DHEA provides many benefits along with its ability
to improve human sexuality and the quality of life

The DHEAging
of Romance

DHEA could be better than flowers or
chocolate for Valentine’s Day

By Will Block

F ebruary is the month of hearts, when we celebrate Valentine’s day. For many this kicks off the beginning of spring, independent of whether the groundhog sees its shadow or not. V-day is usually represented by an exchange of “I love you’s,” which appear on greeting cards, or by gifts of flowers or chocolate. However, to usher in spring this year, why not give a different gift, a gift for love and for a longer healthspan? That gift is DHEA.

Some of the most robust strategies are found where you least expect them to be …. right in front of your eyes. For 20 years, this author has written about and championed the use of dehydroepiandrosterone (DHEA) for replacement therapy to address the loss of approximately 80% of DHEA between the ages 25 and 75 years (see sidebar “DHEA Redux”). And since my first article written in 1993, much has been studied about DHEA and especially its use for heightened sexuality. The following research highlights just the tip of what has been discovered to date.

DHEA Redux

Back in 1993, I wrote a lengthy article about what was then known about DHEA. Published in The Life Extension Newsletter and later incorporated into a book, The Physicians’ Guide to Life Extension Drugs, the gist of my report was that, while the data looked promising, more information was needed. (Haven’t you heard that before?) Nevertheless, I wrote, “DHEA may be able to, by its absence or presence, foretell the future of degenerative diseases such as ­diabetes, cancer, cardiovascular disease, memory disorders, and perhaps aging ­itself.”

Later that year, a friend of mine told me that his physician was recommending DHEA supplementation to replace what had been lost by age. His doctor insisted that it would offer him a substantial improvement in health. When I asked my friend for supporting evidence, his physician sent a copy of my article which he forwarded to me, unaware that I was the author. Over the next two years, I kept seeing and hearing my lines about DHEA again and again. Until my article appeared, little had been written about DHEA, other than what was published in scientific journals, and most of that was largely inaccessible.

Two years later, in August of 1995, a certain company in California, with which I was affiliated, began to market DHEA. While this company was not the first to sell it—there were a few small AIDS buyers clubs offering it for the chronically ill—the California company was the first company to actively market this amazing hormone. But its task was not without some difficulty. In anticipation of a possible regulatory assault, they had written the commissioners of both the FDA and the DEA—who were toying with the idea of classifying DHEA under the Anabolic Steroid Act—stating their intentions. With the support of DHEA conference organizer, textbook author, and researcher Bill Regelson, they announced the availability of DHEA scientists to testify about the high prospects and low side effects of DHEA. At the same time, they cautioned the commissioners about potential violations of the Administrative Procedures Act, the Dietary Health and Supplements Education Act, and the Bill of Rights.

In 1996, Newsweek magazine called it “The Fountain of Youth,” and the rush was on. Before you could say ­dehydroepiandrosterone, there were 12-foot-high pyramids of DHEA in Costco and elsewhere, and history was made. Before long, the corner lemonade stand was offering DHEA as an optional ingredient, and what had started as a trickle became an avalanche. The speed of its introduction to America and the rest of the world ranks right up there with “the madness of crowds,” but the crowds weren’t mad. They wanted to be healthier.

While many of us long-time nutrient users have become jaded about old warhorses such as DHEA, there’s never been a stop to the flow of provocative scientific studies, and the story that we feature in this issue may help to revitalize DHEA’s well-deserved, but often forgotten, reputation as a good candidate for “The Hormone of Youth.”

Increased Physical and Psychological Well-Being

In a study published in 1994,1 the effects of 50 mg/day of DHEA in 13 men and 17 women, 40-70 years of age, given for a 6-month duration, found a 2-fold increase in serum levels of androgens (androstenedione, testosterone, and dihydrotestosterone) in the women. Also, an increased bioavailability of insulin-like growth factor 1 (IGF-I) to target tissues was associated with a remarkable increase in perceived physical and psychological well-being for both men (67%) and women (84%). These observations—together with improvement of physical and psychological well-being in both genders and the absence of side-effects—constitute the first demonstration of novel effects of DHEA replacement in age-advanced men and women.

