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Sexual Function
Sexual Function / Libido / Erectile Dysfunction
DHEA is converted into testosterone, which is known to enhance libido in
both men and women. This helps to explain why so many people report
heightened sexual desire after they begin taking DHEA supplements. But there
may be more to DHEA’s enhancement of sexual desire and performance than
simply raising testosterone levels. Because taking DHEA raises the levels of
all adrenal hormones, it tends to make people feel more energetic, and
enhances feelings of well-being in general. It also tends to improve overall
heath, and anything that improves physical health and well-being is likely
to reflect positively on one’s sexual health as well.
The
results of studies vary on the use of DHEA in erectile dysfunction and
sexual function, in both men and women. Still, other studies have shown that
DHEA may be an effective therapy for erectile dysfunction. Although there
are conflicting studies in this regard, a few have shown that among men
without heart or vascular disease, DHEA has been able to improve erectile
dysfunction.
Clinical Studies
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Center For Sexual Function, Lahey Clinic
Northshore, One Essex Center Drive, Peabody, MA 01960, USA.
Much more
information is available concerning decreased libido in postmenopausal
than in premenopausal women.
Even less is known about androgen deficiency
in younger women. In a study, the total and free testosterone levels were
measured in 12 consecutive premenopausal women complaining of decreased
libido. Of the 12 women, 8 had low or immeasurable levels of testosterone
despite having regular menstrual periods. Androgen precursor hormones,
DHEA-S and Androstenedione, were low-normal to high-normal. Treatment with
oral DHEA, 50 to 100 mg per day, restored sexual desire in 6 of the 8
women, gave partial improvement in one, and failed in another. Possible
significance and etiological mechanism are discussed.
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Center for Sexual Function, Lahey Clinic
Northshore, One Essex Center Drive, Peabody, MA 01960, USA.
A prior study has shown that premenopausal women could have decreased
testosterone levels and still have regular menstrual cycles. Since ovarian
function in such women was normal, the question of a possible adrenal
dysfunction causing androgen deficiency was considered. If this was true,
the question then arose as to whether the same defect could be seen in
postmenopausal women. A study was conducted with 105 women who presented
during a 6-month period of time with the chief complaint of decreased
sexual desire. On subsequent testing, 74 of the women (70%) were found to
have decreased total testosterone, free testosterone, and
dehydroepiandrosterone sulfate (DHEA-S). Thirty-six of these women were
premenopausal (ages range 24-50 years), and 38 were postmenopausal (ages
range 47-78 years). All androgen levels for the women were lower than
age-matched control groups found in the literature. The decreased DHEA-S
levels suggest a defect in adrenal steroidogenesis, which was seen in both
premenopausal and postmenopausal women.
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Department of Psychiatry and Behavioral
Sciences, University of Washington, Seattle, Washington.
The age-related decline of dehydroepiandrosterone (DHEA) has prompted
research on its experimental replacement in women. Although no
relationship to sexual functioning in healthy women has been shown to
date, DHEA replacement has potential for affecting sexual response. To
investigate DHEA effects, 16 sexually functional postmenopausal women
participated in a randomized, double-blind, crossover protocol in which
oral administration of DHEA (300 mg) or placebo occurred 60 minutes before
the presentation of an erotic video segment. Blood DHEA sulfate (DHEAS)
changes, subjective and physiological sexual responses, as well as
affective responses were measured in response to
videotaped neutral and erotic video segments. The concentration of
DHEAS increased 2-5-fold following DHEA administration in all 16 women.
Subjective ratings across DHEA and placebo conditions
showed significantly greater mental (p < 0.016) and physical (p < 0.036)
sexual arousal to the erotic video with DHEA vs. placebo. Positive affect
also increased during the erotic video across drug conditions. Vaginal
pulse amplitude (VPA) and vaginal blood volume (VBV) demonstrated a
significant increase (p < 0.001) between neutral and erotic film segments
within both conditions (DHEA and placebo) but did not differentiate drug
conditions. In sum, increases in mental and physical sexual arousal
ratings significantly increased in response to an acute dose of DHEA in
postmenopausal women.
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