The Effect of Dehydroepiandrosterone Supplementation to Symptomatic Perimenopausal Women on Serum Endocrine Profiles, Lipid Parameters, and Health-Related Quality of Life
Circulating levels of dehydroepiandrosterone (DHEA), an androgen primarily of adrenal gland origin, decline with advancing age so that perimenopausal women have only about half of peak levels. Although scientific data are limited, DHEA has been increasingly used as a dietary supplement to combat symptoms of aging and to enhance general well-being. This is the first randomized, double-blind, placebo-controlled study of oral DHEA supplementation. Sixty perimenopausal women aged 45 to 55 years who reported symptoms of fatigue, anxiety, irritability, depression, insomnia, difficulty remembering or concentrating, or decreased libido and who had been amenorrheic for at least 2 months in the past year but not for longer than 12 months formed the study population. They were assigned to receive 50 mg of DHEA daily in capsule form or a placebo capsule for 3 months. The treatment and placebo groups were comparable at baseline. Serum testosterone as well as DHEA levels rose significantly in the treated group, and cortisol levels declined significantly compared with the placebo group. High-density lipoprotein levels fell 10 percent from baseline in women assigned to receive DHEA and 3 percent in placebo recipients. Lipoprotein(a) levels decreased 18 and 8 percent, respectively. There were no significant changes in total cholesterol, triglycerides, low-density lipoprotein, or apolipoprotein levels. Scores for change in the severity of perimenopausal symptoms did not differ significantly in the treatment and control groups after 3 months. Overall, there was a significant reduction in total symptom scores and improvement in quality-of-life scores. These findings suggest that DHEA supplementation would best be used under medical supervision and that endocrine and lipid parameters should be monitored in recipients. There is no support for replacing estrogen by DHEA when treating perimenopausal or postmenopausal symptoms. There is insufficient evidence to warrant prescribing DHEA to improve well-being and quality of life. J Clin Endocrinol Metab 1999;84:3896–3902