title: Clinical review: The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis.
abstract: BACKGROUND
  Exogenous dehydroepiandrosterone (DHEA) therapy has been proposed to replenish the depletion of endogenous DHEA and its sulfate form, which occurs with advancing age and is thought to be associated with loss of libido and menopausal symptoms.
  
  
  OBJECTIVE
  We conducted a systematic review and meta-analysis to summarize the evidence supporting the use of systemic DHEA in postmenopausal women with normal adrenal function.
  
  
  METHODS
  We searched MEDLINE, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through January 2014. Pairs of reviewers, working independently, selected studies and extracted data from eligible randomized controlled trials (RCTs). We used the random-effects model to pool across studies and evaluated heterogeneity using the I(2) statistic.
  
  
  RESULTS
  We included 23 RCTs with moderate to high risk of bias enrolling 1188 women. DHEA use was not associated with significant improvement in libido or sexual function (standardized mean difference, 0.35; 95% confidence interval, -0.02 to 0.73; P value = .06; I(2) = 62%). There was also no significant effect of DHEA on serious adverse effects, serum lipids, serum glucose, weight, body mass index, or bone mineral density. This evidence warranted low confidence in the results, mostly due to imprecision, risk of bias, and inconsistency across RCTs.
  
  
  CONCLUSIONS
  Evidence warranting low confidence suggests that DHEA administration does not significantly impact sexual symptoms or selected metabolic markers in postmenopausal women with normal adrenal function.
authors.affiliation: Knowledge and Evaluation Research Unit (T.E., M.B.S., Z.W., T.K., N.A., C.U., M.N., O.A., V.M.M., M.H.M.), and Center for the Science of Healthcare Delivery (T.E., Z.W., N.A., M.H.M.), Mayo Clinic, Rochester, Minnesota 55905; Internal Medicine Department (M.B.S.), Georgia Regents University, Augusta, Georgia 30912; and Mayo Clinic Libraries (L.P.), Division of Endocrinology, Diabetes, Metabolism, and Nutrition (V.M.M.), and Division of Preventive, Occupational and Aerospace Medicine (M.H.M.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Tarig
authors.initials: T
authors.lastname: Elraiyah
authors.forename: Mohamad Bassam
authors.initials: MB
authors.lastname: Sonbol
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Tagwa
authors.initials: T
authors.lastname: Khairalseed
authors.forename: Noor
authors.initials: N
authors.lastname: Asi
authors.forename: Chaitanya
authors.initials: C
authors.lastname: Undavalli
authors.forename: Mohammad
authors.initials: M
authors.lastname: Nabhan
authors.forename: Osama
authors.initials: O
authors.lastname: Altayar
authors.forename: Larry
authors.initials: L
authors.lastname: Prokop
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Murad
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000311:Adrenal Glands / Q000187:drug effects* / Q000502:physiology; D000375:Aging / Q000502:physiology*; D003687:Dehydroepiandrosterone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects* / Q000502:physiology; D016032:Randomized Controlled Trials as Topic; D019529:Sexuality / Q000187:drug effects* / Q000502:physiology
chemical_list: D000276:Adjuvants, Immunologic; D003687:Dehydroepiandrosterone