FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

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.

Full Text of this Article

This article has been cited by other articles:

• Brzoza, Z., Kasperska-Zajac, A., Badura-Brzoza, K., Matysiakiewicz, J., Hese, R. T., Rogala, B. (2008). Decline in Dehydroepiandrosterone Sulfate Observed in Chronic Urticaria is Associated With Psychological Distress. Psychosom. Med. 70: 723-728 [Abstract] [Full Text]  
• Walters, K.A., Allan, C.M., Handelsman, D.J. (2008). Androgen Actions and the Ovary. Biol. Reprod. 78: 380-389 [Abstract] [Full Text]  
• Gurnell, E. M., Hunt, P. J., Curran, S. E., Conway, C. L., Pullenayegum, E. M., Huppert, F. A., Compston, J. E., Herbert, J., Chatterjee, V. K. K. (2008). Long-Term DHEA Replacement in Primary Adrenal Insufficiency: A Randomized, Controlled Trial. J. Clin. Endocrinol. Metab. 93: 400-409 [Abstract] [Full Text]  
• Hartkamp, A, Geenen, R, Godaert, G L R, Bootsma, H, Kruize, A A, Bijlsma, J W J, Derksen, R H W M (2008). Effect of dehydroepiandrosterone administration on fatigue, well-being, and functioning in women with primary Sjogren syndrome: a randomised controlled trial. Ann Rheum Dis 67: 91-97 [Abstract] [Full Text]  
• Cooper, M. S., Stewart, P. M. (2007). Adrenal Insufficiency in Critical Illness. J Intensive Care Med 22: 348-362 [Abstract]  
• Hahner, S., Loeffler, M., Fassnacht, M., Weismann, D., Koschker, A.-C., Quinkler, M., Decker, O., Arlt, W., Allolio, B. (2007). Impaired Subjective Health Status in 256 Patients with Adrenal Insufficiency on Standard Therapy Based on Cross-Sectional Analysis. J. Clin. Endocrinol. Metab. 92: 3912-3922 [Abstract] [Full Text]  
• Walters, K. A., Allan, C. M., Jimenez, M., Lim, P. R., Davey, R. A., Zajac, J. D., Illingworth, P., Handelsman, D. J. (2007). Female Mice Haploinsufficient for an Inactivated Androgen Receptor (AR) Exhibit Age-Dependent Defects That Resemble the AR Null Phenotype of Dysfunctional Late Follicle Development, Ovulation, and Fertility. Endocrinology 148: 3674-3684 [Abstract] [Full Text]  
• Lovas, K., Husebye, E. S (2007). Continuous subcutaneous hydrocortisone infusion in Addison's disease. Eur J Endocrinol 157: 109-112 [Abstract] [Full Text]  
• Miller, K. K., Biller, B. M. K., Schaub, A., Pulaski-Liebert, K., Bradwin, G., Rifai, N., Klibanski, A. (2007). Effects of Testosterone Therapy on Cardiovascular Risk Markers in Androgen-Deficient Women with Hypopituitarism. J. Clin. Endocrinol. Metab. 92: 2474-2479 [Abstract] [Full Text]  
• Panjari, M., Davis, S. R. (2007). DHEA therapy for women: effect on sexual function and wellbeing. Hum Reprod Update 13: 239-248 [Abstract] [Full Text]  
• Kocis, P. (2006). Prasterone. Am J Health Syst Pharm 63: 2201-2210 [Abstract] [Full Text]  
• Brooke, A. M., Kalingag, L. A., Miraki-Moud, F., Camacho-Hubner, C., Maher, K. T., Walker, D. M., Hinson, J. P., Monson, J. P. (2006). Dehydroepiandrosterone Improves Psychological Well-Being in Male and Female Hypopituitary Patients on Maintenance Growth Hormone Replacement. J. Clin. Endocrinol. Metab. 91: 3773-3779 [Abstract] [Full Text]  
• Wierman, M. E., Basson, R., Davis, S. R., Khosla, S., Miller, K. K., Rosner, W., Santoro, N. (2006). Androgen Therapy in Women: An Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 91: 3697-3710 [Abstract] [Full Text]  
• Hahn, S., Benson, S., Elsenbruch, S., Pleger, K., Tan, S., Mann, K., Schedlowski, M., van Halteren, W. B., Kimmig, R., Janssen, O. E. (2006). Metformin treatment of polycystic ovary syndrome improves health-related quality-of-life, emotional distress and sexuality. Hum Reprod 21: 1925-1934 [Abstract] [Full Text]  
