A randomized trial of oral DHEA treatment for sexual function, well-being, and menopausal symptoms in postmenopausal women with low libido. Effect of 1-year, low-dose DHEA therapy on climacteric symptoms and female sexuality Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause Intravaginal dehydroepiandrosterone (Prasterone), a physiological and highly efficient treatment of vaginal atrophy Effect of intravaginal dehydroepiandrosterone (Prasterone) on libido and sexual dysfunction in postmenopausal women Endocrine, neuroendocrine and behavioral effects of oral dehydroepiandrosterone sulfate supplementation in postmenopausal women. DHEA, important source of sex steroids in men and even more in women. A randomized controlled trial of dehydroepiandrosterone in postmenopausal women with fibromyalgia. Intravaginal dehydroepiandrosterone (prasterone), a highly efficient treatment of dyspareunia Changes in hormones, lipids and symptoms after the administration of a commercial preparation with dehydroepiandrosterone in postmenopausal women. The use of dehydroepiandrosterone in the treatment of hypoactive sexual desire disorder: A report of gender differences Androgens and estrogens in relation to hot flushes during the menopausal transition. Low serum levels of sex steroids are associated with disease characteristics in primary Sjogren's syndrome; supplementation with dehydroepiandrosterone restores the concentrations. Acute dehydroepiandrosterone (DHEA) effects on sexual arousal in postmenopausal women. Replacement of dehydroepiandrosterone in adrenal failure: no benefit for subjective health status and sexuality in a 9-month, randomized, parallel group clinical trial. Dehydroepiandrosterone for the treatment of hot flashes: a pilot study. Changes in androgens during treatment with four low-dose contraceptives.
INTRODUCTION Dehydroepi and rosterone ( DHEA ) and its sulfate DHEAS , which are the most abundant steroids in women , decline with age . We have shown association between low sexual function and low circulating DHEAS levels in women . AIM The aim of this study was to evaluate whether restoration of circulating DHEA levels in postmenopausal women to the levels seen in young individuals improves sexual function . METHODS Ninety-three postmenopausal women not using concurrent estrogen therapy were enrolled in a 52-week r and omized , double-blind , placebo controlled trial and received either DHEA 50 mg or placebo ( PL ) daily . MAIN OUTCOME MEASURES Efficacy was assessed through 26 weeks . The main outcome measures were the change in total satisfying sexual events ( SSE ) and the change in the Sabbatsberg Sexual Self-Rating Scale ( SSS ) total score . Secondary measures were the Psychological General Well-Being Question naire ( PGWB ) , and the Menopause-Specific Quality of Life Question naire ( MENQOL ) . Hormonal levels , adverse events ( AEs ) , serious adverse events ( SAEs ) and clinical labs were evaluated over 52 weeks . RESULTS Eighty-five participants ( 91 % ) were included in the 26-week efficacy analysis . There were no significant differences between the DHEA and PL groups in the change in total SSE per month or the SSS , PGWB , and MENQOL change scores . Overall AE reports and number of withdrawals as a result of AEs were similar in both groups ; however more women in the DHEA group experienced and rogenic effects of acne and increased hair growth . CONCLUSIONS In this study treatment of postmenopausal women with low sexual desire with 50 mg/day DHEA result ed in no significant improvements in sexual function over PL therapy over 26 weeks ABSTRACT Background Sexual desire is affected by endocrine and psychosocial factors . Menopausal hormonal changes are relevant to the causes of sexual dysfunction during reproductive aging . Aim To evaluate the effects of different types of hormonal replacement therapy ( HRT ) on sexual function , frequency of sexual intercourse , and quality of relationship in early postmenopausal women . We recruited 48 healthy postmenopausal women aged 50–60 years ( mean age 54.5 ± 3.3 years ) . Women with climacteric symptoms were uniformly r and omized into three groups receiving either dehydroepi and rosterone ( DHEA 10 mg ) daily , or daily oral estradiol ( 1 mg ) plus dihydrogesterone ( 5 mg ) , or daily oral tibolone ( 2.5 mg ) for 12 months . Women who refused hormonal therapy were treated with oral vitamin D ( 400 IU ) . Efficacy was evaluated using the McCoy Female Sexuality Question naire before treatment and after 12 months . We evaluated the hormonal profile before treatment and after 3 , 6 and 12 months . Results The groups receiving DHEA or HRT reported a significant