The clinical use of dehydroepiandrosterone in postmenopausal women

A basic understanding of the distinct metabolism, mechanism of action, and clinical use of dehydroepiandrosterone and its metabolites is critical to balancing the hormone milieu in postmenopausal women. To date, studies of dehydroepiandrosterone therapy in women with adrenal insufficiency suggest that they are the most likely group to gain health benefits from dehydroepiandrosterone replacement therapy. Our understanding of the potential long-term health benefits of replacing dehydroepiandrosterone along with other deficient hormones is still only in its infancy. With the evidence currently available, however, one can reasonably suggest that dehydroepiandrosterone offers the promise of a safe and efficient replacement therapy for specific symptoms common to postmenopausal women. This article reviews the metabolism, physiology, and clinical use of dehydroepiandrosterone in postmenopausal women. The clinical effectiveness of dehydroepiandrosterone for vulvovaginal atrophy, sexual dysfunction, osteoporosis, adrenal and immunological function, cardiovascular disease, and, in combination, hormone replacement therapy is reviewed. In addition, the use of the dehydroepiandrosterone metabolite 7-keto-dehydroepiandrosterone for weight loss is discussed.