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Androgen therapy with dehydroepiandrosterone.

Jacques Buvat1

  • 1Centre d'Etude et de Traitement de la Pathologie de l'Appareil, Reproducteur et de la Psychosomatique (CETPARP), 3 rue Carolus, 59000 Lille, France. jacques-buvat@wanadoo.fr

World Journal of Urology
|October 11, 2003
PubMed
Summary

Dehydroepiandrosterone (DHEA) supplementation shows potential benefits for women

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Area of Science:

  • Endocrinology
  • Neuroendocrinology
  • Gerontology

Background:

  • The physiological role of dehydroepiandrosterone (DHEA) remains unclear, despite its decline with age.
  • DHEA's potential involvement in cognitive, metabolic, vascular, immune, and sexual functions is suggested by its neurosteroid capacity and receptor discoveries.
  • Conflicting epidemiologic data and limited clinical trials necessitate further research into DHEA's human functions and supplementation efficacy.

Purpose of the Study:

  • To review the current understanding of dehydroepiandrosterone (DHEA) physiological roles.
  • To evaluate the evidence for DHEA supplementation's benefits and risks in various human conditions.
  • To provide practical guidance on DHEA dosage, contraindications, and follow-up.

Main Methods:

  • Review of existing epidemiologic studies and clinical trial data on DHEA and DHEA sulfate (DHEAS).
  • Analysis of double-blind placebo-controlled trials investigating DHEA supplementation in different patient groups.
  • Consideration of DHEA's metabolic pathways, including conversion to testosterone and estradiol.

Main Results:

  • DHEA supplementation (30-50 mg) may improve mood, well-being, and sexual function in women with adrenal insufficiency.
  • Long-term DHEA supplementation in women over 60 increased bone mineral density and sexual function in older subgroups.
  • A 200 mg dose of DHEA reduced disease activity in systemic lupus erythematosus, and higher doses improved mood in depressive symptoms.
  • DHEA therapy may be considered for women with sexual dysfunction and documented androgen deficiency, with a lower risk of overdose compared to testosterone.
  • DHEA conversion to estradiol poses a potential cancer risk in postmenopausal women; no consistent benefits were found in men.

Conclusions:

  • DHEA supplementation demonstrates plausible benefits for specific conditions in women, including mood, sexual function, bone density, and lupus.
  • While DHEA therapy may be considered for certain sexual dysfunctions in women, potential risks like estradiol conversion must be managed.
  • Evidence for DHEA's benefits in men is lacking, and its role in other conditions requires further substantiation.

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