Prescription drugs such as Viagra, Cialis, and Levitra have revolutionized the treatment of erectile dysfunction. These medications are effective for about 80% of men. However, the medications do have side effects and cannot be taken by men who take nitroglycerin for heart disease. In addition, drugs sometimes stop working after a few years. Fortunately, a variety of other therapies are available, including holistic or alternative approaches.
One approach that is getting a lot of press isa supplement called DHEA. DHEA, or dehydroepiandrosterone, is a steroid hormone that is produced naturally by the adrenal glands.The hormone circulates in the bloodstream and is converted into the male hormone testosterone and the female hormone estrogen. DHEA production peaks early in life and begins to decline as we reach adulthood. By age 60, the body produces just 5% to 15% as much DHEA as at age 20.
Men with erectile dysfunction often have low levels of DHEA, so it is logical to think that taking DHEA supplements might protect against erectile dysfunction. Some people even believe that DHEA is a “fountain of youth” and can slow down the aging process. However, most studies have found that DHEA does not improve mood, mental function, or general well-being in seniors, nor does it increase muscle mass. There is some evidence that it does improve signs of aging skin.
Some athletes use DHEA supplements to increase muscle mass, strength, and energy. However, DHEA supplements are banned by the National Collegiate Athletic Association (NCAA) and by the NBA. They are also banned by the World Anti-Doping Agency which manages drug testing for the Olympics.
In men with erectile dysfunction, there is some clinical evidence that DHEA supplements are effective, but only when erectile dysfunction is caused by low testosterone. A study published in 1999 in Urology compared DHEA to placebo in 40 men with erectile dysfunction who also had low measured levels of DHEA. The results showed that DHEA at a dose of 50 mg daily significantly improved sexual performance.However, there is no evidence that DHEA supplements are effective in men whose erectile dysfunction is caused by poor blood flow, diabetes, or nerve disorders.
A typical therapeutic dose of DHEA is 50 mg to 200 mg daily, although some studies used dosages above and below this range. In one study, 90 milligrams of DHEA was taken by mouth daily for three weeks followed by 450 milligrams daily for three weeks. Another study used a dose escalation of DHEA from 100 milligrams to 400 milligrams daily for eight weeks (increasing by 100 milligrams at weekly intervals).
A DHEA cream is also available, which some health care providers feel is a better option. The cream is applied to the anal area and is rapidly absorbed into the bloodstream, where it goes to the heart and is then pumped to every cell in the body. With oral DHEA, the pill goes to the intestines and then the liver, where much of it is targeted for disposal through the kidneys.
Is DHEA safe? In general, DHEA appears to be safe at low doses, at least in the short term. However, in two studies DHEA was associated with decreased levels of HDL (“good”) cholesterol. Since many men with erectile dysfunction have cardiovascular problems, this is a potentially dangerous effect. DHEA can increase levels of male sex hormones, which can lead to acne and growth of facial and body hair. Other potential side effects include aggressiveness, irritability, and trouble sleeping. Some researchers believe that long-term use of DHEA can increase the risk of prostate cancer, diabetes, and stroke.
DHEA should not be used by people with liver problems. It should be used with caution in people with diabetes, depression and mood disorders, or cholesterol problems. Insulin has been shown to decrease natural DHEA levels, so insulin might decrease the effectiveness of DHEA supplements.
Using DHEA in combination with certain herbs that slow blood clotting could increase the risk of bleeding in some people. These herbs include clove, garlic, gingko, ginger, red ginseng, and angelica.Licorice and soy have been shown to increase natural levels of DHEA, so taking DHEA in combination with these foods might exacerbate side effects.
Consumers should be aware that DHEA supplements are not regulated by the FDA and that there have been quality control issues in the past. Some products labeled to contain DHEA have been found to contain no DHEA at all, while others contain more than the labeled amount.In some cases, DHEA supplements contain potentially dangerous stimulants such as ephedra, an herb that has been shown to cause insomnia and irregular heartbeat.
It is also important to realize that the DHEA purchased at a health food stores or online is not a natural supplement, but is made by a synthetic chemical process. A chemical called diosgenin is extracted from the roots and bulbs of wild yam plants or soy plants. The molecular structure of diosgenin is then altered in a laboratory to produce synthetic DHEA. Although wild yam and soy are used to make DHEA in the laboratory, eating wild yam and soy will not affect the body’s DHEA levels, since the body does not convert diosgenin to DHEA.
In conclusion, there is some evidence that DHEA is an effective treatment for erectile dysfunction, but only when erectile dysfunction is caused by low testosterone levels (which is fairly uncommon). Men with severe erectile dysfunction are probably better off seeking a more established therapy. However, keep in mind that erectile dysfunction may be a symptom of an underlying health issue, so it is important to consult a doctor or healthcare provider.
Source: NYU Langone Medical Center
3) DHEA Dosing
Source: Mayo Clinic