improvement in sexual function compared to baseline ( p < 0.001 and p < 0.01 , respectively ) using the McCoy total score . The quality of relationship was similar at baseline and after 3 , 6 and 12 months of treatment . There were significant increases in the numbers of episodes of sexual intercourse in the previous 4 weeks in women treated with DHEA , HRT and tibolone in comparison with the baseline value ( p < 0.01 , p < 0.05 , p < 0.01 , respectively ) . No changes in the McCoy score occurred in women receiving vitamin D. Conclusions Daily oral DHEA therapy at the dose of 10 mg , HRT and tibolone all provided a significant improvement in comparison with vitamin D  in sexual function and in frequency of sexual intercourse in early postmenopausal women Objective : The aim of this study is to confirm the local beneficial effects of intravaginal dehydroepi and rosterone ( DHEA , Prasterone ) on moderate to severe dyspareunia or pain at sexual activity , the most frequent symptom of vulvovaginal atrophy due to menopause or genitourinary syndrome of menopause ( GSM ) . Methods : In a prospect i ve , r and omized , double-blind , and placebo-controlled phase III clinical trial , the effect of daily intravaginal 0.50 % DHEA ( 6.5 mg ) ( Prasterone , EndoCeutics ) was examined on four co primary objectives , namely percentage of parabasal cells , percentage or superficial cells , vaginal pH , and moderate to severe pain at sexual activity ( dyspareunia ) identified by the women as their most bothersome vulvovaginal atrophy symptom . The intent-to-treat population included 157 and 325 women in the placebo and DHEA-treated groups , respectively . Results : After daily intravaginal administration of 0.50 % DHEA for 12 weeks , when compared to baseline by the analysis of covariance test , the percentage of parabasal cells decreased by 27.7 % over placebo ( P < 0.0001 ) , whereas the percentage of superficial cells increased by 8.44 % over placebo ( P < 0.0001 ) , vaginal pH decreased by 0.66 pH unit over placebo ( P < 0.0001 ) , and pain at sexual activity decreased by 1.42 severity score unit from baseline or 0.36 unit over placebo ( P = 0.0002 ) . On the other h and , moderate to severe vaginal dryness present in 84.0 % of women improved at 12 weeks by 1.44 severity score unit compared to baseline , or 0.27 unit over placebo ( P = 0.004 ) . At gynecological evaluation , vaginal secretions , epithelial integrity , epithelial surface thickness , and color all improved by 86 % to 121 % over the placebo effect ( P < 0.0001 for all comparisons with placebo ) . Serum steroid levels remained well within the normal postmenopausal values according to the involved mechanisms of intracrinology . The only side effect reasonably related to treatment is vaginal discharge due to melting of the vehicle at body temperature and this was reported in about 6 % of the participants . Conclusions : The daily intravaginal administration of 0.50 % ( 6.5 mg ) DHEA ( Prasterone ) has shown clinical ly and highly statistically significant effects on the four co primary parameters suggested by the US Food and Drug Administration . The strictly local action of Prasterone is in line with the absence of significant drug-related adverse events , thus showing the high benefit-to-risk ratio of this treatment based upon the novel underst and ing of the physiology of sex steroids in women Objective : Because the secretion of dehydroepi and rosterone ( DHEA ) , the exclusive source of sex steroids in postmenopausal women , is already decreased by 60 % and continues to decline at the time of menopause , the objective of this study was to examine the effect of intravaginal DHEA on the symptoms and signs of vaginal atrophy . Methods : This prospect i ve , r and omized , double-blind and placebo-controlled phase III clinical trial studied the effect of Prasterone ( DHEA ) applied locally in the vagina on the signs and symptoms of  vaginal atrophy in 216 postmenopausal women . Results : All three doses ( 0.25 % , 0.5 % , and 1.0 % ) of DHEA ovules applied daily intravaginally induced a highly significant beneficial change in the percentage of vaginal parabasal and superficial cells and pH as well as in the most bothersome symptom at 2 weeks . At the st and ard 12-week time interval , 0.5 % DHEA caused a 45.9 ± 5.31 ( P < 0.0001 vs placebo ) decrease in the percentage of parabasal cells , a 6.8 ± 1.29 % ( P < 0.0001 ) increase in superficial cells , a 1.3 ± 0.13 unit ( P < 0.0001 ) decrease in vaginal pH , and a 1.5 ± 0.14 score unit ( P < 0.0001 ) decrease in the severity of the most bothersome symptom . Similar changes were seen on vaginal secretions , color , epithelial