Dehydroepiandrosterone in the treatment of erectile dysfunction: A prospective, double-blind, randomized, placebo-controlled study

Objectives. In 1994, the Massachusetts Male Aging Study presented an invers e correlation of the serum levels of dehydroepiandrosterone (DHEA) and the incidence of erectile dysfunction (ED). We evaluated the efficacy of DHEA r eplacement in the treatment of ED in a prospective, double-blind, randomize d, 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 mu mol/L. Also all patients had a full erectio n after a pharmacologic erection test with 10 mu g prostaglandin E-1; pharm acocavernosography showed no visualization in corporeal venous structures. Forty patients from our impotence clinic were recruited and randomly divide d into two groups of 20 patients each. Group 1 was treated with an oral dos e 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 th e National Institutes of Health Consensus Development Panel on Impotence. D HEA treatment was associated with higher,mean scores for all five domains o f 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 pos tvoid 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. (C) 1999, Elsevier Science Inc. All rights reserved.