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Volume 341:1013-1020 September 30, 1999 Number 14 Next

	Full Text PDF Editorial by Oelkers, W. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background The physiologic role of dehydroepiandrosterone in humans is still unclear. Adrenal insufficiency leads to a deficiency of dehydroepiandrosterone; we therefore investigated the effects of dehydroepiandrosterone replacement in patients with adrenal insufficiency.

Methods In a double-blind study, 24 women with adrenal insufficiency received in random order 50 mg of dehydroepiandrosterone orally each morning for four months and placebo daily for four months, with a one-month washout period. We measured serum steroid hormones, insulin-like growth factor I, lipids, and sex hormone–binding globulin, and we evaluated well-being and sexuality with the use of validated psychological questionnaires and visual-analogue scales, respectively. The women were assessed before treatment, after one and four months of treatment with dehydroepiandrosterone, after one and four months of placebo, and one month after the end of the second treatment period.

Results Treatment with dehydroepiandrosterone raised the initially low serum concentrations of dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, and testosterone into the normal range; serum concentrations of sex hormone–binding globulin, total cholesterol, and high-density lipoprotein cholesterol decreased significantly. Dehydroepiandrosterone significantly improved overall well-being as well as scores for depression and anxiety. For the global severity index, the mean (±SD) change from base line was –0.18±0.29 after four months of dehydroepiandrosterone therapy, as compared with 0.03±0.29 after four months of placebo (P=0.02). As compared with placebo, dehydroepiandrosterone significantly increased the frequency of sexual thoughts (P=0.006), sexual interest (P=0.002), and satisfaction with both mental and physical aspects of sexuality (P=0.009 and P=0.02, respectively).

Conclusions Dehydroepiandrosterone improves well-being and sexuality in women with adrenal insufficiency.

Source Information

From the Department of Endocrinology, Medical University Hospital, Wuerzburg (W.A., F.C., J.C.V., I.K., M.R., B.A.); Medical University Hospital Innenstadt, Munich (M.B.); Jenapharm, Jena (D.H., M.O., M.E.); and the Institute for Hormone and Fertility Research, Hamburg (H.M.S.) — all in Germany.

Address reprint requests to Dr. Arlt at the Department of Endocrinology, Medical University Hospital, Josef-Schneider Str. 2, 97080 Wuerzburg, Germany, or at w.arlt{at}medizin.uni-wuerzburg.de.

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