Dehydroepiandrosterone replacement in women with adrenal insufficiency.

Authors: Arlt W, Callies F, Van Vlijmen JC, Koehler I, Reincke M,
Publication Year: 1999
Citation:  N Eng J Med 1999;341(14):1013-20.

This double-blind crossover study reviewed alternately the effects of 50mg of oral dehydroepiandrosterone (DHEA) daily with placebo in 24 women with adrenal insufficiency. Participants were evaluated using established well-being (depression and anxiety scores) and sexuality (thoughts, interest, satisfaction) scales and serum profiles. Results showed that serum DHEA, DHEA-S and active androgen increased to normal or low-normal levels during treatment. SHBG levels were significantly lower following treatment. IGF-I concentrations increased after treatment (only in women with primary adrenal insufficiency), but IGF-binding protein 3 levels did not change. Serum total and HDL lipoprotein cholesterol levels decreased significantly during treatment. LDL and triglyceride concentrations did not change significantly. Psychological testing scores for well-being and sexuality both improved significantly during treatment. These effects were noticed after treatment for four months, but not after treatment for one month. Authors recommended that treatment with DHEA should be part of hormone replacement therapy for women with adrenal insufficiency.