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Men’s Sexual Health & the Role of DHEA

Sexual Health Sexual Health

DHEA (dehydroepiandrosterone or dehydroepiandrostenedione) is a prohormone produced in the adrenal glands and testes. As a prohormone, it can be converted into testosterone and/or estrogens in various peripheral target tissues throughout the body.1 However, plasma DHEA decreases about 80 percent between ages 25 and 75 years.2 This is determined by measuring the blood marker for measuring DHEA, called DHEA-S.

Low Levels of DHEA May Lead to Impaired Sexual Function

DHEA-S levels were found to be significantly lower in the men with aging male symptoms (e.g. decrease in sexual desire/libido) and in men with sexual dysfunction in a study3 involving 348 male patients. Furthermore, in other studies4,5 serum levels of DHEA-S in patients with erectile dysfunction (ED) were lower than in healthy volunteers. All of this suggests that it may be worthwhile for men to consider supplementation with DHEA if they are over 40, and if their sexual function isn’t what it used to be. Consider the following research on DHEA supplementation.

DHEA Supplementation in Men With ED

A study6 was conducted on 85 patients with ED caused by hypertension, diabetes, and neurological disorders or from unknown causes. All of the men received 50 mg DHEA daily for six months. Results showed that DHEA treatment was associated with statistically significantly improvement in scores relating to frequency of penetration and maintenance of erections after penetration.

In another study,7 this time one that was double-blind, randomized and placebo-controlled, 40 ED patients were treated with 50 mg DHEA or a placebo daily for six months. The results were DHEA treatment was associated with higher sexual health scores, including the ability to achieve or maintain an erection sufficient for satisfactory sexual performance.

DHEA Supplementation in Older Men and Women

In a double-blind, placebo-controlled study,8 280 healthy men and women (60–79 years old) were given 50 mg DHEA or placebo daily for a year. The results were that supplementation reestablished “young” concentrations of DHEA-S and modestly increased testosterone and estradiol levels. The authors concluded that 50 mg/day DHEA administration over one year normalized some effects of aging, but does not create supermen/superwomen” (doping).

In another six-month study,9 18 men and women (aged 72-74 years) received 50 mg DHEA daily, while another 18 men and women of similar age served as a control group. The results were that bone mineral density (BMD) of the total body and lumbar spine increased (P ≤ 0.05), fat mass decreased (P < 0.01), and fat-free mass increased (P ≤ 0. 05) in response to DHEA replacement. DHEA replacement also resulted in a significant increase (P ≤ 0.05) of about 46 percent in total serum testosterone concentrations in the men and about 114 percent in the women.

Adverse Reactions

The advantage of DHEA over other androgenic compounds is that it is converted into testosterone or estrogens only in the specific target tissues, limiting the action of the sex steroids to those tissues and leaving other tissues unaffected—thereby minimizing the potential side effects observed with other types of androgens or estrogens.10 Furthermore, when DHEA was taken for one year at 50 mg/day,11 no potentially harmful accumulation of DHEA-S and active steroids or other harmful consequences were seen.

Conclusion

As a prohormone, supplementation with DHEA appears to be relatively safe and effective. Nevertheless, there is value in assessing blood serum DHEA-S levels for individuals planning to use DHEA regularly. This is particularly important in populations younger than 40 years of age who are more likely to have naturally higher levels of DHEA.

References:

1 Labrie F, Luu-The V, Bélanger A, Lin SX, Simard J, Pelletier G, Labrie C. Is dehydroepiandrosterone a hormone? J Endocrinol. 2005;187:169–196.

2 Weiss EP, Villareal DT, Fontana L, Han D-H, and Holloszy JO. Dehydroepiandrosterone (DHEA) replacement decreases insulin resistance and lowers inflammatory cytokines in aging humans. Aging. 2011;3:533–542.

3 Basar MM, Aydin G, Mert HC, Keles I, Caglayan O, Orkun S, Batislam E. Relationship between serum sex steroids and Aging Male Symptoms score and International Index of Erectile Function. Urology. 2005;66:597–601.

4 Reiter WJ, Pycha A, Schatzl G, Klingler HC, Märk I, Auterith A, and Marberger M Serum dehydro¬epiandrosterone sulfate concentrations in men with erectile dysfunction. Urology. 2000;55(5):755–758.

5 Vakina TN, Shutov AM, Shalina SV, Zinov’eva EG, Kiselev IP. Dehydroepiandrosterone and sexual function in men with chronic prostatitis. Urologiia. 2003;1:49–52. 6 Reiter WJ, Schatzl G, Märk I, Zeiner A, Pycha A, Marberger M. Dehydroepiandrosterone in the treatment of erectile dysfunction in patients with different organic etiologies. Urol Res. 2001;29:278–281.

7 Reiter WJ, Pycha A, Schatzl G, Pokorny A, Gruber DM, Huber JC, Marberger M. Dehydroepiandrosterone in the treatment of erectile dysfunction: A prospective, double-blind, randomized, placebo-controlled study. Urology. 1999;53:590–594.

8 Baulieu EE, Thomas G, Legrain S, et al. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci USA. 2000;97:4279–4284.

9 Villareal DT, Holloszy JO, Kohrt WM. Effects of DHEA replacement on bone mineral density and body composition in elderly women and men. Clin Endocrinol (Oxf). 2000;53:561–568.

10 Labrie F, Luu-The V, Labrie C, Bélanger A, Simard J, Lin SX, Pelletier G. Endocrine and intra¬crine sources of androgens in women: Inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone. Endocr Rev. 2003;24:152–182.

11 Baulieu EE, Thomas G, Legrain S, et al. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci USA. 2000;97:4279–4284.

Gene Bruno, MS, MHS, the dean of academics for Huntington College of Health Sciences, is a nutritionist, herbalist, writer and educator. For more than 30 years he has educated and trained natural product retailers and health care professionals, has researched and formulated natural products for dozens of dietary supplement companies, and has written articles on nutrition, herbal medicine, nutraceuticals and integrative health issues for trade, consumer magazines and peer-reviewed publications. He can be reached at gbruno@hchs.edu.