surface thickness , and epithelial integrity . Comparable effects were observed at the 0.25 % and 1.0 % DHEA doses . Conclusions : Local Prasterone , through local and rogen and estrogen formation , causes a rapid and efficient reversal of all the symptoms and signs of vaginal atrophy with no or minimal changes in serum steroids , which remain well within the normal postmenopausal range . This approach avoids the fear of systemic effects common to all presently available estrogen formulations and adds a novel physiological and rogenic component to therapy Objective : The objective of this study was to provide evidence that the transformation of DHEA into both and rogens and /or estrogens locally in cells of the three layers of the vagina ( epithelium , lamina propria , and muscularis ) would have effects of greater impact , including effects on sexual function , than only effects on superficial epithelial cells as achieved with estrogens . Methods : This prospect i ve , r and omized , double-blind , and placebo-controlled phase III clinical trial has evaluated the effect of daily local intravaginal application of Prasterone ( dehydroepi and rosterone ; DHEA ) for 12 weeks on the domains of sexual dysfunction , namely , desire/interest , arousal , orgasm , and pain at sexual activity , in 216 postmenopausal women with moderate to severe symptoms of vaginal atrophy . Results : A time- and dose-dependent improvement of the four domains of sexual function was observed . At the 12-week time interval , the 1.0 % DHEA dose led , compared with placebo , to 49 % ( P = 0.0061 ) and 23 % ( P = 0.0257 ) improvements of the desire domains in the Menopause Specific Quality of Life and Abbreviated Sex Function question naires , respectively . Compared with placebo , the Abbreviated Sex Function arousal/sensation domain was improved by 68 % ( P = 0.006 ) , the arousal/lubrication domain by 39 % ( P = 0.0014 ) , orgasm by 75 % ( P = 0.047 ) , and dryness during intercourse by 57 % ( P = 0.0001 ) . Conclusions : By a local action in the vagina , DHEA applied daily at doses at which serum steroids remain well within normal postmenopausal values exerts relatively potent beneficial effects on all four aspects of sexual dysfunction . Such data indicate that combined and rogenic/estrogenic stimulation in the three layers of the vagina exerts important beneficial effects on sexual function in women without systemic action on the brain and other extravaginal tissues Aging in women and men is characterized by a progressive decline of circulating dehydroepi and rosterone ( DHEA ) levels and its sulfate ester ( DHEAS ) . The improvement of wellbeing described in postmenopausal women treated with DHEA  suggests that this steroid may exert specific actions on the central nervous system ( CNS ) . The postmenopausal period is associated with several neuroendocrine modifications . The decrease of circulating levels of beta-endorphin is considered a hormonal marker of those changes . The aim of the present study was to investigate neuroendocrine and behavioral effects of three months of DHEAS supplementation in postmenopausal women . Postmenopausal women ( n = 22 ) were divided in three groups : the first group was treated with oral DHEAS ( n = 8) ( 50 mg/day ) , the second treated with the same dose of oral DHEAS + transdermal estradiol ( n = 8) ( DHEAS ) 50 mg/day , estradiol 50 micrograms/patch ) and the third with transdermal estradiol alone ( n = 6 ) ( 50 micrograms/day ) . Before and after 1 , 2 and 3 months of therapy , the following circulating steroid and protein hormone levels were evaluated : DHEA , DHEAS , and rostenedione , testosterone , estrone , estradiol , 17-hydroxyprogesterone , sex hormone-binding globulin ( SHBG ) , follicle-stimulating hormone ( FSH ) , luteinizing hormone ( LH ) , beta-endorphin , growth hormone ( GH ) and cortisol , and a Kupperman score was performed . Before and after treatments , plasma beta-endorphin levels were evaluated in response to three neuroendocrine tests : ( a ) clonidine , an alpha 2-presynaptic adrenergic agonist ( 1.25 mg i.v . ) ( b ) naloxone , an opioid receptor antagonist ( 4 mg i.v . ) and ( c ) fluoxetine , a serotonin selective reuptake inhibitor ( 30 mg p.o . ) . In both groups of women treated with  DHEAS  , mean basal serum DHEA , DHEAS , and rostenedione , and testosterone levels significantly increased after treatment , while no changes were shown in the group receiving estradiol alone . Serum estradiol , estrone , GH and plasma beta-endorphin levels significantly increased progressively for the three months of treatment , with higher levels for estrone and estradiol in subjects