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
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.