• Miller, K. K., Biller, B. M. K., Beauregard, C., Lipman, J. G., Jones, J., Schoenfeld, D., Sherman, J. C., Swearingen, B., Loeffler, J., Klibanski, A. (2006). Effects of Testosterone Replacement in Androgen-Deficient Women with Hypopituitarism: A Randomized, Double-Blind, Placebo-Controlled Study. J. Clin. Endocrinol. Metab. 91: 1683-1690 [Abstract] [Full Text]  
• Basson, R. (2006). Sexual Desire and Arousal Disorders in Women. NEJM 354: 1497-1506 [Full Text]  
• Arlt, W. (2006). Androgen therapy in women. Eur J Endocrinol 154: 1-11 [Abstract] [Full Text]  
• Salvatori, R. (2005). Adrenal Insufficiency. JAMA 294: 2481-2488 [Abstract] [Full Text]  
• Labrie, F, Luu-The, V, Belanger, A, Lin, S-X, Simard, J, Pelletier, G, Labrie, C (2005). Is dehydroepiandrosterone a hormone?. J Endocrinol 187: 169-196 [Abstract] [Full Text]  
• (2005). Dehydroepiandrosterone (DHEA). Obstet Gynecol 106: 1096-1097 [Full Text]  
• Bancroft, J (2005). The endocrinology of sexual arousal. J Endocrinol 186: 411-427 [Abstract] [Full Text]  
• Shafqat, A., Einhorn, L. H., Hanna, N., Sledge, G. W., Hanna, A., Juliar, B. E., Monahan, P., Bhatia, S. (2005). Screening studies for fatigue and laboratory correlates in cancer patients undergoing treatment{dagger}. Ann Oncol 16: 1545-1550 [Abstract] [Full Text]  
• Santoro, N., Torrens, J., Crawford, S., Allsworth, J. E., Finkelstein, J. S., Gold, E. B., Korenman, S., Lasley, W. L., Luborsky, J. L., McConnell, D., Sowers, M. F., Weiss, G. (2005). Correlates of Circulating Androgens in Mid-Life Women: The Study of Women's Health Across the Nation. J. Clin. Endocrinol. Metab. 90: 4836-4845 [Abstract] [Full Text]  
• Vigersky, R. A. (2005). Goldilocks and Menopause. Arch Intern Med 165: 1571-1572 [Full Text]  
• van Thiel, S. W., Romijn, J. A., Pereira, A. M., Biermasz, N. R., Roelfsema, F., van Hemert, A., Ballieux, B., Smit, J. W. A. (2005). Effects of Dehydroepiandrostenedione, Superimposed on Growth Hormone Substitution, on Quality of Life and Insulin-Like Growth Factor I in Patients with Secondary Adrenal Insufficiency: A Randomized, Placebo-Controlled, Cross-Over Trial. J. Clin. Endocrinol. Metab. 90: 3295-3303 [Abstract] [Full Text]  
• Kraus, M R, Schafer, A, Bentink, T, Scheurlen, M, Weissbrich, B, Al-Taie, O, Seufert, J (2005). Sexual dysfunction in males with chronic hepatitis C and antiviral therapy: interferon-induced functional androgen deficiency or depression?. J Endocrinol 185: 345-352 [Abstract] [Full Text]  
• Suarez, C, Vela, J, Garcia-Tornadu, I, Becu-Villalobos, D (2005). Dehydroepiandrosterone (DHEA) modulates GHRH, somatostatin and angiotensin II action at the pituitary level. J Endocrinol 185: 165-172 [Abstract] [Full Text]  
• Boone, S. A., Shields, K. M. (2005). Dietary supplements for female sexual dysfunction. Am J Health Syst Pharm 62: 574-580 [Full Text]  
• Dhatariya, K., Bigelow, M. L., Nair, K. S. (2005). Effect of Dehydroepiandrosterone Replacement on Insulin Sensitivity and Lipids in Hypoadrenal Women. Diabetes 54: 765-769 [Abstract] [Full Text]  
• Handelsman, D. J. (2005). Andro and the Prosteroids: Bolting the Stable Door. J. Clin. Endocrinol. Metab. 90: 1249-1251 [Full Text]  
• Schmidt, P. J., Daly, R. C., Bloch, M., Smith, M. J., Danaceau, M. A., Simpson St. Clair, L., Murphy, J. H., Haq, N., Rubinow, D. R. (2005). Dehydroepiandrosterone Monotherapy in Midlife-Onset Major and Minor Depression. Arch Gen Psychiatry 62: 154-162 [Abstract] [Full Text]  
• Christiansen, J. J., Gravholt, C. H., Fisker, S., Moller, N., Andersen, M., Svenstrup, B., Bennett, P., Ivarsen, P., Christiansen, J. S., Jorgensen, J. O. L. (2005). Very short term dehydroepiandrosterone treatment in female adrenal failure: impact on carbohydrate, lipid and protein metabolism. Eur J Endocrinol 152: 77-85 [Abstract] [Full Text]  
