Dihydrotestosterone (dht) accumulation as a consequence of long-term dhea supplementation in postmenopausal women

Abstract

Increasing numbers of women are using nonprescription DHEA because of its purported beneficial effects on a variety of organ systems as an alternative hormone replacement therapy in dosages between 25 mg and 200 mg daily. Although DHEA has no inherent androgenic activity, it is readily metabolized to potent androgens, specifically testosterone (T) and DHT. DHEA is also a substrate for androstenedione, which can be converted to estrone (E1) and estradiol (E2) in peripheral tissues. The objective of this study was to determine the extent of accumulation of T, DHT, E1 and E2 with prolonged DHEA administration. Five postmenopausal women, ages 55–65 years, were studied. Each subject ingested a tablet containing a low dose (25 mg) of DHEA daily for 6 months. Blood samples were obtained at frequent intervals (0, 1, 2, 3, 4, 6, 8, 12, and 24 hours) on day 1 (after DHEA ingestion) and after 3 and 6 months of treatment. T, DHT, E1 and E2 were quantified in serum by RIA following extraction and celite column chromatography. Serum levels of 3α-androstanediol glucuronide (3AG), a metabolite of DHT and a marker of a peripheral androgen action, was measured by a highly specific direct RIA. Results are shown below. ResultsBaselineMonth 3Month 6P ValueT (ng/dL)16.5 ± 4.528.0 ± 926.9 ± 3.5<.01DHT (ng/dL)6.3 ± 3.017.9 ± 7.914.8 ± 4.0<.013AG (ng/mL)2.14 ± 1.688.53 ± 5.937.76 ± 3.38<.05E1 (pg/mL)29 ± 661 ± 2458 ± 45NSE2 (pg/mL)12 ± 237 ± 2944 ± 60NS