Improved Overall Well-Being and Sexuality in Women

In a German study published in the New England Journal of Medicine in 1999,2 researcher investigated the physiologic role of DHEA in patients with adrenal insufficiency. This study was randomized and double-blinded, and followed 24 women with adrenal insufficiency who received 50 mg of DHEA or placebo orally each morning for four months, with a one-month washout period, and then the DHEA and the placebo were reversed. DHEA raised the initially low serum concentrations of DHEA, DHEA’s sulfate form (DHEAS), androstenedione, and testosterone into the normal range, while serum concentrations of sex hormone-binding globulin, total cholesterol, and high-density lipoprotein cholesterol (HDL) decreased significantly, probably due to an androgenic effect. Also, DHEA significantly increased the frequency of sexual thoughts, sexual interest, and satisfaction with both mental and physical aspects of sexuality. The researchers concluded that DHEA improves well-being and sexuality in women with adrenal insufficiency.


DHEA significantly increased the
frequency of sexual thoughts,
sexual interest, and satisfaction with
both mental and physical
aspects of sexuality.


DHEAging Study Finds Libido Increase in Women

In a so-called DHEAge Study,3 led by Étienne-Émile Baulieu, MD, PhD,* researchers followed 280 healthy individuals (women and men 60–79 years old) given 50 mg of DHEA or placebo, daily for a year in a double-blind, placebo-controlled study. No potentially harmful accumulation of DHEAS or active steroids was recorded. A small increase of testosterone and estradiol was noted, particularly in women, and bone turnover improved selectively in women >70 years old. A significant increase in most libido parameters was also found in these older women, plus there were improvements of skin status observed, particularly in women, in terms of hydration, epidermal thickness, sebum production, and pigmentation.


* Dr, Baulieu is the famous French biochemist and endocrinologist who in 1960 demonstrated that DHEA was the main adrenal androgen.


Sexual Interest and the Level of Satisfaction with Sex

In another adrenal insufficiency study,4 German researchers investigated the effects of DHEA replacement in 24 women with primary and secondary adrenal insufficiency employing a double blind, placebo-controlled, randomized crossover design in which 50 mg/d of DHEA or placebo were given to over the course of four months. Then, following a washout period, those who got the DHEA received placebo and vice versa.

Treatment with DHEA raised the initially low serum concentrations of DHEA, DHEAS, androstenedione, and testosterone into the normal range. DHEA induced a slight increase in serum IGF-I, but only in patients with primary adrenal insufficiency, suggesting a growth hormone-mediated effect. DHEA treatment significantly improved overall well-being as well as scores for depression, anxiety, and their physical correlates. Furthermore, DHEA significantly increased both sexual interest and the level of satisfaction with sex.

DHEA replacement had no influence on cognitive performance, which was already on a high level at baseline. In conclusion, DHEA replacement improves well-being and sexuality in women with adrenal insufficiency.

Sexual Arousal in Postmenopausal Women

In Seattle, researchers investigated the relationship of the age-related decline of DHEA in healthy women with regard to sexual functioning, something that had not been done to date.5 Sixteen 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 DHEAS changes, subjective and physiological sexual responses, as well as affective responses were measured in response to videotaped neutral and erotic video segments.

DHEAS levels increased 2–5-fold following DHEA administration in all 16 women. Subjective ratings showed significantly greater mental and physical sexual arousal to the erotic video for DHEA compared to placebo. Vaginal pulse amplitude and vaginal blood volume demonstrated a significant increase between neutral and erotic film segments for both DHEA and placebo but did not differentiate for DHEA vs. placebo. The p-values were quite low, indicating high probability the results were statistically meaningful. In summary, increases in mental and physical sexual arousal ratings significantly increased in response to an acute dose of DHEA in postmenopausal women.

Improvement Health-Related Quality of Life in Lupus

A study conducted in Sweden6 evaluated the efficacy of low-dose DHEA on health-related quality of life (HRQOL) in glucocorticoid treated female patients with systemic lupus erythematosus (SLE). Forty one women taking ≥5 mg of prednisolone/day were included in a double-blind, randomized, placebo-controlled study for 6 months where DHEA was given at 30 mg/20 mg (≤45/ ≥46 years) daily, or placebo, followed by 6 months open DHEA treatment to all patients. DHEA treatment increased serum levels of DHEAS from subnormal to normal. The DHEA group improved in the emotional realm. During open DHEA treatment, the former placebo group improved in mental health. DHEA replacement decreased HDL cholesterol and increased IGF-I and hematocrit (the volume percentage of red cells in blood). There were no effects on bone density or disease activity and no serious adverse events. Side effects were mild. The researchers concluded that low-dose DHEA treatment improves HRQOL with regard to mental well-being and sexuality, and can be offered to women with SLE where mental distress and/or impaired sexuality constitutes a problem.