receiving estradiol alone or plus DHEAS . Serum SHBG , cortisol , and 17-hydroxyprogesterone did not show significant variations under any treatment . Serum LH and FSH levels showed a significant decrease in groups treated with estradiol alone or plus DHEAS at the second and third months . The Kupperman score showed that all treatments were associated with similar and progressive improvement . Before therapy clonidine , naloxone and fluoxetine stimuli failed to modify circulating beta-endorphin levels . After each of the treatments , the beta-endorphin response was completely restored and was similar , independent of the kind of therapy . Restoration of the beta-endorphin response to specific stimuli suggests that DHEAS and /or its active metabolites modulates the neuroendocrine control of pituitary beta-endorphin secretion , which may support the therapeutic efficacy of the DHEAS on behavioral symptoms A major achievement from 500 million years of evolution is the establishment of a high secretion rate of dehydroepi and rosterone ( DHEA ) by the human adrenal gl and s coupled with the indroduction of menopause which stops secretion of estrogens by the ovary . Cessation of estrogen secretion at menopause eliminates the risks of endometrial hyperplasia and cancer which would result from non-opposed estrogen stimulation during the post-menopausal years . In fact , from the time of menopause , DHEA becomes the exclusive and tissue-specific source of sex steroids for all tissues except the uterus . Intracrinology , a term coined in 1988 , describes the local formation , action and inactivation of sex steroids from the inactive sex steroid precursor DHEA . Over the past 25 years most , if not all , the genes encoding the human steroidogenic and steroid-inactivating enzymes have been cloned and sequenced and their enzymatic activity characterized . The problem with DHEA , however , is that its secretion decreases from the age of 30 years and is already decreased , on average , by 60 % at time of menopause . In addition , there is a large variability in the circulating levels of DHEA with some post-menopausal women having barely detectable serum concentrations of the steroid while others have normal values . Since there is no feedback mechanism controlling DHEA secretion within ' normal ' values , women with low DHEA will remain with such a deficit of sex steroids for their remaining lifetime . Since there is no other significant source of sex steroids after menopause , one can reasonably believe that low DHEA is involved , in association with the aging process , in a series of medical problems classically associated with post-menopause , namely osteoporosis , muscle loss , vaginal atrophy , fat accumulation , hot flashes , skin atrophy , type 2 diabetes , memory loss , cognition loss and possibly Alzheimer 's disease . A recent r and omized , placebo-controlled study has shown that all the signs and symptoms of vaginal atrophy , a classical problem recognized to be due to the hormone deficiency of menopause , can be rapidly improved or corrected by local administration of DHEA without systemic exposure to estrogens . In addition , the four domains of sexual dysfucntion are improved . For the other problems of menopause , although similar large scale , r and omized and placebo-controlled studies usually remain to be performed , the available evidence already strongly suggests that they could be improved , corrected or even prevented by exogenous DHEA . In men , the contribution of adrenal DHEA to the total and rogen pool has been measured at 40 % in 65 - 75-year-old men . Such data stress the necessity of blocking both the testicular and adrenal sources of and rogens in order to achieve optimal benefits in prostate cancer therapy . On the other h and , the comparable decrease in serum DHEA levels observed in both sexes has less consequence in men who continue to receive a practically constant supply of testicular sex steroids during their whole life . In fact , in men , the appearance of hormone-deficiency symptoms common to women is observed at a later age and with a lower degree of severity . Consequently , DHEA replacement has shown much more easily measurable beneficial effects in women . Most importantly , despite the non-scientific and unfortunate availability of DHEA as a food supplement in the United States , a situation that discourages rigorous clinical trials on the crucial physiological and therapeutic role of DHEA , no serious adverse event related to DHEA has ever been reported in the world literature ( thous and s of subjects exposed ) or in the monitoring of adverse events by the FDA ( millions of subjects exposed ) , thus indicating , as expected from its known physiology , the excellent safety profile of DHEA . With today 's knowledge , one can reasonably suggest that DHEA offers the promise of a safe and efficient replacement therapy for the multiple problems related to hormone deficiency after menopause without the risks associated with estrogen-based or any other treatments OBJECTIVE Patients with fibromyalgia ( FM ) consistently have adrenal hyporesponsiveness and low dehydroepi and rosterone ( DHEA ) levels . DHEA is promoted for and used by patients with FM . We tested the efficacy and safety of DHEA supplementation in ameliorating the symptoms of FM . METHODS In a double-blind crossover study , postmenopausal women with FM were r and omized to DHEA supplementation  ( 50 mg/day ) or placebo for 3 months , with a one-month washout period in between . Patients were assessed monthly for well-being and pain and by medical evaluations at the beginning and the end of each treatment period . The primary outcome was well being ; secondary outcomes were pain , fatigue , cognition , sexuality , functional impairment , depression , and anxiety . RESULTS A total of 52 patients were r and omized , 47 patients completed the  DHEA  treatment period , and 45 the placebo treatment period . After 3 months of treatment with 50 mg of DHEA , median DHEA sulfate blood levels had tripled , but there was no improvement in well-being , pain , fatigue , cognitive dysfunction , functional impairment , depression , or anxiety , nor in objective measurements made by physicians . And rogenic side effects ( greasy skin , acne , and increased growth of body hair ) were more common during the DHEA treatment period ( p = 0.02 ) . CONCLUSION DHEA does not improve quality of life , pain , fatigue , cognitive function , mood , or functional impairment in FM Objective To examine the effect of intravaginal dehydroepi and rosterone ( DHEA ) on pain at sexual activity ( dyspareunia ) identified as the most bothersome symptom of vaginal atrophy in postmenopausal women at both screening and day 1 . Methods This prospect i ve , r and omized , double-blind and placebo-controlled phase III clinical trial studied the effect of prasterone ( DHEA ) applied locally in the vagina on the severity of dyspareunia in 114 postmenopausal women who had identified dyspareunia as their most bothersome symptom of vaginal atrophy , while meeting the criteria for superficial cells ≤ 5 % and pH > 5.0 at both screening and day 1 . Results At the st and ard duration of 12 weeks of treatment , increasing doses of 0.25 % , 0.5 % and 1.0 % DHEA decreased the percentage of parabasal cells by 48.6 ± 6.78 % , 42.4 ± 7.36 % and 54.9 ± 6.60 % ( p < 0.0001 vs. placebo for all ) with no change with placebo ( p = 0.769 ) . The effects on superficial cells and pH were also highly significant compared to placebo at all DHEA doses . The severity score of pain at sexual activity decreased by 0.5 , 1.4 , 1.6 and 1.4 units in the placebo and 0.25 % , 0.5 % and 1.0 % DHEA groups , respectively , with the p value of differences from placebo ranging from 0.0017 to < 0.0001 . Conclusions Intravaginal DHEA , through local estrogen and and rogen formation , causes a rapid and highly efficient effect on pain at sexual activity without systemic exposure of the other tissues , thus avoiding the recently reported systemic effects of estrogens Dehydroepi and rosterone ( DHEA ) is an adrenal and rogen precursor of sex steroids with effects on a variety of physiological events [ 1 ] . DHEA and its sulfate ( DHEAS ) , as well as and rostendione , have minimal and rogenic activity [ 2 ] . It has been reported that serum levels of DHEA and DHEA-S substantially decrease with age , and experimental studies have demonstrated benefit with DHEA substitution at physiologic doses [ 3 ] . DHEA and DHEA-S are abundant in the circulation . DHEA-S accounts for more than 99 % of the steroid in the serum , with less than 1 % of free DHEA . Their main actions have been related to cellular control , immunoregulation , obesity and lipid metabolism [ 2 ] . Estrogen and and rogen replacement therapy date s to 1941 , when Geist and Salmon used and rogen therapy to treat climacteric symptoms [ 4 ] . DHEA has also been used as part of hormone therapy . In a study in which women from 60 to 70 years age received  DHEA  , a significant increase was observed in bone mineral density at the hip . This was followed by an increase in serum osteocalcin ( a bone formation marker ) , which was supposed to be due to DHEA and rogenic action . These results suggest that DHEA can be useful in the prevention and treatment of osteoporosis [ 5 ] . In another