• (2004). Sexual Dysfunction. Obstet Gynecol 104: 85S-91S [Full Text]  
• Rivera-Woll, L.M., Papalia, M., Davis, S.R., Burger, H.G. (2004). Androgen insufficiency in women: diagnostic and therapeutic implications. Hum Reprod Update 10: 421-432 [Abstract] [Full Text]  
• Miller, K. K., Rosner, W., Lee, H., Hier, J., Sesmilo, G., Schoenfeld, D., Neubauer, G., Klibanski, A. (2004). Measurement of Free Testosterone in Normal Women and Women with Androgen Deficiency: Comparison of Methods. J. Clin. Endocrinol. Metab. 89: 525-533 [Abstract] [Full Text]  
• Leblanc, M., Labrie, C., Belanger, A., Candas, B., Labrie, F. (2003). Bioavailability and Pharmacokinetics of Dehydroepiandrosterone in the Cynomolgus Monkey. J. Clin. Endocrinol. Metab. 88: 4293-4302 [Abstract] [Full Text]  
• Arlt, W., Allolio, B. (2003). DHEA Replacement in Adrenal Insufficiency. J. Clin. Endocrinol. Metab. 88: 4001-4001 [Full Text]  
• Lovas, K., Kampe, O., Husebye, E. S. (2003). Authors' Response: DHEA Replacement in Adrenal Insufficiency. J. Clin. Endocrinol. Metab. 88: 4001-4002 [Full Text]  
• Fassnacht, M., Schlenz, N., Schneider, S. B., Wudy, S. A., Allolio, B., Arlt, W. (2003). Beyond Adrenal and Ovarian Androgen Generation: Increased Peripheral 5{alpha}-Reductase Activity in Women with Polycystic Ovary Syndrome. J. Clin. Endocrinol. Metab. 88: 2760-2766 [Abstract] [Full Text]  
• Miller, H. B., Hunt, J. S. (2003). Female Sexual Dysfunction: Review of the Disorder and Evidence for Available Treatment Alternatives. Journal of Pharmacy Practice 16: 200-208 [Abstract]  
• Hampl, V., Bibova, J., Povysilova, V., Herget, J. (2003). Dehydroepiandrosterone sulphate reduces chronic hypoxic pulmonary hypertension in rats. Eur Respir J 21: 862-865 [Abstract] [Full Text]  
• Humphries, K. H., Gill, S. (2003). Risks and benefits of hormone replacement therapy: The evidence speaks. CMAJ 168: 1001-1010 [Abstract] [Full Text]  
• Labrie, F., Luu-The, V., Labrie, C., Belanger, A., Simard, J., Lin, S.-X., Pelletier, G. (2003). Endocrine and Intracrine Sources of Androgens in Women: Inhibition of Breast Cancer and Other Roles of Androgens and Their Precursor Dehydroepiandrosterone. Endocr. Rev. 24: 152-182 [Abstract] [Full Text]  
• Wu, F. C. W., von Eckardstein, A. (2003). Androgens and Coronary Artery Disease. Endocr. Rev. 24: 183-217 [Abstract] [Full Text]  
• Cleare, A. J. (2003). The Neuroendocrinology of Chronic Fatigue Syndrome. Endocr. Rev. 24: 236-252 [Abstract] [Full Text]  
• Lovas, K., Gebre-Medhin, G., Trovik, T. S., Fougner, K. J., Uhlving, S., Nedrebo, B. G., Myking, O. L., Kampe, O., Husebye, E. S. (2003). Replacement of Dehydroepiandrosterone in Adrenal Failure: No Benefit for Subjective Health Status and Sexuality in a 9-Month, Randomized, Parallel Group Clinical Trial. J. Clin. Endocrinol. Metab. 88: 1112-1118 [Abstract] [Full Text]  
• Cooper, M. S., Stewart, P. M. (2003). Corticosteroid Insufficiency in Acutely Ill Patients. NEJM 348: 727-734 [Full Text]  
• Joint LWPES/ESPE CAH Working Group, (2002). Consensus Statement on 21-Hydroxylase Deficiency from The Lawson Wilkins Pediatric Endocrine Society and The European Society for Paediatric Endocrinology. J. Clin. Endocrinol. Metab. 87: 4048-4053 [Full Text]  
• Johannsson, G., Burman, P., Wiren, L., Engstrom, B. E., Nilsson, A. G., Ottosson, M., Jonsson, B., Bengtsson, B.-A., Karlsson, F. A. (2002). Low Dose Dehydroepiandrosterone Affects Behavior in Hypopituitary Androgen-Deficient Women: A Placebo-Controlled Trial. J. Clin. Endocrinol. Metab. 87: 2046-2052 [Abstract] [Full Text]  