Decreased Depression and Increased Life Satisfaction

At the University of California at San Diego, La Jolla, California, researchers set out to examine the effects of DHEA supplementation on cognitive function and quality of life in healthy older adults.7 Enlisted were 110 men and 115 women, aged 55 to 85, who were given 50 mg of oral DHEA or placebo for one year. Six cognitive function tests were given at baseline, 3 months, 6 months, and 12 months. The tests were for depression medical outcomes, life satisfaction, female sexual function, and male erectile function. There were no differences between the DHEA and placebo groups in change over time in cognitive function. However, depression scores decreased for men and women, and life satisfaction scores increased for women.

Intravaginal DHEA Improves Desire, Arousal, Lubrication

In Quebec, Canada researchers investigated the transformation of DHEA into both androgens and/or estrogens locally in cells of the three layers of the vagina (epithelium, lamina propria, and muscularis).8 They wanted to determine if DHEA would have effects of greater impact, including effects on sexual function, than only effects on superficial epithelial cells as achieved with estrogens. This prospective, randomized, double-blind, and placebo-controlled phase III clinical trial evaluated the effect of daily local intravaginal application of DHEA for 12 weeks on the domains of sexual dysfunction, namely, desire/interest, arousal, orgasm, and pain at sexual activity, in 216 postmenopausal women with moderate to severe symptoms of vaginal atrophy.

As measured by a questionnaire, at the 12-week time interval, the 1.0% DHEA dose led, compared with placebo, to 49% and 23% improvements in sexual desire and quality of life plus sexual function. Compared with placebo, the arousal/sensation domain was improved by 68%, the arousal/lubrication domain by 39%, orgasm by 75%, and dryness during intercourse by 57%. Such data indicate that combined androgenic/estrogenic stimulation in the three layers of the vagina exerts important beneficial effects on sexual function in women without systemic action on the brain and other extravaginal tissues.

Increased Frequency of Sexual Intercourse

In Italy at the University of Pisa, researchers set out to evaluate the effects of different types of hormonal replacement therapy (HRT) on sexual function, frequency of sexual intercourse, and quality of relationship in early postmenopausal women.9 Forty-eight healthy postmenopausal women aged 50–60 years with climacteric (menopausal) symptoms were uniformly randomized into three groups receiving either DHEA at 10 mg/day, or daily oral estradiol at 1 mg/day plus dihydrogesterone at 5 mg/day, or daily oral tibolone at 2.5 mg/day for 12 months. Women who refused hormonal therapy were treated with oral vitamin D at 400 IU/day. Efficacy was evaluated using the McCoy Female Sexuality Questionnaire before treatment and after 12 months. And the hormonal profile was evaluated before treatment and after 3, 6 and 12 months.


The researchers concluded that low-
dose DHEA treatment improves
health-related quality of life with
regard to mental well-being and
sexuality and can be offered to
women with lupus where mental
distress and/or impaired sexuality
constitutes a problem.


The groups receiving DHEA or HRT (estradiol plus dihydrogeteroone) reported a significant improvement in sexual function compared to baseline. Plus there were significant increases in the numbers of episodes of sexual intercourse in the previous 4 weeks in women treated with DHEA, HRT and tibolone in comparison with the baseline. No changes in the McCoy score occurred in women receiving vitamin D. The researchers concluded that daily oral DHEA therapy at the low-dose of 10 mg, HRT, and tibolone all provided a significant improvement in comparison with vitamin D in sexual function and in frequency of sexual intercourse in early postmenopausal women.

