The secretion and the blood levels of the adrenal steroid dehydroepiandrosterone (DHEA) and its sulfate ester (DHEAS) decrease profoundly with age, and the question is posed whether administration of the steroid to compensate for the decline counteracts defects associated with aging. The commercial availability of DHEA outside the regular pharmaceutical-medical network in the United States creates a real public health problem that may be resolved only by appropriate long-term clinical trials in elderly men and women. Two hundred and eighty healthy individuals (women and men 60 -79 years old) were given DHEA, 50 mg, or placebo, orally, daily for a year in a double-blind, placebo-controlled study. No potentially harmful accumulation of DHEAS and active steroids was recorded. Besides the reestablishment of a ''young'' concentration of DHEAS, a small increase of testosterone and estradiol was noted, particularly in women, and may be involved in the significantly demonstrated physiological-clinical manifestations here reported. Bone turnover improved selectively in women >70 years old, as assessed by the dual-energy x-ray absorptiometry (DEXA) technique and the decrease of osteoclastic activity. A significant increase in most libido parameters was also found in these older women. Improvement of the skin status was observed, particularly in women, in terms of hydration, epidermal thickness, sebum production, and pigmentation. A number of biological indices confirmed the lack of harmful consequences of this 50 mg͞day DHEA administration over one year, also indicating that this kind of replacement therapy normalized some effects of aging, but does not create ''supermen͞women'' (doping). C urrently, many strategies for delaying͞diminishing physiological deficits associated with aging are offered to a public, whose mean life expectancy is increasing, without appropriate scientific justifications and͞or medical precautions. Because of the profound age-related decrease of blood levels of the steroid dehydroepiandrosterone (DHEA; prasterone) and its sulfate ester (DHEAS), both essentially secreted by adrenals in human beings (1-5), it has been suggested that there is an ''adrenopause'' characterized by low value of blood DHEA(S) with maintenance of cortisol level. If this condition is involved in some impairment of health, the compensatory administration of DHEA may be of benefit, as is estrogen in women after menopause. The commercial availability of DHEA outside the regular pharmaceutical-medical network in the United States (because of passage of the Dietary Supplement Health and Education Act of 1994) creates a real public health problem. Not only may the quality of, and sometimes the very presence of, DHEA in some samples on sale in supplement stores or supermarkets be questioned, but the usage of a product in the absence of medical indication and supervision could be improper for a number of consumers. Extravagant publicity based on fantasy (''fountain of youth,'' ''miracle pill'') or pseudoscientific assertion (''moth...

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