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Effect of 12-month dehydroepiandrosterone replacement therapy on bone, vagina and endometrium in postmenopausal women.
Abstract
The effect of 12-month dehydroepiandrosterone (DHEA) replacement therapy has been evaluated in 14 60- to 70-yr-old women who received daily applications of a 10% DHEA cream. Vaginal epithelium maturation was stimulated by DHEA administration in 8 of 10 women who had a maturation value of zero at the onset of therapy, whereas a stimulatory effect was also seen in all three women who had an intermediate vaginal maturation index before therapy. The estrogenic effect of DHEA observed in the vagina was not observed in the endometrium, which remained atrophic in all women. Most interesting, the bone mineral density significantly increased at the hip from 0.744 +/- 0.021 to 0.759 +/- 0.025 g/cm2 after 12 months of treatment (P < 0.05). These changes in bone mineral density were associated with a significant 20.0% decrease (P < 0.01) in plasma bone alkaline phosphatase and a 28% decrease in the urinary hydroxyproline/creatinine ratio. A 2.1-fold increase over the control value (P < 0.01) in plasma osteocalcin was concomitantly observed. The present data describe for the first time a series of medically important beneficial effects of DHEA therapy in postmenopausal women through transformation of the precursor steroid DHEA into androgens and/or estrogens in specific peripheral intracrine tissues without significant adverse effects. The stimulatory effect on the vaginal epithelium in the absence of stimulation of the endometrium is of particular interest because it eliminates the need for progestin replacement therapy. On the other hand, the stimulatory effect on bone mineral density accompanied by an increase in serum osteocalcin, a marker of bone formation, suggests stimulation of bone formation by the androgenic action of DHEA, a finding of particular interest for both the prevention and treatment of osteoporosis.
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“second, other studies of DHEA therapy in postmenopausal women (9) or aging (40,47) have also shown selective improvement in BMD at this site.”
From Long-Term DHEA Replacement in Primary Adrenal Insufficiency: A Randomized, Controlled Trial (2008) · cites this paper as [9]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
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“positive effects of DHEA replacement have been described on psychological well-being (6), body composition (7,8), and bone mineral density (BMD) (9) in older, normal adults.”
From Long-Term DHEA Replacement in Primary Adrenal Insufficiency: A Randomized, Controlled Trial (2008) · cites this paper as [9]
In the citing paper
“the absence of a stimulatory effect of DHEA on the human endometrium (73, 280) eliminates the need to administer a progestin to neutralize the stimulatory effect of estrogens in this tissue.”
From Endocrine and intracrine sources of androgens in women: inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone (2003) · cites this paper as [280]
In the citing paper
“Bone mass density was increased by 2.3% at the hip, 3.75% at the hip Ward's triangle, and 2.2% at the lumbar spine level (all P Ͻ 0.05; Ref. 280).”
From Endocrine and intracrine sources of androgens in women: inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone (2003) · cites this paper as [280]
In the citing paper
“women, at menopause, are not only deprived from estrogens because of a rapid loss of ovarian activity but also have been deprived from androgens for a longer period because of a progressive decrease of serum DHEA levels starting quite a few years before menopause.”
From Endocrine and intracrine sources of androgens in women: inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone (2003) · cites this paper as [280]
In the citing paper
“the estrogenic stimulatory effect observed in the vagina was not found in the endometrium, which remained completely atrophic in all women after 12 months of DHEA treatment (280).”
From Endocrine and intracrine sources of androgens in women: inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone (2003) · cites this paper as [280]
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“We have also determined that the serum levels of DHEA using a 10% cream (280) were comparable to the ones obtained after daily oral administration of 100 mg of DHEA (our unpublished data).”
From Endocrine and intracrine sources of androgens in women: inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone (2003) · cites this paper as [280]
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Metadata
- Authors
- Labrie, F., Diamond, P., Cusan, L., Gomez, J.-L., Bélanger, A., & Candas, B.
- Affiliations
- Centre hospitalier de l'Université Laval (CA)
- Corresponding author
- Labrie, Fernand
- ORCID
- Candas, Bernard
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 1997-10
- Volume
- 82
- Issue
- 10
- Pages
- 3498-3505
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1970025509
- Cited by
- 292
- References
- 71
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 6 · 2016: 5 · 2015: 7 · 2014: 5 · 2013: 5 · 2012: 10
- FWCI
- 12.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Estrogen and related hormone effects
- Keywords
- dehydroepiandrosterone, DHEA replacement therapy, postmenopausal women, bone mineral density, endometrial atrophy, osteocalcin, bone-specific alkaline phosphatase, urinary hydroxyproline, osteoporosis prevention, androgenic effects, estrogenic effects
- MeSH terms
- Aged, Atrophy, Bone and Bones, Bone Resorption, Dehydroepiandrosterone, Endometrium, Female, Humans, Middle Aged, Osteogenesis, Sebum, Sex Hormone-Binding Globulin, Vagina, Biomarkers, Bone Density, Bone Remodeling, Postmenopause
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