study , DHEA was given in a dose of 50 mg/day for 6 months to men and women aged 40 to 70 years . No changes were observed in estrone ( E ) and estradiol ( E2 ) serum levels in either sex . In women , there was a decrease in high-density lipoprotein cholesterol ( HDL-C ) levels without changes in the other lipids . Insulin sensitivity and mean body fat were not modified , and an increase in subjective physical well-being was cl aim ed in 67 % of men and in 84 % of women [ 6 ] . When DHEA was applied percutaneously in women from 60 to 70 years age for 12 months , no changes were observed in body weight . However , there was a 3.8 % decrease of body fat and an increase of 3.5 % in the muscular mass at the femoral level . HDL-C levels decreased 8 % , but the HDL-C/total cholesterol ratio did not change due to a parallel decrease of total cholesterol [ 7 ] . It then appears that the literature is controversial about DHEA effects . Commercial DHEA formulations are frequently used in Mexico , as in other countries . Therefore , the objective of this study was to evaluate a formulation of DHEA ( Siscelar plus  ) , commercially available in Mexico , on hormone and lipid levels and on climacteric symptoms after administration to postmenopausal women Data regarding the efficacy of dehydroepi and rosterone ( DHEA ) in the treatment of hypoactive sexual desire disorder ( HSDD ) are scarce and inconsistent . We aim ed to determine possible gender differences in the efficacy of DHEA as a treatment for HDSS . Postmenopausal women ( n=27 ) , and men ( n=21 ) with HSDD , were r and omized to receive either DHEA 100 mg daily or placebo for 6 weeks in a controlled , double blind study . Primary outcome measures were sexual function question naires . Hormone serum levels of DHEAS , total and bioavailable testosterone , estradiol , and urine levels of DHEA and and rosterone were also measured . Participants on active treatment showed a significant increase in circulating serum levels of DHEAS , while bioavailable testosterone levels increased in women only . In women only , significant interaction effects were observed for sexual arousal ( p<0.05 ) , satisfaction ( p<0.05 ) , and cognition ( trend ; p=0.06 ) . For arousal , a significant improvement was observed for the DHEA treated group at 6 weeks ( p=0.001 ) . Significant correlations were observed between bioavailable T and sexual cognitions , arousal and orgasm , while DHEAS was correlated with satisfaction . In the men , significant correlations were observed between testosterone and arousal ( r=.45 ) , sexual drive ( r=.50 ) and orgasm ( r=.55 ) . In women with HSDD , DHEA treatment had a significant beneficial effect on arousal , whereas no efficacy was demonstrated in men , indicating a possible gender difference . This improvement seems to be mediated via DHEA 's metabolism to testosterone . Our positive results suggest that the neurosteroid DHEA may be effective as a treatment for women with HSDD if administered at a dose of at least 100 mg per day In this paper , the association of hormones to vasomotor complaints during the menopausal transition is discussed . Fifty-seven regularly menstruating women without history of hormone replacement therapy ( HRT )  were selected for a longitudinal , prospect i ve study around the menopausal transition . The mean age at the start of the study was 51.3 ( + /-2.0 ) years . At intervals of 12 months all women went through a semi-structured interview and filled in question naires .  Venous blood sample s were collected every 12-month for analyses of estradiol ( E2 ) , testosterone , and rostendione , dehydroepi and rosterone-sulphate ( DHEA-S ) , follicle stimulating hormone ( FSH ) , thyrotropin ( TSH ) , and luteinizing hormone ( LH ) . Vasomotor complaints were tested using questions about hot flushes and bouts of sweating in terms of occurrence , frequency and degree of distress . Forty-six percent of the subjects reported hot flushes and bouts of sweating before menopause , increasing to 67 % during the first year after menopause and 49 % in the second year postmenopause . Low levels of estradiol and high levels of FSH were associated with vasomotor complaints before menopause . During menopause high levels of TSH were related to vasomotor complaints . The first year after menopause , women , who at this point achieved hot flushes , were characterised by high levels of E2 , but declining and low levels of FSH , but increasing . Postmenopausal , high levels of testosterone and DHEA-S seemed to protect against vasomotor symptoms . Our most important finding was , that among women who achieved hot flushes at the first assessment postmenopause , the high and rogen levels was a significant predictor of recovery from hot flushes at the last assessment , 1 year later CONTEXT Serum levels of the sex steroid prohormones dehydroepi and rosterone ( DHEA ) and DHEA sulfate ( DHEA-S ) decline upon aging and are reduced in primary Sjogren 's syndrome . OBJECTIVE Our aim was to investigate : 1 ) effects of 50 mg oral DHEA/day on changes in serum levels of DHEA and 12 of its metabolites ; 2 ) relationships between steroid levels and disease characteristics ; and 3 ) whether these parameters were influenced by DHEA . DESIGN Twenty-three postmenopausal women with primary Sjogren 's syndrome and subnormal levels of DHEA-S were included in a r and omized , 9-month , controlled , double blind crossover study . Liquid chromatography/mass spectrometry (MS)/MS and gas chromatography/MS were used to measure the sex steroids . Anti-SS-A/Ro and /or anti-SS-B/La , salivary gl and focus score , salivary flow rates , dry mouth and eye symptoms , and routine laboratory tests were assessed . RESULTS Baseline erythrocyte sedimentation rate was inversely correlated with testosterone ( Testo ) , dihydrotestosterone , and DHEA-S ( rs = -0.42 , -0.45 , and -0.58 , respectively ) . Dry mouth symptoms correlated with low Testo and and rostenedione , whereas dry eyes correlated with low estrogens , most strongly estrone ( rs = -0.63 ) . Presence of anti-SS-A and /or anti-SS-B was independently associated with low estradiol ( area under the receiver operating characteristic curve , 0.82 ) . All metabolites increased during DHEA but not during placebo . The relative increases were less for estrogens and Testo compared to dihydrotestosterone and glucuroni date d and rogen metabolites . Dry mouth symptoms decreased during DHEA therapy . CONCLUSIONS Disease manifestations in primary Sjogren 's syndrome were associated with low sex hormone levels , dry mouth symptoms with low and rogens , and dry eyes with low estrogens . Exogenous DHEA was preferentially transformed into and rogens rather than into estrogens BACKGROUND The age-related decline of dehydroepi and rosterone ( DHEA ) has prompted research on its experimental replacement in women . Although no relationship to sexual functioning in healthy women has been shown to date , DHEA replacement has potential for affecting sexual response . METHODS To investigate DHEA effects , 16 sexually functional postmenopausal women participated in a r and omized , double-blind , crossover protocol in which oral administration of DHEA ( 300 mg ) or placebo occurred 60 minutes before the presentation of an erotic video segment . Blood DHEA sulfate ( DHEAS ) changes , subjective and physiological sexual responses , as well as affective responses were measured in response to videotaped neutral and erotic video segments . RESULTS The concentration of DHEAS increased 2 - 5-fold following DHEA administration in all 16 women . Subjective ratings across DHEA and placebo conditions showed significantly greater mental ( p < 0.016 ) and physical ( p < 0.036 ) sexual arousal to the erotic video with DHEA vs. placebo .  Positive affect also increased during the erotic video across drug conditions . Vaginal pulse amplitude ( VPA ) and vaginal blood volume ( VBV ) demonstrated a significant increase ( p < 0.001 ) between neutral and erotic film segments within both conditions ( DHEA and placebo ) but did not differentiate drug conditions . CONCLUSION In sum , increases in mental and physical sexual arousal ratings significantly increased in response to an acute dose of DHEA in postmenopausal women The physiological role of dehydroepi and rosterone ( DHEA ) is not well understood , but studies suggest positive effects on subjective health and bone metabolism . We have conducted a clinical trial with DHEA replacement in adrenal failure with the primary aim of evaluating effects on subjective health status and sexuality .  Thirty-nine women with adrenal failure were r and omized to 9 months of treatment with 25 mg DHEA ( n = 19 ) or placebo ( n = 20 ) . Treatment effects were assessed by vali date d question naires of subjective health and sexuality .  DHEA replacement yielded a wide variation of effects on the subjective health scales , which were not different from the effects of placebo . Almost all patients receiving DHEA obtained normal and rogen levels . Eighty-nine percent of the patients receiving DHEA experienced side-effects , in particular increased sweat odor and scalp itching .  