Dehydroepiandrosterone Treatment in the Aging Male – What Should the Urologist Know?

Saad, Farid; Hoesl, C.E.; Oettel, M; Fauteck, Jan-Dirk; Römmler, A.

doi:10.1016/j.eururo.2005.06.020

Cited by 14 publications

(10 citation statements)

References 79 publications

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“…DHEA may be involved in cognitive, memory, metabolic, vascular, immune, and sexual functions [121]. DHEA is an androgen precursor produced by the adrenal glands that exerts its effects via downstream conversion to testosterone and estradiol [122]. DHEA deficiencies in men have been reportedly associated with various drugs, and endocrine, nonhormonal, and age-related disorders (DHEA steadily decreases from age 40).…”

Section: Dehydroepiandrosteronementioning

confidence: 99%

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Testosterone and Erectile Function: From Basic Research to a New Clinical Paradigm for Managing Men with Androgen Insufficiency and Erectile Dysfunction

2007

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Objectives-Androgens are essential for the development and growth of the penis, and they regulate erectile physiology by multiple mechanisms. Our goal is to provide a concise overview of the basic research and how this knowledge can be translated into a new clinical paradigm for patient management. In addition, this new paradigm may serve as a basis for stimulating constructive debate regarding the use of testosterone in men, and to promote new, innovative basic and clinical research to further understand the underlying mechanisms of androgen action in restoring erectile physiology. Methods-A literature review was performed utilizing the US National Library of Medicine's PubMed database.Results-On the basis of evidence derived from laboratory animal studies and clinical data, we postulate that androgen insufficiency disrupts cellular-signaling pathways and produces pathologic alterations in penile tissues, leading to erectile dysfunction. In this review, we discuss androgendependent cellular, molecular, and physiologic mechanisms modulating erectile function in the animal model, and the implication of this knowledge in testosterone use in the clinical setting to treat erectile dysfunction. The new clinical paradigm incorporates many of the consensed points of view discussed in traditional consensed algorithms exclusively designed for men with androgen insufficiency. There are, however, novel and innovative differences with this new clinical paradigm. This paradigm represents a fresh effort to provide mandatory and optional management strategies for men with both androgen insufficiency and erectile dysfunction. Conclusions-The new clinical paradigm is evidence-based and represents one of the first attempts to address a logical management plan for men with concomitant hormonal and sexual health concerns.

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Section: Dehydroepiandrosteronementioning

confidence: 99%

“…Saad and colleagues [122] noted DHEA supplementation had positive effects on the cardiovascular system, body composition, bone mineral density, skin, central nervous system, the immune system, and sexual function. DHEA use may be justified in aging men with periodic evaluations to maintain serum concentrations in the physiologic range [149].…”

Section: 42mentioning

confidence: 99%

Testosterone and Erectile Function: From Basic Research to a New Clinical Paradigm for Managing Men with Androgen Insufficiency and Erectile Dysfunction

2007

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“…In this review article, we will analyze the role of the pituitary hormone prolactin (PRL) and growth hormone (GH) along with thyroid hormones and adrenal androgens (dehydroepiandrosterone [DHEA]) in male sexual dysfunctions. The topic has been covered by other recent reviews [1–4]. Level of evidence was rated according to Oxford Centre for Evidence‐Based Medicine—Levels of Evidence (EBML, March 2009) whenever it was possible (http://www.cEBML.net/index.aspx?o=1025).…”

Section: Introductionmentioning

confidence: 99%

Hormonal Causes of Male Sexual Dysfunctions and Their Management (Hyperprolactinemia, Thyroid Disorders, GH Disorders, and DHEA)

