Dehydroepiandrosterone (DHEA) and DHEA-Sulfate (DS) as Therapeutic Options in Menopause

Katz, Seth E.; Morales, Arlene J.

doi:10.1055/s-2007-1016267

Cited by 33 publications

(13 citation statements)

References 64 publications

(100 reference statements)

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“…At present there is little evidence in favour of the therapeutic use of DHEA in human insulin resistance, and until results of prospective studies are available its use in patients is not advised [99].…”

Section: Human Studiesmentioning

confidence: 99%

Sex steroids and insulin resistance

LIVINGSTONE¹,

COLLISON²

2002

Clinical Science

153

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There is extensive experimental evidence that sex steroids and insulin interact in their actions on tissues. At physiological levels, testosterone and oestradiol are thought to be involved in maintaining normal insulin sensitivity. However, outside this 'physiological window' these steroids may promote insulin resistance. Considerable research has been carried out on polycystic ovarian syndrome, a common disorder associated with excessive androgen production and insulin resistance. Hyperinsulinaemia in patients with this condition is believed to stimulate ovarian androgen production, and there is also evidence that androgens act directly on peripheral tissues to promote insulin resistance. There is the potential for a vicious circle to develop with increasing androgen production and insulin resistance. The molecular basis of this insulin resistance has been reported to involve reduced insulin receptor autophosphorylation, reduced expression and translocation of insulin-responsive glucose transporters and defects of the insulin signalling pathway distal to the insulin receptor. These defects await full characterization. Insulin-sensitizing agents can reverse many of the effects of insulin resistance and may have a future place in the treatment of polycystic ovarian syndrome and other conditions associated with steroid-induced insulin resistance. Recognition and treatment of sex steroid-associated insulin resistance at an early stage in patients may reduce their risk of developing Type II (non-insulin-dependent) diabetes mellitus, hypertension and dyslipidaemia, and so may improve fertility and reduce cardiovascular risk. Here we review the interplay between sex steroids and insulin resistance, and consider the implications this has for clinical conditions.

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Section: Human Studiesmentioning

confidence: 99%

Sex steroids and insulin resistance

LIVINGSTONE¹,

COLLISON²

2002

Clinical Science

153

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“…Why then do depression levels not rise dramatically from the twenties in women and the thirties in men ? In later life, there has been a focus on DHEA ' replacement' to reverse these natural age effects and their correlates in numerous body and brain systems in the hope of incurring wide-ranging health benefits (Katz & Morales, 1998;Larkin, 1998;Morales et al 1998 ;Hinson & Raven, 1999;Pepping, 2000 ;Martina et al 2001), but it remains to be seen whether there really will be therapeutic benefits.…”

Section: Is It Time For a Trial Of Dhea Treatment For Depression In Cmentioning

confidence: 99%

Adolescent depression, cortisol and DHEA

Angold¹

2003

Psychol. Med.

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Since the mid-1980s Ian Goodyer and his colleagues have been engaged in trying to understand the dynamics of the relationship between acute and chronic life stresses and depression in adolescents (Goodyer et al. 1985, 1986). One of the great strengths of their work has been their attention to an array of potential risk factors ranging from the apparently exogenous (such as life events, e.g. Goodyer et al. 1988; Goodyer & Altham, 1991; Goodyer, 1999), through those of uncertain origin (e.g. peer and family relationships and problems, Goodyer et al. 1990), to those that can be regarded as being endogenous to the child (e.g. measures of temperament or endocrine function, Goodyer et al. 1993, 1996, 1998; Herbert et al. 1996). They have then typically attempted to determine how subsets of these factors interact in the generation of disorder (see Goodyer, 2002 for a speculative presentation of his current thinking about the relationships between social adversity and depression). A second characteristic of their research lies in its frequent attention to outcomes over time, as opposed to cross-sectional relationships (e.g. Goodyer et al. 1997a,b). Thirdly, in line with growing evidence that the relationships between environmental stress (and perhaps neuro-anatomical correlates) and depression change as repeated episodes occur (Lewinsohn et al. 1999; Daley et al. 2000), they have distinguished among first, recurrent, remitting and chronic depressive episodes. The group's latest work, presented in this issue (Goodyer et al. 2003), nicely illustrates these characteristics, and their extension to consideration of potential dynamic relations among endocrine parameters in relation to psychopathology.

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“…Finally, a 12-month trial of 10% DHEA vaginal cream in 14 postmenopausal women suggests that DHEA may have beneficial effects on the vagina, without significant adverse effects, through the transformation of DHEA into androgens or estrogens or both in peripheral tissues [79,80]. Notably, the endometrium remained atrophic while vaginal epithelium maturation was stimulated.…”

Section: Sexual Effectsmentioning

confidence: 99%

Hormonal aspects of sexual dysfunction: The therapeutic use of exogenous androgens in men and women

Seidman

2000

Curr Psychiatry Rep

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Hormones exert a pervasive influence on sexual activity. Androgens are involved in the initiation and maintenance of libido and spontaneous arousal. In recent years, the clinical use of exogenous androgens for treatment of sexual dysfunction has received a great deal of attention. Good evidence exists that such treatment is effective for arousal difficulties in men and women in the setting of a hypo-androgenic state. This article reviews the relationship between androgens and sexual function.

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Dehydroepiandrosterone (DHEA) and DHEA-Sulfate (DS) as Therapeutic Options in Menopause

Cited by 33 publications

References 64 publications

Sex steroids and insulin resistance

Sex steroids and insulin resistance

Adolescent depression, cortisol and DHEA

Hormonal aspects of sexual dysfunction: The therapeutic use of exogenous androgens in men and women

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