TY - JOUR
T1 - The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function
T2 - A systematic review and meta-analysis
AU - Elraiyah, Tarig
AU - Sonbol, Mohamad Bassam
AU - Wang, Zhen
AU - Khairalseed, Tagwa
AU - Asi, Noor
AU - Undavalli, Chaitanya
AU - Nabhan, Mohammad
AU - Altayar, Osama
AU - Prokop, Larry
AU - Montori, Victor M.
AU - Murad, Mohammad Hassan
N1 - Publisher Copyright:
Copyright © 2014 by the Endocrine Society.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Context: Exogenous dehydroepiandrosterone (DHEA) therapy has been proposed to replenish the depletion of endogenous DHEA and its sulfate form, which occurs with advancing age and is thought to be associated with loss of libido and menopausal symptoms.Objective: We conducted a systematic review and meta-analysis to summarize the evidence supporting the use of systemic DHEA in postmenopausal women with normal adrenal function.Methods: We searched MEDLINE, EMBASE, Psyc Info, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through January 2014. Pairs of reviewers, working independently, selected studies and extracted data from eligible randomized controlled trials (RCTs). We used the random-effects model to pool across studies and evaluated heterogeneity using the I2 statistic.Results: We included 23 RCTs with moderate to high risk of bias enrolling 1188 women. DHEA use was not associated with significant improvement in libido or sexual function (standardized mean difference, 0.35; 95% confidence interval, -0.02 to 0.73; P value =.06; I2 = 62%). There was also no significant effect of DHEA on serious adverse effects, serum lipids, serum glucose, weight, body mass index, or bone mineral density. This evidence warranted low confidence in the results, mostly due to imprecision, risk of bias, and inconsistency across RCTs.Conclusions: Evidence warranting low confidence suggests that DHEA administration does not significantly impact sexual symptoms or selected metabolic markers in postmenopausal women with normal adrenal function.
AB - Context: Exogenous dehydroepiandrosterone (DHEA) therapy has been proposed to replenish the depletion of endogenous DHEA and its sulfate form, which occurs with advancing age and is thought to be associated with loss of libido and menopausal symptoms.Objective: We conducted a systematic review and meta-analysis to summarize the evidence supporting the use of systemic DHEA in postmenopausal women with normal adrenal function.Methods: We searched MEDLINE, EMBASE, Psyc Info, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through January 2014. Pairs of reviewers, working independently, selected studies and extracted data from eligible randomized controlled trials (RCTs). We used the random-effects model to pool across studies and evaluated heterogeneity using the I2 statistic.Results: We included 23 RCTs with moderate to high risk of bias enrolling 1188 women. DHEA use was not associated with significant improvement in libido or sexual function (standardized mean difference, 0.35; 95% confidence interval, -0.02 to 0.73; P value =.06; I2 = 62%). There was also no significant effect of DHEA on serious adverse effects, serum lipids, serum glucose, weight, body mass index, or bone mineral density. This evidence warranted low confidence in the results, mostly due to imprecision, risk of bias, and inconsistency across RCTs.Conclusions: Evidence warranting low confidence suggests that DHEA administration does not significantly impact sexual symptoms or selected metabolic markers in postmenopausal women with normal adrenal function.
UR - http://www.scopus.com/inward/record.url?scp=84907621381&partnerID=8YFLogxK
U2 - 10.1210/jc.2014-2261
DO - 10.1210/jc.2014-2261
M3 - Review article
C2 - 25279571
AN - SCOPUS:84907621381
SN - 0021-972X
VL - 99
SP - 3536
EP - 3542
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 10
ER -