Rabijewski Michal, Papierska Lucyna, Binkowska Malgorzata, Maksym Radoslaw, Jankowska Katarzyna, Skrzypulec-Plinta Wioletta, Zgliczynski Wojciech
Department of Reproductive Health, Center of Postgraduate Medical Education, Warsaw, Poland.
Department of Endocrinology of the Centre of Postgraduate Medical Education, Warsaw, Poland, Warsaw, Poland.
Ginekol Pol. 2020;91(9):554-562. doi: 10.5603/GP.2020.0091.
Dehydroepiandrosterone (DHEA) concentration decreases with age, therefore, DHEA has been considered a hormone that reduces the symptoms associated with aging, so the usefulness of DHEA in premenopausal and postmenopausal women, and the options of hormone therapy have received a large amount of attention. The effectiveness of DHEA in the premenopausal women remains unclear, while in postmenopausal women with coexisting estrogens deficiency is controversial. Despite many years of study, the use of DHEA is still controversial, especially regarding its effectiveness. The aim of present article was to evaluate DHEA specific effects on metabolic parameters, bone mineral density, insulin resistance as well as the therapeutic potential of DHEA in pre- and postmenopausal women using measures of sexual activity, cognition and well-being. The summary of this article is the position statement of expert group of the Polish Menopause and Andropause Society regarding the efficacy and safety of DHEA supplementation in women. We concluded, that currently available clinical trials and meta-analyses indicate that DHEA supplementation is effective in women with adrenal insufficiency and chronically treated with exogenous glucocorticoids, postmenopausal women with low bone mineral density and/or osteoporosis, premenopausal women with sexual disorders and low libido, and in women with vulvovaginal atrophy due to menopause or genitourinary syndrome of menopause. Currently available clinical trials also suggest that DHEA supplementation is probably effective in postmenopausal women with hypoactive sexual disorders, infertile women with diminished ovarian reserve, women suffering from depression and anxiety, and women with obesity and insulin resistance. No serious adverse effects have been reported.
脱氢表雄酮(DHEA)的浓度会随着年龄增长而降低,因此,DHEA被认为是一种可减轻与衰老相关症状的激素,所以DHEA在绝经前和绝经后女性中的效用以及激素疗法的选择受到了大量关注。DHEA在绝经前女性中的有效性尚不清楚,而在同时存在雌激素缺乏的绝经后女性中其有效性存在争议。尽管经过多年研究,但DHEA的使用仍然存在争议,尤其是在其有效性方面。本文的目的是通过性行为、认知和幸福感等指标,评估DHEA对绝经前和绝经后女性代谢参数、骨密度、胰岛素抵抗的具体影响以及DHEA的治疗潜力。本文的总结是波兰绝经与男性更年期协会专家组关于女性补充DHEA的疗效和安全性的立场声明。我们得出结论,目前可用的临床试验和荟萃分析表明,补充DHEA对患有肾上腺功能不全且长期接受外源性糖皮质激素治疗的女性、骨密度低和/或患有骨质疏松症的绝经后女性、患有性功能障碍和性欲低下的绝经前女性以及因绝经或绝经后泌尿生殖综合征导致外阴阴道萎缩的女性有效。目前可用的临床试验还表明,补充DHEA可能对患有性功能减退障碍的绝经后女性、卵巢储备功能减退的不孕女性、患有抑郁症和焦虑症的女性以及患有肥胖症和胰岛素抵抗的女性有效。尚未报告严重的不良反应。