Healthnotes Newswire (March 8, 2001)—The hormone dehydroepiandrosterone (DHEA) improves feelings of well-being, including sexual interest and satisfaction, in women with primary or secondary adrenal insufficiency, according to a clinical trial completed by researchers at the University of Würzburg, Germany.¹

Women in the trial were treated for four months with 50 mg of DHEA followed by one month of no treatment and then four months of taking a placebo. All 24 women studied had low blood levels of DHEA and DHEA sulfate (DHEAS)—two forms of the hormone that are commonly measured in people with adrenal insufficiency. In all cases, blood levels of DHEA and DHEAS reached the lower limits of the normal range expected for a healthy adult female.

Several measures of well-being and mood indicated that treatment with DHEA, but not placebo, improved overall well-being and led to decreased feelings of anxiety, depression, and exhaustion. After only one month of DHEA supplementation, women reported a greater degree of sexual interest and frequency of sexual thoughts and fantasies. This effect increased throughout the duration of DHEA treatment and continued to be notable up to four weeks after the hormone was stopped.

Adrenal Insufficiency vs. Adrenal Exhaustion

Adrenal insufficiency is defined as either primary or secondary. Primary adrenal insufficiency, also known as Addison’s disease, is caused by direct damage or injury to the adrenal gland, while the secondary form can be due to a variety of causes, including pituitary disease and cessation of steroid therapy. Both forms lead to a deficiency of the adrenal hormones cortisol, aldosterone, and DHEA. Early symptoms of adrenal insufficiency include low blood pressure, weakness, and fatigue. As the condition progresses, people may notice changes in skin pigmentation. Left untreated, the conditions may lead to heart and kidney disease. Both forms of adrenal insufficiency are typically treated with regular use of hydrocortisone.

It is important to distinguish adrenal insufficiency from the popular concept of adrenal “exhaustion.” While increased attention is being paid to the role lowered adrenal function may play in people suffering from exhaustion and perhaps chronic fatigue secondary to stress, adrenal insufficiency is a far more serious condition that requires careful medical diagnosis and care.

Who Should Use DHEA?

The University of Würzburg trial suggests that DHEA may potentially provide an alternative to hydrocortisone for the treatment of adrenal insufficiency. While hydrocortisone leads to similar positive effects on well-being and sexual desire, long-term oral use of the drug is associated with many side effects, including osteoporosis, decreased immune function, and high blood pressure.

DHEA is the most prevalent of the hormones produced by the adrenal glands. After being secreted by the adrenal glands, it circulates in the bloodstream as DHEAS and is converted as needed into other hormones. Supplementation with DHEAS has resulted in increased levels of testosterone and androstenedione, two steroid hormones.² Other than this, little is known about how DHEA works in the body.

This is the second clinical trial to suggest that 50 mg of DHEA per day may effectively treat adrenal insufficiency. In the other trial, women with Addison’s disease were treated with 50 mg of DHEA every morning for three or four months. As was the case in the current study, their DHEA and DHEAS levels returned to normal, with a simultaneous improvement in well-being and sexuality.³

Although it has become a popular over-the-counter supplement, DHEA is not for everyone. Most people do not need to supplement DHEA, and the question of who should take this hormone remains controversial. People should consult a doctor to have DHEA levels monitored before deciding on supplementation. People with low blood levels of DHEA and DHEAS—as was the case in all women with adrenal insufficiency who were studied in the current trial—may benefit from supplementation. However, healthy people with normal blood levels of DHEA or DHEAS should not take this hormone until more is known about its effects.