Endocrine dysfunction is commonly observed in women with epilepsy and may influence seizure frequency, response to antiseizure medications (ASMs), and reproductive health.

A retrospective case–control study was conducted at a tertiary neurology center in South India. The study included 40 women aged 15–35 years with IGE, diagnosed according to the ILAE criteria, and 40 age-matched healthy controls.

Fasting venous samples were collected on day 3 of the follicular phase and analyzed for thyroid hormones, gonadotropins, prolactin, and sex steroids using chemiluminescence immunoassay. Androstenedione and 17-hydroxyprogesterone were measured by ELISA. Additional parameters including fasting glucose, insulin, insulin resistance, lipid profile, hematologic indices and body mass index were recorded.

Patient has markedly elevated levels of LH (6.01 ± 3.90 mIU/L vs 2.85 ± 1.36 mIU/L; p < 0.001) , while FSH levels were significantly reduced (6.51 ± 2.41 mIU/L vs 9.03 ± 1.22 mIU/L; p < 0.001), resulting in an altered LH/FSH ratio. Androstenedione (0.76 ± 0.27 ng/ml vs 1.90 ± 0.71 ng/ml; p < 0.001), and testosterone(0.22 ± 0.17 ng/ml vs 0.29 ± 0.12 ng/ml; p = 0.04), were significantly lower in patients, same for estradiol(44.94 ± 31.97 pg/ml vs 78.23 ± 13.76 pg/ml; p < 0.001) and 17-OH-progesterone (0.54 ± 0.27 ng/ml vs 1.01 ± 0.34 ng/ml; p < 0.001) is significantly lower in patients . Metabolic assessment showed lower insulin resistance(0.95 ± 0.23 vs 1.08 ± 0.25; p = 0.02), with comparable fasting glucose levels (87.73 ± 18.42 mg/dl vs 81.00 ± 8.40 mg/dl; p = 0.07)is seen. BMI was higher than controls (23.87 vs.24.45,p=0.05).

Women with IGE show significant hormonal and metabolic alterations, including an increased LH/FSH ratio and reduced sex steroid levels. These findings suggest underlying hypothalamic–pituitary–gonadal axis dysfunction.