Increasing Healthspan by Improving Glucose Tolerance

In a preliminary study, researchers in the US and Italy have found that 6 months of DHEA replacement improved insulin action in elderly individuals.10 The purpose of the present larger, randomized double‐blind study was to determine whether a longer period of DHEA replacement improves glucose tolerance. Fifty-seven men and 68 women aged 65 to 75 years were randomly assigned to 50 mg of DHEA or placebo once daily. Year one was a randomized, double-blind trial. Year 2 was an open-label continuation. DHEA replacement improved glucose tolerance in participants who had abnormal glucose tolerance initially, reduced plasma triglycerides, and the inflammatory cytokines IL6 and TNFα.

The US/Italy study was undertaken to determine whether a longer period of DHEA replacement improves both insulin action and glucose tolerance in elderly women and men and it did.

Summary

All told there are 991 clinical trials on DHEA in the ­National Library of Medicine containing many positive outcomes. All together, these represent a plethora of reasons that DHEA can support enhanced sexuality and improved quality of life for both men and women. Now what did we say about a great gift for Valentine’s Day?

References

  1. Morales AJ, Nolan JJ, Nelson JC, Yen SS. Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. J Clin Endocrinol Metab. 1994 Jun;78(6):1360-7.
  2. Arlt W, Callies F, van Vlijmen JC, Koehler I, Reincke M, Bidlingmaier M, Huebler D, Oettel M, Ernst M, Schulte HM, Allolio B. Dehydroepiandrosterone replacement in women with adrenal insufficiency. N Engl J Med. 1999 Sep 30;341(14):1013-20.
  3. Baulieu EE, Thomas G, Legrain S, Lahlou N, Roger M, Debuire B, Faucounau V, Girard L, Hervy MP, Latour F, Leaud MC, Mokrane A, Pitti-Ferrandi H, Trivalle C, de Lacharrière O, Nouveau S, Rakoto-Arison B, Souberbielle JC, Raison J, Le Bouc Y, Raynaud A, Girerd X, Forette F. Proc Natl Acad Sci USA. 2000 Apr 11;97(8):4279-84.
  4. Arlt W, Callies F, Allolio B. DHEA replacement in women with adrenal insufficiency—pharmacokinetics, bioconversion and clinical effects on well-being, sexuality and cognition. Endocr Res. 2000 Nov;26(4):505-11.
  5. Hackbert L, Heiman JR. Acute dehydroepiandrosterone (DHEA) effects on sexual arousal in postmenopausal women. J Womens Health Gend Based Med. 2002 Mar;11(2):155-62.
  6. Nordmark G, Bengtsson C, Larsson A, Karlsson FA, Sturfelt G, Rönnblom L. Effects of dehydroepiandrosterone supplement on health-related quality of life in glucocorticoid treated female patients with systemic lupus erythematosus. Autoimmunity. 2005 Nov;38(7):531-40.
  7. Kritz-Silverstein D, von Mühlen D, Laughlin GA, Bettencourt R. Effects of dehydroepiandrosterone supplementation on cognitive function and quality of life: the DHEA and Well-Ness (DAWN) Trial. J Am Geriatr Soc. 2008 Jul;56(7):1292-8. doi: 10.1111/j.1532-5415.2008.01768.x. Epub 2008 May 14.
  8. Labrie F, Archer D, Bouchard C, Fortier M, Cusan L, Gomez JL, Girard G, Baron M, Ayotte N, Moreau M, Dubé R, Côté I, Labrie C, Lavoie L, Berger L, Gilbert L, Martel C, Balser J. Effect of intravaginal dehydroepiandrosterone (Prasterone) on libido and sexual dysfunction in postmenopausal women. Menopause. 2009 Sep-Oct;16(5):923-31. doi: 10.1097/gme.0b013e31819e85c6.
  9. Genazzani AR, Stomati M, Valentino V, Pluchino N, Pot E, Casarosa E, Merlini S, Giannini A, Luisi M. Effect of 1-year, low-dose DHEA therapy on climacteric symptoms and female sexuality. Climacteric. 2011 Dec;14(6):661-8.
  10. Weiss EP, Villareal DT, Fontana L, Han DH, Holloszy JO. Dehydroepiandrosterone (DHEA) replacement decreases insulin resistance and lowers inflammatory cytokinesin aging humans. Aging (Albany NY). 2011 May;3(5):533-42.


Will Block is the publisher and editorial director of Life Enhancement magazine.

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