Dehydroepiandrosterone therapy as female androgen replacement

Dehydroepiandrosterone (DHEA) is an abundant circulating androgen precursor preferentially produced by the adrenal glands. DHEA has been shown to exert its effects via downstream conversion to sex steroid hormones, neuromodulation, improvement in endothelial cell function, and possibly by acting on a cell membrane-bound receptor. Low levels of circulating DHEA have been demonstrated in women with diminished libido and other symptoms of sexual dysfunction. DHEA deficiency has also been associated with various drugs, and endocrine, nonhormonal, and age-related disorders. DHEA supplementation has been shown to produce beneficial effects in women with adrenal insufficiency. However, DHEA supplementation in healthy euadrenal subjects (including premenopausal and postmenopausal women with androgen insufficiency) is controversial; studies have yielded conflicting results regarding its beneficial effects on sexual function, metabolism, and overall well-being. Further research is needed to better elucidate the efficacy and safety of DHEA supplementation for the treatment of androgen insufficiency in women.