Low Dose Dehydroepiandrosterone Affects Behavior in Hypopituitary Androgen-Deficient Women: A Placebo-Controlled Trial
Gudmundur Johannsson,
Pia Burman,
Lena Wirén,
Britt Edén Engström,
Anna G. Nilsson,
Malin Ottosson,
Björn Jonsson,
Bengt-Åke Bengtsson and
F. Anders Karlsson
Research Center for Endocrinology and Metabolism, Sahlgrenska University Hospital (G.J., L.W., M.O., B.-Å.B.), SE-413 45 Goteborg, Sweden; Department of Medical Sciences, Uppsala University Hospital (P.B., B.E.E., A.G.N., F.A.K.), SE-751 85 Uppsala, Sweden; and Department of Womens and Childrens Health, Karolinska Institute (B.J.), SE-171 77 Stockholm, Sweden
Address all correspondence and requests for reprints to: Gudmundur Johannsson, M.D., Ph.D., Research Center for Endocrinology and Metabolism, Sahlgrenska University Hospital, SE-413 45 Goteborg, Sweden. E-mail: . gudmundur.johannsson{at}medic.gu.se
Abstract
Thirty-eight women, aged 2565 yr, with androgen deficiencydue to hypopituitarism were treated with oral dehydroepiandrosterone(DHEA; 30 mg/d if <45 yr of age and 20 mg if 45 yr of age)for 6 months in a randomized, placebo-controlled, double blindstudy, followed by a 6-month open treatment period. The administrationof DHEA raised the serum levels of DHEAS to normal age-relatedreference ranges and increased androstenedione and T to subnormallevels. Androgen effects on skin and/or pubic and/or axillaryhair were observed in 84% (32 of 38) of the women after allreceived 6 months of DHEA treatment. No such effects were observedafter the placebo treatment. These effects after 6 months werecorrelated with the serum levels of DHEAS (r = 0.37; P = 0.03),androstenedione (r = 0.42; P = 0.01), and T (r = 0.37; P = 0.03).The percentages of partners who reported improved alertness,stamina, and initiative by their spouses were 70%, 64%, and55%, respectively, in the DHEA group and 11%, 6%, and 11%, respectively,in the placebo group (P < 0.05). According to the partners,sexual relations tended to improve compared with placebo (P= 0.06). After 6 months of treatment, increased sexual interestor activity was reported by 50% of the women taking 30 mg DHEA,by none taking 20 mg DHEA, and by two women taking placebo (P= NS). Compared with levels after placebo administration, highdensity lipoprotein cholesterol and apolipoprotein A-1 levelsdecreased after DHEA. Serum concentrations of IGF-I, serum markersof bone metabolism, and bone density did not change.
In conclusion, oral administration of a low dose of DHEA toadult hypopituitary women induced androgen effects on skin andaxillary and pubic hair as well as changes in behavior, withonly minor effects on metabolism.
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