title: Dehydroepiandrosterone replacement in women with adrenal insufficiency.
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.
authors.affiliation: Department of Endocrinology, Medical University Hospital, Wuerzburg, Germany. w.arlt@medizin.uni-wuerzburg.de
authors.forename: W
authors.initials: W
authors.lastname: Arlt
authors.forename: F
authors.initials: F
authors.lastname: Callies
authors.forename: J C
authors.initials: JC
authors.lastname: van Vlijmen
authors.forename: I
authors.initials: I
authors.lastname: Koehler
authors.forename: M
authors.initials: M
authors.lastname: Reincke
authors.forename: M
authors.initials: M
authors.lastname: Bidlingmaier
authors.forename: D
authors.initials: D
authors.lastname: Huebler
authors.forename: M
authors.initials: M
authors.lastname: Oettel
authors.forename: M
authors.initials: M
authors.lastname: Ernst
authors.forename: H M
authors.initials: HM
authors.lastname: Schulte
authors.forename: B
authors.initials: B
authors.lastname: Allolio
mesh_terms: D000309:Adrenal Insufficiency / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D000328:Adult; D000339:Affect / Q000187:drug effects*; D000728:Androgens / Q000097:blood; D001007:Anxiety / Q000188:drug therapy / Q000209:etiology; D018592:Cross-Over Studies; D003687:Dehydroepiandrosterone / Q000009:adverse effects / Q000172:deficiency / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008603:Mental Health; D008875:Middle Aged; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D019529:Sexuality / Q000187:drug effects*; D011795:Surveys and Questionnaires
chemical_list: D000728:Androgens; D008055:Lipids; D012738:Sex Hormone-Binding Globulin; D003687:Dehydroepiandrosterone