Dr. Ron’s Research Review – June 3, 2010

This week’s research review focuses on DHEA with one article on its use for post-menopausal women and another for asthma.

This month’s Townsend Letter has an article you may be interested in: St. John's Wort and Oral Contraceptives

The main issue is that St. John's Wort induces cytochrome P450 (CYP) enzymes, and therefore may alter the pharmacokinetics of the estrogen and/or progestin and result in a reduction of their contraceptive efficacy.

Dr. Ron

Abstracts

DHEA for postmenopausal women: A review of the evidence

            (Panjari and Davis 2010) Download

BACKGROUND: Dehydroepiandrosterone (DHEA) and its sulphate DHEAS are the most abundant sex steroids in women and provide a large reservoir of precursors for the intracellular production of androgens and estrogens in non-reproductive tissues. Levels of DHEA and DHEAS decline with age. It has been proposed that restoring the circulating levels of these steroids to those found in young women may have anti-aging effects and improve sexual function and wellbeing in postmenopausal women. AIM: To review the published literature for the efficacy of DHEA therapy data regarding safety. METHODS: A systematic literature search of MEDLINE (Ovid) and Pub-Med (1966 to November 2009) for original studies that included any of the terms dehydroepiandrosterone, DHEA or DHEAS, sexual function, wellbeing, women and metabolic parameters of interest. RESULTS: Overall the interpretation of the data was limited by inadequate sample size and short treatment duration of available studies with inconsistent results. The more recent randomized controlled trials however do not support a benefit of oral DHEA therapy for women. A possible benefit that emerged is that vaginally administered DHEA may improve vaginal atrophy with concomitant improvements in sexual function in women who are estrogen deficient due to menopause. The potential value of oral DHEA therapy for postmenopausal women is called into question.

Asthma and Dehydroepiandrosterone (DHEA): Facts and Hypotheses

            (Kasperska-Zajac 2010) Download

Dehydroepiandrosterone (DHEA) is considered as an important immunomodulating and anti-inflammatory hormone. Despite the continuing interest in DHEA replacement therapy, our knowledge of its effects upon asthma is very limited. DHEA is able to reverse cytokine imbalances associated with asthma, may prevent and attenuate allergic inflammation in airways, and does not possess the undesirable side effects of glucocorticoids; therefore, it may be potentially applied in the treatment of asthma. The steroid-sparing effect observed with DHEA clinically could appear especially favorable in asthmatic patients receiving oral treatment and those inhaling high doses of glucocorticoids. In addition, DHEA and its analogs might prove useful in reversing relative glucocorticoids insensitivity in patients with corticosteroid-resistant asthma. In this review we have focused specifically on DHEA's role in asthma.

St. John's Wort and Oral Contraceptives

            (Hudson, 2010) Download

           

References

Kasperska-Zajac, A. (2010). "Asthma and Dehydroepiandrosterone (DHEA): Facts and Hypotheses." Inflammation.

Panjari, M. and S. R. Davis (2010). "DHEA for postmenopausal women: A review of the evidence." Maturitas.