Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective,
double-blind, randomized, placebo-controlled study
by
Reiter
WJ, Pycha A, Schatzl G, Pokorny A,
Gruber DM, Huber JC, Marberger M
Department
of Urology,
University of Vienna, Austria.
Urology 1999 Mar; 53(3):590-4;
discussion 594-5
ABSTRACT
OBJECTIVES:
In 1994, the Massachusetts Male Aging Study presented an inverse correlation of
the serum levels of dehydroepiandrosterone (DHEA) and the incidence of erectile
dysfunction (ED). We evaluated the efficacy of DHEA replacement in the treatment
of ED in a prospective, double-blind, randomized, placebo-controlled study. METHODS:
The inclusion criteria included ED, normal physical and neurologic examinations,
serum levels of testosterone, dihydrotestosterone, prolactin, and prostate-specific
antigen (PSA) within the normal range, and a serum DHEA sulfate level below 1.5
micromol/L. Also all patients had a full erection after a pharmacologic erection
test with 10O microg prostaglandin E1; pharmacocavernosography showed no visualization
in corporeal venous structures. Forty patients from our impotence clinic were
recruited and randomly divided into two groups of 20 patients each. Group 1 was
treated with an oral dose of 50 mg DHEA and group 2 with a placebo one time a
day for 6 months. The International Index of Erectile Function (IIEF), a 15-item
questionnaire, was used to rate the success of this therapy. RESULTS: Therapy
response was defined as the ability to achieve or maintain an erection sufficient
for satisfactory sexual performance according to the National Institutes of Health
Consensus Development Panel on Impotence. DHEA treatment was associated with higher
mean scores for all five domains of the IIEF. There was no impact of DHEA treatment
on the mean serum levels of PSA, prolactin, testosterone, the mean prostate volume,
and the mean postvoid residual urine volume. CONCLUSIONS: Our results suggest
that oral DHEA treatment may be of benefit in the treatment of ED. Although our
patient data base is too small to do relevant statistical analysis, we believe
that our data show a biologically obvious trend that justifies further extended
studies.
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