
• Unemployment means financial and emotional strain on families. This may be associated feeling of anxiety, stress, guilt or sometimes shame
• Men who feel in control of their lives are more likely to look after their health while unemployed men often feel helpless

Things you can do:

• It may help to speak with your employer about your seizures and ways to manage them in the work environment. This can be difficult step especially if you think it may put your job in jeopardy. Disclosure is not something to take lightly. However, your employer has a duty of care to keep you and the employees safe.
• Have a Epilepsy Management Plan (EMP) in place
• If you decide to tell your employer. offer useful and practical information. Many people have limited understanding about epilepsy
• Know your rights, especially regarding discrimination. Your employer is obliged to make reasonable adjustments for you in the workplace
• You may need to prepare to change your role for a time- e.g. if you need to drive for work there re legal timeframes about when you can recommence driving.
• Consider if it’s a time to retrain – this will depend on seizure control and your current role
• Seek advise from a specialist employment service if you know you will not be able to continue your current employment

Driving

Driving is almost a necessity for most of us. For many, it enables us to work, socialise and be independent. The loss of a driving licence has a significant impact on a person’s life in many ways, including keeping your job, getting to and from work, maintaining social contact and accessing daily needs.

For further information go to : Driving with Epilepsy

Relationships

It is common for people with epilepsy to experience some challenges and fears regarding relationships, especially new relationships. This is particularly true if there have been negative experiences in the past. Some common fears and difficulties people with epilepsy may have include:

• Uncertainty and fear about how family and friends respond to their diagnosis
• Worry about being a burden or not being able to look after the family
• Concerns that potential partners will not want a relationship with someone with epilepsy
• Fear that others will judge you negatively if they see a seizure
• Cultural beliefs

These fears can be stronger for someone if:

• You have had previous negative experiences related to your seizures
• Parents, family or friends have been overprotective
• Social life and opportunities have been restricted relating to missed schooling, inability to drive or being unable to as party hard as peers
• Social opportunities and relationships have been avoided because of anxiety about having seizures in public, fear of rejection or depression
• There is poor understanding of epilepsy
• There is uncertainty and fears about how, when and who to tell about your epilepsy

Some things that may help:

• Learn more about epilepsy and educate people around you about epilepsy and what to do
• Keep a seizure diary and note other factors related to your epilepsy. This can help identify triggers and patterns
• Be open about your epilepsy
• Feeling comfortable and being prepared to talk about your epilepsy
• Ask others for help when you need it
• Go out with friends who know about your epilepsy

Reference;

Courtesy Epilepsy Australia 2021

Epilepsy Foundation 3540 Crain Highway, Suite 675, Bowie, MD 20716- 1800.332.1000

Kristine Ziemba MD, PhD – 08/2018 Reviewed by: Joseph I. Sirven MD – August 21, 2018