Abstract
Dehydroepiandrosterone (DHEA), and its metabolite, dehydroepiandrosterone sulfate ester (DHEAS), are the most abundant circulating steroid hormones, and are synthesized in the zona reticularis of the adrenal cortex, in the gonads, and in the brain. The precise physiological role of DHEA and DHEAS is not yet fully understood, but these steroid hormones can act as androgens, estrogens, and neurosteroids, and perform many roles in the human body. Since both levels decline with age, use of DHEA supplements have gained more attention due to being advertised as an antidote to aging in postmenopausal women, who may have concerns on age-related diseases and overall well-being. However, current research has not reached an overall consensus on the effects of DHEA on postmenopausal women. This overview is a summary of the current literature, addressing the metabolic pathway for DHEA synthesis and utilization, as well as the effects of DHEA on premenopausal and postmenopausal women with disease states and other factors. As for the therapeutic effects on menopausal syndrome and other age-related diseases, several studies have found that DHEA supplementations can alleviate vasomotor symptoms, preserve the integrity of the immune system, reduce bone loss, and increase muscle mass. Intravaginal DHEA has shown significant beneficial effects in menopausal women with severe vulvovaginal symptoms. On the other hand, DHEA supplements have not shown definitive effects in cardiovascular disease, adrenal insufficiency, insulin sensitivity, and cognition. Due to inadequate sample sizes and treatment durations of current studies, it is difficult to assess the safety and efficacy of DHEA and draw reliable conclusions for the physiological role, the optimal dosage, and the effects on premenopausal and postmenopausal women; therefore, the study of DHEA warrants future investigation. Further research into the roles of these steroid hormones may bring us closer to a therapeutic option in the future.
Highlights
Dehydroepiandrosterone (DHEA), an endogenous 19-carbon steroid hormone, and its metabolite, dehydroepiandrosterone sulfate ester (DHEAS), are the most abundant circulating steroid hormones, and are predominantly secreted by the zona reticularis of the adrenal cortex, the gonads, as well as the brain
An early report studied administration of 1600 mg DHEA for four weeks to obese postmenopausal women, and the results demonstrated that DHEA did not affect body fat mass, but the levels of total serum cholesterol and high-density lipoprotein cholesterol were significantly lowered
DHEA is a precursor for many androgenic and estrogenic entities, and its metabolic pathways may differ between genders and among ages
Summary
Dehydroepiandrosterone (DHEA), an endogenous 19-carbon steroid hormone, and its metabolite, dehydroepiandrosterone sulfate ester (DHEAS), are the most abundant circulating steroid hormones, and are predominantly secreted by the zona reticularis of the adrenal cortex, the gonads, as well as the brain. DHEA becomes DHEAS in the plasma; DHEAS is present in a much greater concentration compared to DHEA [1], and is reserved and converted into specific hormones 4.0/). Both levels decline in concentration with age [2], and age-related diseases become more prevalent. At around 25 years of age, plasma DHEAS declines gradually thereafter at a rate of 10% per decade [2,3]. Throughout the entire adult lifespan, normal DHEAS values range from 0.3 to 3.5 μg/mL. By 75 years of age, the plasma DHEAS levels are about 80% lower than those at 25 years of age due to decreased adrenal production [1]
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