The role of dehydroepiandrosterone (DHEA) in women and its potential as a therapeutic agent continues to attract controversy. DHEA is also produced by the testes and ovaries and can be synthesized within the brain, whereas DHEAS is a unique secretory product of the adrenal zona reticularis. With the loss of ovarian follicular activity at menopause, adrenal DHEA, DHEAS, and androstenedione become major precursors for the extragonadal production of estrogens and androgens in postmenopausal women. Various studies have raised the possibility that DHEA may improve lipid metabolism and insulin sensitivity, enhance the immune response, and boost physical and psychological well-being in older men and women. Much of the evidence supporting these potential benefits is from studies in rodents, whose adrenals do not produce DHEA. The initial human studies that provoked substantial interest in DHEA mostly involved small subject numbers and were conducted over short time frames. More recently, it has been proposed that because DHEA and DHEAS are important precursors for estrogen and androgen production, treatment with DHEA is a physiologically based strategy for the alleviation of hormone deficiency symptoms in postmenopausal women. To explore this hypothesis, researchers have briefly summarized the known physiology of DHEA and DHEAS in women and reviewed the more recent evidence provided by randomized controlled trials (RCT) that have evaluated the effects of DHEA therapy in postmenopausal women with normal adrenal function.
Davis SR, Panjari M, Stanczyk FZ. DHEA Replacement for Postmenopausal Women. J Clin Endocrinol Metab:jc.2010-888. DHEA Replacement for Postmenopausal Women -- Davis et al., 10.1210/jc.2010-2888 -- Journal of Clinical Endocrinology & Metabolism
Context It has been proposed that because dehydroepiandrosterone (DHEA) and its sulfate, DHEAS, are important precursors for estrogen and androgen production, treatment with DHEA is a physiologically based strategy for the alleviation of hormone deficiency symptoms in postmenopausal women. We have summarized the physiology of DHEA in women and reviewed the findings from randomized controlled trials (RCT) of the effects of DHEA therapy in postmenopausal women with normal adrenal function.
Evidence Acquisition We reviewed the medical literature for key papers investigating DHEA physiology and RCT of the use of DHEA in postmenopausal women through November 2010. The focus was on sexual function, well-being, metabolic parameters, and cognition as study endpoints.
Evidence Synthesis Although cross-sectional studies have indicated a link between low DHEA levels and impaired sexual function, well-being, and cognitive performance in postmenopausal women, placebo-controlled RCT do not show benefits of oral DHEA for any of these outcomes or favorable effects on lipids and carbohydrate metabolism.
Conclusions Taken together, findings from this review of the published literature of studies do not support the use of DHEA in postmenopausal women at this time.
Davis SR, Panjari M, Stanczyk FZ. DHEA Replacement for Postmenopausal Women. J Clin Endocrinol Metab:jc.2010-888. DHEA Replacement for Postmenopausal Women -- Davis et al., 10.1210/jc.2010-2888 -- Journal of Clinical Endocrinology & Metabolism
Context It has been proposed that because dehydroepiandrosterone (DHEA) and its sulfate, DHEAS, are important precursors for estrogen and androgen production, treatment with DHEA is a physiologically based strategy for the alleviation of hormone deficiency symptoms in postmenopausal women. We have summarized the physiology of DHEA in women and reviewed the findings from randomized controlled trials (RCT) of the effects of DHEA therapy in postmenopausal women with normal adrenal function.
Evidence Acquisition We reviewed the medical literature for key papers investigating DHEA physiology and RCT of the use of DHEA in postmenopausal women through November 2010. The focus was on sexual function, well-being, metabolic parameters, and cognition as study endpoints.
Evidence Synthesis Although cross-sectional studies have indicated a link between low DHEA levels and impaired sexual function, well-being, and cognitive performance in postmenopausal women, placebo-controlled RCT do not show benefits of oral DHEA for any of these outcomes or favorable effects on lipids and carbohydrate metabolism.
Conclusions Taken together, findings from this review of the published literature of studies do not support the use of DHEA in postmenopausal women at this time.