• Arlt, W., Callies, F., Koehler, I., van Vlijmen, J. C., Fassnacht, M., Strasburger, C. J., Seibel, M. J., Huebler, D., Ernst, M., Oettel, M., Reincke, M., Schulte, H. M., Allolio, B. (2001). Dehydroepiandrosterone Supplementation in Healthy Men with an Age-Related Decline of Dehydroepiandrosterone Secretion. J. Clin. Endocrinol. Metab. 86: 4686-4692 [Abstract] [Full Text]  
• Yen, S. S. C. (2001). Dehydroepiandrosterone sulfate and longevity: New clues for an old friend. Proc. Natl. Acad. Sci. USA 98: 8167-8169 [Full Text]  
• Vermeulen, A. (2001). Androgen Replacement Therapy in the Aging Male--A Critical Evaluation. J. Clin. Endocrinol. Metab. 86: 2380-2390 [Full Text]  
• Miller, K. K. (2001). Androgen Deficiency in Women. J. Clin. Endocrinol. Metab. 86: 2395-2401 [Abstract] [Full Text]  
• Callies, F., Fassnacht, M., van Vlijmen, J. C., Koehler, I., Huebler, D., Seibel, M. J., Arlt, W., Allolio, B. (2001). Dehydroepiandrosterone Replacement in Women with Adrenal Insufficiency: Effects on Body Composition, Serum Leptin, Bone Turnover, and Exercise Capacity. J. Clin. Endocrinol. Metab. 86: 1968-1972 [Abstract] [Full Text]  
• Snyder, P. J. (2001). Editorial: The Role of Androgens in Women. J. Clin. Endocrinol. Metab. 86: 1006-1007 [Full Text]  
• Bruining, H., Bootsma, A. H., Koper, J. W., Bonjer, J., de Jong, F. H., Lamberts, S. W. J. (2001). Fertility and Body Composition after Laparoscopic Bilateral Adrenalectomy in a 30-Year-Old Female with Congenital Adrenal Hyperplasia. J. Clin. Endocrinol. Metab. 86: 482-484 [Abstract] [Full Text]  
• Miller, K. K., Sesmilo, G., Schiller, A., Schoenfeld, D., Burton, S., Klibanski, A. (2001). Androgen Deficiency in Women with Hypopituitarism. J. Clin. Endocrinol. Metab. 86: 561-567 [Abstract] [Full Text]  
• Berga, S. L. (2001). Systemic Benefits of Cyclic Ovarian Function. Reproductive Sciences 8: S3-S6 [Abstract]  
• Hunt, P. J., Gurnell, E. M., Huppert, F. A., Richards, C., Prevost, A. T., Wass, J. A. H., Herbert, J., Chatterjee, V. K. K. (2000). Improvement in Mood and Fatigue after Dehydroepiandrosterone Replacement in Addison's Disease in a Randomized, Double Blind Trial. J. Clin. Endocrinol. Metab. 85: 4650-4656 [Abstract] [Full Text]  
• Legrain, S., Massien, C., Lahlou, N., Roger, M., Debuire, B., Diquet, B., Chatellier, G., Azizi, M., Faucounau, V., Porchet, H., Forette, F., Baulieu, E.-E. (2000). Dehydroepiandrosterone Replacement Administration: Pharmacokinetic and Pharmacodynamic Studies in Healthy Elderly Subjects. J. Clin. Endocrinol. Metab. 85: 3208-3217 [Abstract] [Full Text]  
• Wisniewski, A. B., Migeon, C. J., Meyer-Bahlburg, H. F. L., Gearhart, J. P., Berkovitz, G. D., Brown, T. R., Money, J. (2000). Complete Androgen Insensitivity Syndrome: Long-Term Medical, Surgical, and Psychosexual Outcome. J. Clin. Endocrinol. Metab. 85: 2664-2669 [Abstract] [Full Text]  
• White, P. C., Speiser, P. W. (2000). Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency. Endocr. Rev. 21: 245-291 [Abstract] [Full Text]  
• Baulieu, E.-E., Thomas, G., Legrain, S., Lahlou, N., Roger, M., Debuire, B., Faucounau, V., Girard, L., Hervy, M.-P., Latour, F., Leaud, M.-C., Mokrane, A., Pitti-Ferrandi, H., Trivalle, C., de Lacharriere, O., Nouveau, S., Rakoto-Arison, B., Souberbielle, J.-C., Raison, J., Le Bouc, Y., Raynaud, A., Girerd, X., Forette, F. (2000). Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEAge Study to a sociobiomedical issue. Proc. Natl. Acad. Sci. USA 97: 4279-4284 [Abstract] [Full Text]  
• (1999). DHEA Replacement for Women with Adrenal Insufficiency. JWatch Women's Health 1999: 16-16 [Full Text]  
• Oelkers, W. (1999). Dehydroepiandrosterone for Adrenal Insufficiency. NEJM 341: 1073-1074 [Full Text]