5-Androgens and postmenopause: effects of 6 months DHEA supplementation in postmenopausal women

Abstract

Background: The adrenal production of dehydroepiandrosterone (DHEA) and its sulphate ester, dehydroepiandrosterone sulphate (DHEAS), declines linearly with ageing. Starting from the evidence that DHEA and DHEAS (DHEA(S)) administration may alleviate some of the problems related to ageing, the present study aimed to investigate the effects of a 6-month DHEA supplementation. Methods: Early and late postmenopausal women, with different body mass index (BMI), were treated with oral DHEA (50 mg/daily) for 6 months. Circulating steroids, sex-hormone binding globulin (SHBG), β-endorphin (β-EP) and gonadotropins were evaluated monthly. The adrenal gland response to dexamethasone (dxm) suppression and ACTH stimulation were evaluated before and after 3 and 6 months of therapy. Postmenopausal symptoms were evaluated with a Kupperman questionnaire. Results: DHEA, DHEAS, androstenedione (A), testosterone (T), dihydrotestosterone (DHT), estrone (E1), estradiol (E2), 17OH-progesterone (17-OHP), allopregnanolone (allop) and β-endorphin levels increased during the 6 months of the treatment. Progesterone (P) and 17-OH pregnenolone (17-OH pregn) remained constant. Sex hormone-binding globulin levels significantly decreased only in overweight, late postmenopausal women, while cortisol and gonadotropins levels progressively deceased in all groups. ACTH stimulus induced a significant response in all parameters and, after the treatment, it prompted a greater response in Δ5 and Δ4 androgens, progesterone and 17-OHP, while cortisol responded less, both in younger and in older normal-weight subjects. Conclusions: The present findings confirm that DHEA supplementation produces physiological and supraphysiological modifications in steroid milieu and adrenal function.