DHEA replacement did not significantly change the levels of blood lipids , IGF-I , and markers of bone metabolism . In conclusion , we do not find evidence of beneficial effects of DHEA on subjective health status and sexuality in adrenal failure . However , DHEA may be beneficial for subgroups of patients with adrenal failure , but these remain to be identified . Premenopausal and rogen levels can be restored with 25 mg DHEA daily in most female patients , but side-effects are frequent BACKGROUND Published data regarding the negative risk-benefit ratio of traditional estrogen/progesterone hormone replacement therapy for menopausal symptoms have indicated the need for alternative treatments . Dietary supplements and herbal products are popularly used for menopausal control without a large evidence base . Therefore , a prospect i ve pilot trial using 50 mg of dehydroepi and rosterone ( DHEA ) once daily for 4 weeks following a baseline week was developed to explore whether DHEA has any efficacy in reducing hot flashes . Safety issues were also evaluated . PATIENTS AND METHODS Twenty-eight women were enrolled in this study , 22 of whom are evaluable . The primary outcome was the reduction in hot flash score ( frequency multiplied by average severity ) from baseline as measured by vali date d self-report daily hot flash diaries . RESULTS The mean hot flash score decreased 50 % from baseline , and there were no side effects that were significantly worse compared with baseline . Quality of life related to hot flashes showed statistically significant improvement after 4 weeks of DHEA therapy . CONCLUSION This pilot study provides data supporting the hypothesis that DHEA is well tolerated and can reduce hot flashes . Dehydroepi and rosterone should be studied further in a larger , placebo-controlled trial The aim of the present study was to compare changes in the endogenous and rogen environment in healthy women while on low-dose oral contraceptives ( OCs ) . One-hundred healthy women were r and omized to receive one of four OCs during six months : 21 tablets of Cilest , Femodeen , Marvelon , or Mercilon . During the luteal phase of the pretreatment cycle , body weight and blood pressure were recorded and the following parameters were measured : sex hormone-binding globulin ( SHBG ) , corticosteroid-binding globulin ( CBG ) , testosterone ( T ) , free testosterone ( FT ) , 5 alpha-dihydrotestosterone ( DHT ) , and rostenedione ( A ) , dehydroepi and rosterone-sulphate ( DHEA-S ) and 17 alpha-hydroxyprogesterone ( 170HP ) while also the free and rogen index ( FAI ) was calculated . Measurements were repeated during the 3rd week of pill intake in the 4th and the 6th pill month . There were no differences on body mass and blood pressure with the use of the four OCs . The mean serum DHEA-S decreased significantly in all groups though less in the Mercilon group when compared to Cilest and Marvelon ( approximately 20 % vs 45 % ) . Mean serum SHBG and CBG increased significantly in all four groups approximately 250 % and 100 % , respectively . In each group CBG also increased significantly but less in women taking Mercilon ( -75 % ) as compared to the others ( -100 % ) . Current low-dose OCs were found to have similar impact on the endogenous and rogen metabolism with significant decreases of serum testosterone , DHT , A , and DHEA-S. They may be equally beneficial in women with and rogen related syndromes such as acne and hirsutism
There is no evidence that DHEA  improves quality of life but there is some evidence that it is associated with and rogenic side effects .
There is uncertainty whether DHEA decreases menopausal symptoms , but DHEA may slightly improve sexual function compared with placebo
BACKGROUND During menopause a decreasing ovarian follicular response generally causes a fluctuation and eventual decrease in estrogen levels .
This can lead to the development of various perimenopausal and postmenopausal symptoms ( for example hot flushes , night sweats , vaginal dryness ) .
Dehydroepi and rosterone ( DHEA ) is one of the main precursors of and rogens , which in turn are converted to testosterone and estrogens .
It is possible that the administration of DHEA may increase estrogen and testosterone levels in peri- and postmenopausal women to alleviate their symptoms and improve general wellbeing and sexual function ( for example libido , dyspareunia , satisfaction ) .
Treatment with DHEA is controversial as there is uncertainty about its effectiveness and safety .
This review should clearly outline the evidence for DHEA in the treatment of menopausal symptoms and evaluate its effectiveness and safety by combining the results of r and omised controlled trials .
OBJECTIVES To assess the effectiveness and safety of administering DHEA to women with menopausal symptoms in the peri- or postmenopausal phase .