prasterone

DHEA and DHEA sulfate (DHEA-S) are produced by the adrenal glands. In people with adrenal insufficiency such as in Addison's disease, there may be deficiency of DHEA and DHEA-S. In addition, levels of these steroids decrease throughout life and are 70 to 80% lower in the elderly relative to levels in young adults. Prasterone can be used to increase DHEA and DHEA-S levels in adrenal insufficiency and older age. Although there is deficiency of these steroids in such individuals, clinical benefits of supplementation, if any, are uncertain, and there is insufficient evidence at present to support the use of prasterone for such purposes.{{cite journal | vauthors = Arlt W | title = Dehydroepiandrosterone and ageing | journal = Best Practice & Research. Clinical Endocrinology & Metabolism | volume = 18 | issue = 3 | pages = 363–380 | date = September 2004 | pmid = 15261843 | doi = 10.1016/j.beem.2004.02.006 }}{{cite journal | vauthors = Alkatib AA, Cosma M, Elamin MB, Erickson D, Swiglo BA, Erwin PJ, Montori VM | title = A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 94 | issue = 10 | pages = 3676–3681 | date = October 2009 | pmid = 19773400 | doi = 10.1210/jc.2009-0672 | doi-access = free }}

{{See also|Prasterone enanthate|Estradiol valerate/prasterone enanthate}}

Prasterone is sometimes used as an androgen in menopausal hormone therapy.{{cite journal |pmid=35254428 |date=2022 |title=Should Dehydroepiandrosterone be Administered to Women? |journal=The Journal of Clinical Endocrinology and Metabolism |volume=107 |issue=6 |pages=1679–1685 |doi=10.1210/clinem/dgac130 |pmc=9113789 | vauthors = Wierman ME, Kiseljak-Vassiliades K }}{{cite journal|pmid=35744033 |date=2022 |title=New Innovations for the Treatment of Vulvovaginal Atrophy: An Up-to-Date Review |journal=Medicina (Kaunas, Lithuania) |volume=58 |issue=6 |page=770 |doi=10.3390/medicina58060770 |doi-access=free |pmc=9230595 | vauthors = Benini V, Ruffolo AF, Casiraghi A, Degliuomini RS, Frigerio M, Braga A, Serati M, Torella M, Candiani M, Salvatore S }}{{cite book |vauthors=Lobo RA|title=Treatment of the Postmenopausal Woman: Basic and Clinical Aspects|url=https://books.google.com/books?id=gywV9hkcyOMC&pg=PA821|date=5 June 2007|publisher=Academic Press|isbn=978-0-08-055309-2|pages=821–828|access-date=17 July 2017|archive-date=14 January 2023|archive-url=https://web.archive.org/web/20230114013439/https://books.google.com/books?id=gywV9hkcyOMC&pg=PA821|url-status=live}} In addition to prasterone itself, a long-lasting ester prodrug of prasterone, prasterone enanthate, is used in combination with estradiol valerate for the treatment of menopausal symptoms under the brand name Gynodian Depot.{{cite web | url=https://www.drugs.com/international/gynodian-depot.html | title=Gynodian Depot | work=Drugs.com | access-date=17 July 2017 | archive-date=6 August 2020 | archive-url=https://web.archive.org/web/20200806135419/https://www.drugs.com/international/gynodian-depot.html | url-status=live }}{{cite book| vauthors = Horsky J, Presl J |title=Ovarian Function and its Disorders: Diagnosis and Therapy|url=https://books.google.com/books?id=7IrpCAAAQBAJ&pg=PA146|date=6 December 2012|publisher=Springer Science & Business Media |isbn=978-94-009-8195-9|pages=146–}}{{cite book|vauthors=Platt D|title=Geriatrics 3: Gynecology · Orthopaedics · Anesthesiology · Surgery · Otorhinolaryngology · Ophthalmology · Dermatology|url=https://books.google.com/books?id=vwzpCAAAQBAJ&pg=PA6|date=6 December 2012|publisher=Springer Science & Business Media|isbn=978-3-642-68976-5|pages=6–|access-date=17 July 2017|archive-date=14 January 