Dehydroepiandrosterone replacement in women with adrenal insufficiency

W Arlt; F Callies; J C van Vlijmen; I Koehler; M Reincke; M Bidlingmaier; D Huebler; M Oettel; M Ernst; H M Schulte; B Allolio

doi:10.1056/NEJM199909303411401

Dehydroepiandrosterone replacement in women with adrenal insufficiency

W Arlt, F Callies, J C van Vlijmen, I Koehler, M Reincke, M Bidlingmaier, D Huebler, M Oettel, M Ernst, H M Schulte, B Allolio

Metabolism and Systems Research

Research output: Contribution to journal › Article › peer-review

558 Citations (Scopus)

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.

Original language	English
Pages (from-to)	1013-20
Number of pages	8
Journal	The New England Journal of Medicine
Volume	341
Issue number	14
DOIs	https://doi.org/10.1056/NEJM199909303411401
Publication status	Published - 30 Sept 1999

Keywords

Adrenal Insufficiency
Adult
Affect
Androgens
Anxiety
Cross-Over Studies
Dehydroepiandrosterone
Depression
Double-Blind Method
Female
Humans
Lipids
Mental Health
Middle Aged
Questionnaires
Sex Hormone-Binding Globulin
Sexuality

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1056/NEJM199909303411401

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@article{efc5b8ee206b435f90ac4b89915fa825,

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.",

keywords = "Adrenal Insufficiency, Adult, Affect, Androgens, Anxiety, Cross-Over Studies, Dehydroepiandrosterone, Depression, Double-Blind Method, Female, Humans, Lipids, Mental Health, Middle Aged, Questionnaires, Sex Hormone-Binding Globulin, Sexuality",

author = "W Arlt and F Callies and {van Vlijmen}, {J C} and I Koehler and M Reincke and M Bidlingmaier and D Huebler and M Oettel and M Ernst and Schulte, {H M} and B Allolio",

year = "1999",

month = sep,

day = "30",

doi = "10.1056/NEJM199909303411401",

language = "English",

volume = "341",

pages = "1013--20",

journal = "The New England Journal of Medicine",

issn = "0028-4793",

publisher = "Massachusetts Medical Society",

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TY - JOUR

T1 - Dehydroepiandrosterone replacement in women with adrenal insufficiency

AU - Arlt, W

AU - Callies, F

AU - van Vlijmen, J C

AU - Koehler, I

AU - Reincke, M

AU - Bidlingmaier, M

AU - Huebler, D

AU - Oettel, M

AU - Ernst, M

AU - Schulte, H M

AU - Allolio, B

PY - 1999/9/30

Y1 - 1999/9/30

N2 - 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.

AB - 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.

KW - Adrenal Insufficiency

KW - Adult

KW - Affect

KW - Androgens

KW - Anxiety

KW - Cross-Over Studies

KW - Dehydroepiandrosterone

KW - Depression

KW - Double-Blind Method

KW - Female

KW - Humans

KW - Lipids

KW - Mental Health

KW - Middle Aged

KW - Questionnaires

KW - Sex Hormone-Binding Globulin

KW - Sexuality

U2 - 10.1056/NEJM199909303411401

DO - 10.1056/NEJM199909303411401

M3 - Article

C2 - 10502590

SN - 0028-4793

VL - 341

SP - 1013

EP - 1020

JO - The New England Journal of Medicine

JF - The New England Journal of Medicine

IS - 14

ER -

Dehydroepiandrosterone replacement in women with adrenal insufficiency

Abstract

Keywords

UN SDGs

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