Epilepsy and polycystic ovary syndrome: where is the link?

Several reports in the literature describe an increased prevalence of polycystic ovary syndrome (PCOS) in women with epilepsy. The possible pathogenesis of the association between epilepsy and PCOS is not clear yet, and different hypotheses have been proposed: while some authors suggest that epilepsy may affect the hypothalamic control of reproductive function, others propose a pathogenic role of the antiepileptic drug valproate. In this article we review the literature on the subject, and propose a pathogenic theory in which both epilepsy and valproate play different and significant roles in inducing reproductive endocrine disturbances in women with seizures.