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What’s the link between sexual dysfunction and DHEA?

When my impressionable naiveté was first exposed to the wonders of anti-ageing medicine at a conference in Las Vegas back in 1998, the prevailing doctrine was that ageing could be prevented and even possibly reversed by the Schwarzenegger-like designs of omnipotent hormones and free-radical-nuking antioxidants. Dehydroepiandrosterone (DHEA) assumed centre stage as the hormone that could deliver us into the promised land of eternal youthfulness.

Fast forward to 2015 and the song remains the same. So, separating the science from the salesmanship, where does DHEA reside as a player that has a sizeable contribution to bestow on our obsession with overriding nature’s overweening talons and retaining our youthful mojo?

The importance of DHEA

DHEA is a hormone that’s manufactured mostly by the adrenal glands, which are perched like hats atop the kidneys. It’s also our most abundant hormone and the source of almost 50 per cent of the testosterone manufactured in the male body. Men who are suffering from a lack of drive and sexual energy might simply not be adequately served by the necessary provision of DHEA. In females, DHEA is even more influential. Before menopause, 50–75 per cent of oestrogen — the major female hormone — is derived from DHEA, and most of the testosterone that fuels a range of functions is manufactured from this essential hormone.

The problem with DHEA is that peak production occurs between the ages of 20 and 30, after which its output goes into steady decline.

After menopause, DHEA is the sole reservoir for making testosterone and oestrogen, which means a large chunk of everyday life is entirely governed by the input of this hormone.

The problem with DHEA is that peak production occurs between the ages of 20 and 30, after which its output goes into steady decline. Unremitting stress, which increases the adverse effects of a hormone called cortisol, exacerbates this shortfall even more, so that at the time of the menopausal transition and beyond, a litany of female afflictions including hot flushes, emotional ennui, weight gain, a weakened immune system, sexual dysfunction, cognitive decline, muscle loss, wrinkling and all the other disturbing features that escalate with ageing might be caused by a lack of DHEA and its offspring — oestrogen and testosterone.

Research does show that low levels of DHEA are associated with low life satisfaction, depression, heart disease, osteoporosis, sexual dysfunction and even a greater risk of early mortality, at least in men. Even in younger women, one study has revealed that for those aged 18–44, having low sexual desire, sexual arousal or sexual responsiveness was also associated with having DHEA value below the 10th percentile for their age.

Research also connects heightened levels of DHEA with a number of feelgood parameters. DHEA activates major receptors in the brain connected with mood, cognitive behaviour and memory. Anxiety, excitement, arousal and endorphins, or pleasure chemicals, are all primed by DHEA. Is there evidence, then, that taking DHEA can promote emotional and physical wellbeing, preserve our higher functions and prevent age-related infirmities, while helping us to live healthier and longer lives?

DHEA & female sexual dysfunction

In postmenopausal women, thinning of the vaginal and genito-urinary tissue due to a lack of DHEA and therefore low levels of oestrogen and testosterone, both needed to maintain healthy levels of tissue and normal sexual function, can lead to pain with intercourse, recurrent bladder infections and a host of other problems.

Fernand Labrie, a Canadian physician and scientist, and one of the giants of DHEA research, has demonstrated that taking DHEA via vaginal ovules was able to significantly enhance sexual desire, arousal and intensity of orgasm, at the same time reducing discomfort associated with sexual intercourse by improving the texture and lubrication of vaginal tissue.

Sadly, a study conducted by Professor Susan Davis from Monash University in Melbourne on postmenopausal women failed to demonstrate that taking 50mg of DHEA by mouth for just over a year, a sizeable dose with the aim of restoring DHEA levels to those seen in young women, was able to boost sexual function. This exactly reflects the pattern of research, with some studies supporting the benefits of DHEA for ameliorating sexual dysfunction, while others do not.

DHEA & sexual dysfunction in men

In men, low levels of DHEA are associated with sexual dysfunction. Here, the results of studies are less equivocal, possibly because not that many have explored DHEA’s effects on male sexuality. One study has shown that taking 25mg of DHEA for the duration of one year improved desire, arousal and erectile function. Another has demonstrated similar results. Clearly, more evidence is needed to validate these findings.

DHEA: emotions to heart health

Although the evidence is far from conclusive, research shows that DHEA can alleviate depression and anxiety, improve feelings of wellbeing, reduce fat mass, enhance muscle strength, boost the immune system and reduce hot flushes. DHEA treatment has a positive effect on asthma, eczema, systemic lupus erythematosus and inflammatory bowel disease. Taking 50mg of DHEA daily can boost bone mineral density, while DHEA applied to the skin can increase skin texture and lessen wrinkling. Studies are conflicted with regard to benefits on brain and heart health.

DHEA is unquestionably a highly influential hormone with anti-ageing potential yet to be confirmed by robust scientific evidence. Since its metabolites increase the risk of breast and prostate cancer, medical supervision when using this hormone is advised. Research suggests that taking red clover might obviate these risks.

Michael Elstein

Michael Elstein

Michael Elstein is a Fellow of the Australian College of Nutritional and Environmental Medicine. Anti-ageing medicine is his current passion and he is the author of Eternal Health and You Have The Power, which are available as e-books through his website.

Dr Elstein has just attained a Masters in Nutrition from RMIT university located in Melbourne. He treats those who suffer from fatigue, insomnia, weight gain, hormonal imbalances, digestive disorders and menopausal dysfunction. He utilises diet, nutritional therapy, hormonal interventions and herbal remedies.

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