2023|archive-url=https://web.archive.org/web/20230114013433/https://books.google.com/books?id=vwzpCAAAQBAJ&pg=PA6|url-status=live}}{{cite book| vauthors = Campbell S |title=The Management of the Menopause & Post-Menopausal Years: The Proceedings of the International Symposium held in London 24–26 November 1975 Arranged by the Institute of Obstetrics and Gynaecology, The University of London |url=https://books.google.com/books?id=WT3sCAAAQBAJ&pg=PA395 |date=6 December 2012 |publisher=Springer Science & Business Media |isbn=978-94-011-6165-7 |pages=395–}}{{cite book |vauthors=Bagatell C, Bremner WJ |title=Androgens in Health and Disease |url=https://books.google.com/books?id=vDcBCAAAQBAJ&pg=PA277 |date=27 May 2003 |publisher=Springer Science & Business Media |isbn=978-1-59259-388-0 |pages=277– |access-date=17 July 2017 |archive-date=14 January 2023 |archive-url=https://web.archive.org/web/20230114013454/https://books.google.com/books?id=vDcBCAAAQBAJ&pg=PA277 |url-status=live}}{{cite journal |vauthors=Frigo P, Eppel W, Asseryanis E, Sator M, Golaszewski T, Gruber D, Lang C, Huber J |title=The effects of hormone substitution in depot form on the uterus in a group of 50 perimenopausal women--a vaginosonographic study |journal=Maturitas |volume=21 |issue=3 |pages=221–225 |date=April 1995 |pmid=7616871 |doi=10.1016/0378-5122(94)00893-c}} The current evidence of any benefit of DHEA supplementation to menopausal and postmenopausal women is inconclusive.{{cite journal |pmid=36444726 |date=2023 |title=Current challenges in the pharmacological management of genitourinary syndrome of menopause |journal=Expert Opinion on Pharmacotherapy |volume=24 |issue=1 |pages=23–28 |doi=10.1080/14656566.2022.2152326 |vauthors=Salvatore S, Benini V, Ruffolo AF, Degliuomini RS, Redaelli A, Casiraghi A, Candiani M}}{{cite journal |pmid=36470539 |date=2023 |title=Drugs for the treatment of postmenopausal symptoms: Hormonal and non-hormonal therapy |journal=Life Sciences |volume=312 |doi=10.1016/j.lfs.2022.121255 |vauthors=Pan M, Zhou J, Pan X, Wang J, Qi Q, Wang L}}{{cite journal |pmid=37543737 |date=2023 |author1=Casiano Evans, Elizabeth A. |author2=Hobson, Deslyn T. G. |author3=Aschkenazi, Sarit O. |author4=Alas, Alexandriah N. |author5=Balgobin, Sunil |author6=Balk, Ethan M. |author7=Dieter, Alexis A. |author8=Kanter, Gregory |author9=Orejuela, Francisco J. |author10=Sanses, Tatiana V. D. |author11=Rahn, David D. |title=Nonestrogen Therapies for Treatment of Genitourinary Syndrome of Menopause: A Systematic Review |journal=Obstetrics and Gynecology |volume=142 |issue=3 |pages=555–570 |doi=10.1097/AOG.0000000000005288}} Whereas prasterone (DHEA) supplementation in postmenopausal women can lead to an increase in E1, E2, testosterone, DHEA, and DHEAS serum levels, and a reduction in SHBG; still, the current evidence regarding the benefits of DHEA supplementation in postmenopausal women is inconclusive—while some studies suggest potential benefits, such as improved well-being, sexual function, and possibly decreased menopausal symptoms, these findings are not universally agreed upon.{{cite journal |vauthors=Marina L, Sojat AS, Maseroli E, Spaggiari G, Pandurevic S, Santi D |title=Hormonal profile of menopausal women receiving androgen replacement therapy: a meta-analysis |journal=J Endocrinol Invest |volume=43 |issue=6 |pages=717–735 |date=June 2020 |pmid=32016915 |doi=10.1007/s40618-020-01192-x}} Moreover, the long-term safety data for DHEA supplementation is lacking, which is a significant concern. This is particularly relevant given that DHEA supplementation can lead to increased estrogenic availability, which could potentially have implications for conditions sensitive to hormonal levels.