Maggi

Buvat²,

Corona

et al. 2013

The Journal of Sexual Medicine

118

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Introduction Besides hypogonadism, other endocrine disorders have been associated with male sexual dysfunction (MSD). Aim To review the role of the pituitary hormone prolactin (PRL), growth hormone (GH), thyroid hormones, and adrenal androgens in MSD. Methods A systematic search of published evidence was performed using Medline (1969 to September 2011). Oxford Centre for Evidence-Based Medicine—Levels of Evidence (March 2009) was applied when possible. Main Outcome Measures The most important evidence regarding the role played by PRL, GH, thyroid, and adrenal hormone was reviewed and discussed. Results Only severe hyperprolactinemia (>35 ng/mL or 735 mU/L), often related to a pituitary tumor, has a negative impact on sexual function, impairing sexual desire, testosterone production, and, through the latter, erectile function due to a dual effect: mass effect and PRL-induced suppression on gonadotropin secretion. The latter is PRL-level dependent. Emerging evidence indicates that hyperthyroidism is associated with an increased risk of premature ejaculation and might also be associated with erectile dysfunction (ED), whereas hypothyroidism mainly affects sexual desire and impairs the ejaculatory reflex. However, the real incidence of thyroid dysfunction in subjects with sexual problems needs to be evaluated. Prevalence of ED and decreased libido increase in acromegalic patients; however, it is still a matter of debate whether GH excess (acromegaly) may create effects due to a direct overproduction of GH/insulin-like growth factor 1 or because of the pituitary mass effects on gonadotropic cells, resulting in hypogonadism. Finally, although dehydroepiandrosterone (DHEA) and its sulfate have been implicated in a broad range of biological derangements, controlled trials have shown that DHEA administration is not useful for improving male sexual function. Conclusions While the association between hyperprolactinemia and hypoactive sexual desire is well defined, more studies are needed to completely understand the role of other hormones in regulating male sexual functioning.

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“…It is synthesized predominantly in the adrenal cortex and serves as a precursor for many hormones. In adults, the declining of serum levels of DHEA with age is presumably linked with several agerelated pathologies [17,18]. In addition, positive effects such as the improvement of athletic performance, treatment of neuropsychiatric disorders, cancer, allergic diseases, viral infections and immune pathologies have been attributed to DHEA [19][20][21][22][23][24][25][26][27][28].…”

Section: Research Articlementioning

confidence: 98%

DHEA inhibits Measles Virus through a Mechanism Independent of its ability to Modulate the Raf/MEK/ERK Signaling Pathway

2012

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Aim: Despite the existence of an effective vaccine, measles infection is still frequent in many developing countries with reduced health infrastructure, and it is one of the major causes of child death globally. In the past decade numerous outbreaks have occurred in developed countries, giving a fresh impetus to antiviral research against measles virus. The aim of this study was to investigate the antiviral activity of the natural steroid hormone DHEA against measles virus and the role of the Raf/MEK/ERK signaling pathway in viral multiplication and DHEA’s antiviral activity. Materials & methods: The antiviral activity of DHEA and two ERK modulators, UO126 and anisomycin, was determined using a virus yield reduction assay. Furthermore, we studied DHEA’s virucidal activity and the viral multiplication step affected by the compound. The effect of virus infection on the Raf/MEK/ERK pathway and the activity of those compounds against measles virus spread and induced cytopathic effect were studied using western blot and indirect immunofluorescence. Results & conclusion: We found that DHEA and UO126 are active against measles virus and that they are able to diminish virus-induced cytopathic effects. Also, our study showed that early events in the viral multiplication cycle trigger ERK activation, suggesting that DHEA, a Raf/MEK/ERK modulator, may not exert its antiviral activity through the modulation of this pathway. Our results may provide a first step in the development of new antiviral agents against measles virus.

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Dehydroepiandrosterone Treatment in the Aging Male – What Should the Urologist Know?

Cited by 14 publications

References 79 publications

Testosterone and Erectile Function: From Basic Research to a New Clinical Paradigm for Managing Men with Androgen Insufficiency and Erectile Dysfunction

Testosterone and Erectile Function: From Basic Research to a New Clinical Paradigm for Managing Men with Androgen Insufficiency and Erectile Dysfunction

Hormonal Causes of Male Sexual Dysfunctions and Their Management (Hyperprolactinemia, Thyroid Disorders, GH Disorders, and DHEA)

DHEA inhibits Measles Virus through a Mechanism Independent of its ability to Modulate the Raf/MEK/ERK Signaling Pathway

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