Dehydroepiandrosterone replacement in women with adrenal insufficiency
| Autor: | Martin Reincke, Ines Koehler, Jan Christoph van Vlijmen, Martin Bidlingmaier, Frank Callies, Michael Ernst, Heinrich M. Schulte, Wiebke Arlt, Bruno Allolio, Doris Dr Huebler, Michael Oettel |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
medicine.medical_specialty medicine.drug_class Dehydroepiandrosterone Anxiety Placebo Sex hormone-binding globulin Double-Blind Method Internal medicine Sex Hormone-Binding Globulin Surveys and Questionnaires medicine Adrenal insufficiency Humans Cross-Over Studies biology business.industry Depression Obstetrics and Gynecology General Medicine Middle Aged Androgen medicine.disease Crossover study Lipids Affect Endocrinology Mental Health biology.protein Androgens Female business Androgen insufficiency Sexuality Hormone Adrenal Insufficiency |
| Zdroj: | The New England journal of medicine. 341(14) |
| ISSN: | 0028-4793 |
| Popis: | 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.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.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).Dehydroepiandrosterone improves well-being and sexuality in women with adrenal insufficiency. |
| Databáze: | OpenAIRE |
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