Men and Epilepsy
Comparatively little has been written specifically for men with epilepsy. But this is not because epilepsy affects men any less than it does women. The numbers are generally seen as being pretty much equal between genders even though some writers have reported that slightly more men have epilepsy than women.
For a number of reasons epilepsy support associations usually see more females than males. Some men will only seek information about their own epilepsy once their female partners have made an appointment for them. Perhaps it’s the old thing about men being less inclined to take responsibility for their own adverse health situations than women.
For men a wide range of specific issues have not been articulated in contrast to the number of specific gender issues for women. They exist however, and they can be quite complex, varying with such things as age, seizure type and severity and with a male’s overall health and lifestyle circumstances.
If you are a male with epilepsy it is important to understand that your seizures are not a sign of weakness or of mental instability or of being any less intelligent or capable than anyone else. Although you may feel they are, you will eventually realise that they are not. Seizures are in fact a sign that your seizure threshold has been lowered in some way. They are a clear indication that despite the fact that your brain functions perfectly well on almost every possible occasion, a small and relatively uncommon biochemical glitch can bring things temporarily undone. It is very often a very small glitch. It's usually momentary and isolated. But, as you know, its impact can be devastating.
We therefore encourage you to see what is happening as being firstly a biochemical problem. With your doctor you will work to a solution that is logically going to be first and foremost a biochemical solution: a solution proven in millions of cases to have worked for other people experiencing seizures. And if it doesn’t work straight away there is excellent reasons to keep trying because by two years out from the time of the first seizures, or seizure onset, most people have their seizures completely controlled or very well controlled indeed and are successfully getting on with their lives.
The burden of epilepsy for both men and women is greatly reduced if freedom from seizures is achieved and seizure freedom should be one of the highest priorities you set yourself. Your best chance for gaining this freedom is to follow the advice of your medical practitioner or neurologist. This will include taking prescription medications that your body may take a while to get used to. There will be times when, because the seizures have stopped, and because you may experience one or more side effects from the drugs that you could well do without, you will feel like easing off or stopping the tablets. Understandable as this is it is also a huge mistake.
Men and Compliance
Taking the tablets you have been prescribed in the way your doctor has advised is known as “compliance” and it is reported as a greater issue for men than it is for women. Some writers think it is patronising to talk about “compliance” as they equate it to “doing what you are told to do”. It is perhaps worse to be given a powerful medication and not be told how to use it safely and effectively. Treating epilepsy is not like taking a course of antibiotics to treat an infection. It is not something that popping a few pills will fix. It requires you to take tablets and keep taking them until your doctor or neurologist gives you the all clear to reduce or stop.
What Happens if you Stop or Reduce your Tablets?
If you stop taking the tablets prescribed, or even decrease the dosage, you are likely to experience what are sometimes called “breakthrough seizures” and indeed it may be harder to get your seizures back under control the second time than it was the first time. You may well be able to reduce or even cease taking drugs once you have been seizure free for a couple of years but that is far from the case when you are at still at the stage of getting them well and truly under control. Compliance is a vital step in managing seizures.
If, as an adult, you have been seizure free for two or more years there is a possibility that you may be able to undergo a supervised reduction in the number of tablets you take, and even to stop altogether. It’s not a guarantee that seizures will not return but, with care and appropriate supervision, it can be worth doing.
Alcohol and Other Recreational Drugs
Most men like a drink. Epilepsy shouldn't stop you having a beer or two or a glass of wine with dinner, but you need to be honest with yourself about it. Alcohol can increase the sedating effects of some antiepileptic medications and it can trigger seizures under some circumstances. Some antiepileptic medications specifically recommend that you not drink while taking them and some neurologists expect their patients to follow this restriction to the letter – especially until they get their seizures under control. If it is a problem for you, speak about it with your doctor. You may be able to try another tablet or you may even be able to have the occasional drink and do so with little or no adverse reactions.
Street drugs such as cannabis, ecstasy, heroin, amphetamines or solvents can trigger seizures and when combined with a change in lifestyle that involves late nights and alcohol your risk of seizures is greatly increased. Talk to your doctor or epilepsy counsellor. You should not be playing Russian roulette with seizures. The first three to six months of your treatment are critical for you.
Compliance can become a particular problem for men whose self-image rests at the more rugged higher risk-taking, strongman end of the masculinity scale. It can be a problem for both men and women in the workforce where they have not told their colleagues or employers, or where there is a habit of spending time in the pub with mates or colleagues after work. There is some evidence that men, particularly younger men, can find this especially hard going. For some males their self-image can take a battering when they are not being permitted to drive for a certain period until seizures are controlled. Surveys have revealed that some males would rather tell their work mates and friends that they’re “off the road” for drink-driving than admit to having seizures. Being a male brings with it a range of expectations that can make epilepsy an especially hard condition if you allow yourself to be ruled by stereotypes.
