Dehydroepiandrosterone in the treatment of erectile dysfunction in patients with different organic etiologies

Abstract

In 1994 the Massachusetts Male Aging Study described an inverse correlation of the serum levels of dehydroepiandrosterone sulfate (DHEAS) and the incidence of erectile dysfunction (ED). The positive results of a pilot study in the treatment in patients with no organic etiology prompted a detailed investigation on the efficacy of DHEA therapy for ED in patients with different organic etiologies, in a prospective study. The inclusion criteria included ED, a normal physical condition, normal serum levels of testosterone, prolactin and PSA and a serum DHEAS level < 1.5 micromol/l. The study patients comprised 27 patients (group 1) with hypertension, 24 patients (group 2) with diabetes mellitus, six patients with neurological disorders (group 3) and 28 patients (group 4) with no organic etiology were treated with 50 mg DHEA p.o. for 6 months. We assessed efficacy by using the responses to question 3 (frequency of penetration) and question 4 (maintenance of erections after penetration) of the 15-question International Index of Erectile Function (IIEF). DHEA treatment was associated with statistically significantly higher mean scores compared to baseline values for question 3 and question 4 of the IIEF in groups 1 and 4 after a period of 24 weeks. The differences between the mean scores of groups 2 and 3 and the baseline values were not statistically significant. Our results suggest that oral DHEA-treatment may be of benefit to patients with ED who have hypertension or to patients with ED without organic etiology. There was no impact of DHEA therapy on patients with diabetes mellitus or with neurological disorders.

Testosterone and Erectile Function: From Basic Research to a New Clinical Paradigm for Managing Men with Androgen Insufficiency and Erectile Dysfunction

“…No well-designed clinical trials have definitively substantiated the role of DHEA in these functions in humans, or even the safety and efficacy of DHEA therapy [124]. In a small study, Reiter and colleagues [125] evaluated the efficacy of DHEA replacement in the treatment of ED and found it was associated with higher mean scores for all five domains of the IIEF with no impact on mean serum levels of PSA or testosterone.…”

A Review of Age-Related Dehydroepiandrosterone Decline and Its Association with Well-Known Geriatric Syndromes: Is Treatment Beneficial?

“…59,112 Positive effects on erectile function were mostly achieved in the absence of any underlying organic pathology. 111,113 Indeed, there was no benefit in patients with diabetes or neurological disorders. 113 In women, androgens and estrogens are produced from DHEA in the vagina tissue.…”

“…111,113 Indeed, there was no benefit in patients with diabetes or neurological disorders. 113 In women, androgens and estrogens are produced from DHEA in the vagina tissue. Androgens are well known for their effects on arousability, pleasure, and intensity of orgasm in women.…”

Nutraceuticals for Fertility and Erectile Health: A Brief Overview of What Works and What Is Worthless

“…Small studies of men utilizing 50 mg for 6 months (DHEAS level <1.5 μmol/l) showed some improvements in function in those with hypertension and ED or those without organic etiology, but not in those with diabetes or neurologic issues [211,212]. These men were all generally tested with prostaglandin E1 first to ensure that they were capable of having a full erection with pharmacologic intervention.…”