Most professional drivers are men whether they drive trains, taxis, trams, buses or road transports. The farmer on the tractor is more likely to be a man. For older men, it is often the case that they are the only person left in the household who drives, once the children have grown up and moved out. Having epilepsy can mean that both partners have no immediate access to the car that has until now taken them shopping, visiting the kids, and even on holidays. It’s something to be dealt with, and many people have successfully done so before you. The best way is to get control of your seizures so they are no longer an impediment to your safe driving.
Those men who play sport, and in truth most men watch rather than play, tend to play more physically aggressive sports than women. There are major sports stars who have epilepsy who compete in some of the toughest sports played, but these guys have their seizures controlled. Without freedom from seizures it is inadvisable to play rough contact sports. Interestingly, head protection gear is increasingly seen as an important element to playing contact sports safely.
Being a Good Provider
For many men the idea of supporting a family is what keeps them going to work; often at jobs for which they don’t particularly care. It’s the idea of being the traditional breadwinner and it’s tied up with notions of male physical strength and the ability to protect those you love. Well the truth is, seizures can threaten this. They can lose you your job. They can cause you to have a serious work injury. They can leave you without an income, at home with the possibility of seizures while your partner is out earning money.
While some seizures [central or parietal lobe seizures] can involve sexual feelings and actually cause erections and ejaculation, the experience of epilepsy is more likely to lead to a decline in sexual energy or libido rather than an increase. The culprit most often blamed is the sedating effect of many antiepileptic drugs. While this can be a difficulty, for many men the fatigue from the drugs usually wears off or at least becomes quite manageable. What is now understood however is that the mechanisms of seizures can be implicated in reduced libido [or sexual drive] and reduced sexual function [potency] even without the added impact that some medications bring into the picture.
There is in fact a range of solutions to impotence and newer drugs such as Viagra appear to be compatible with antiepileptic medications. If such drugs help it is likely that they are redressing difficulties that are not based on epilepsy but are the same difficulties that millions of other men without epilepsy experience. If you do have sexual function difficulties and epilepsy, do not assume that one is necessarily the cause of the other.
All kinds of things can go wrong for all of us, and having epilepsy should not be seen as the culprit in every case. The important thing is to talk about anything that worries you with your doctor or counsellor so that you can move forward.
Can Having Sex Provoke Seizures?
Many men wonder if sexual activity can provoke seizures. The answer is that it is unlikely to do so. In fact an active sex life can have a decided stress reducing effect just as the lack of one can cause some guys to become quite stressed out. It’s important stuff to deal with and if you are in a slump since being diagnosed with epilepsy tell your doctor what’s happening. If he or she tells you not to worry about it, because you’re too old, or too young, or whatever, tell him or her that you want to talk to someone who understands why it does matter – a great deal. Your epilepsy association counsellor should also be able to help, or get you the help that you could need.
Don’t forget, if you are in a sexual relationship, your partner may want to reassure you of their love and support and may be frustrated by your lack of interest. So it’s important to talk. It’s not only OK to say the tablets make you tired, it’s important to let your partner in on what’s happening. Closing off from your partner at a time when things are tough may well be a more certain way of wrecking a good relationship than having to work through the issues of drug side effects and anxieties about sex.
Safety in the Home
Your doctor or counsellor will have pointed out a number of safety issues for your consideration. But there are some that are more likely to apply to men. Motor mowers and power tools have made many men’s lives a whole lot easier. They have also sliced through feet and fingers and worse with cold efficiency before the guy being chopped up even realised what was going on. Hammers and chisels, saws and bladed tools, ladders and being the one who climbs onto the roof are all things most men deal with. If you have epilepsy you’ll need to deal with it a bit more. The advice here is if you could hurt yourself by having a seizure while doing anything with tools then you just have to adapt the activity or pass on it until you know that your seizures aren’t going to happen. Fixing a leak in the roof may be sensible and you may be the only one in the house without a fear of heights, but it’s a heck of a lot harder fixing a broken leg or neck. You owe it to yourself and those around you to be careful.
We sometimes talk with men who have epilepsy who have been angry and whose anger has caused their marriages to break up or their friends to become distant or their colleagues to complain. It’s true that everyone can get angry at a diagnosis like epilepsy. In fact it’s pretty normal to feel some anger - as well as some anxiety, even depression. It is important to talk about these feelings because they are manageable. The trouble is many men are not so great at dealing with emotions like these. But you can and once you do you’ll learn that there’s plenty that you can do to improve things.
The one thing you can’t do is try to excuse anger by telling people that they just have to put up with it because you have epilepsy. Anger is a useful emotion but not if you can’t keep a lid on it. Anger if left unchecked, can do you a great deal of damage. Talk to your doctor or epilepsy counsellor and get through it.