{{Androgen replacement therapy formulations and dosages used in women}}

Prasterone, under the brand name Intrarosa, is approved in the United States in a vaginal insert formulation for the treatment of atrophic vaginitis.{{cite web | url = http://adisinsight.springer.com/drugs/800032054 | title = Prasterone vaginal - Bayer/Endoceutics | work = AdisInsight | publisher = Springer Nature Switzerland AG | access-date = 17 July 2017 | archive-date = 4 January 2018 | archive-url = https://web.archive.org/web/20180104073347/http://adisinsight.springer.com/drugs/800032054 | url-status = live }}{{cite web |date=17 November 2016 |title=NTRAROSA (prasterone) Vaginal Inserts, ENDOCEUTICS INC Prescribing Information |url=https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208470s000lbl.pdf |access-date=29 November 2022 |publisher=FDA |archive-date=31 March 2021 |archive-url=https://web.archive.org/web/20210331024157/https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208470s000lbl.pdf |url-status=live }} The mechanism of action of prasterone for this indication is unknown, though it may involve local metabolism of prasterone into androgens and estrogens.

Prasterone has been used orally at a dosage of 10 mg/day to increase sexual desire in women.

{{See also|Prasterone sulfate}}

As the sodium salt of prasterone sulfate (brand names Astenile, Mylis, Teloin),{{cite web|url=https://www.drugs.com/international/mylis.html|title=Prasterone Monograph for Professionals|work=Drugs.com|access-date=17 July 2017|archive-date=4 January 2018|archive-url=https://web.archive.org/web/20180104013724/https://www.drugs.com/international/mylis.html|url-status=live}}{{cite web | url=http://adisinsight.springer.com/drugs/800005333 | title=Prasterone vaginal - Kanebo | work=AdisInsight | publisher=Springer Nature Switzerland AG | access-date=17 July 2017 | archive-date=4 January 2018 | archive-url=https://web.archive.org/web/20180104073504/http://adisinsight.springer.com/drugs/800005333 | url-status=live }} an ester prodrug of prasterone, prasterone is used in Japan as an injection for the treatment of insufficient cervical ripening and cervical dilation during childbirth.{{cite book| vauthors = Elks J |title=The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies|url=https://books.google.com/books?id=0vXTBwAAQBAJ&pg=PA641|date=14 November 2014|publisher=Springer|isbn=978-1-4757-2085-3|pages=641–}}{{cite book| vauthors = Blunt JW, Munro MH |title=Dictionary of Marine Natural Products with CD-ROM|url=https://books.google.com/books?id=w1bLBQAAQBAJ&pg=PA1075|date=19 September 2007|publisher=CRC Press|isbn=978-0-8493-8217-8|pages=1075–}}{{cite book| vauthors = Kleemann A, Engel J, Kutscher B, Reichert D |title=Pharmaceutical Substances, 5th Edition, 2009: Syntheses, Patents and Applications of the most relevant APIs|url=https://books.google.com/books?id=fO2IAwAAQBAJ&pg=PT2441|date=14 May 2014|publisher=Thieme|isbn=978-3-13-179525-0|pages=2441–2442}}{{cite book|vauthors=Negwer M, Scharnow HG|title=Organic-chemical drugs and their synonyms: (an international survey)|url=https://books.google.com/books?id=zmpqAAAAMAAJ|year=2001|publisher=Wiley-VCH|isbn=978-3-527-30247-5|page=1831|quote=3β-Hydroxyandrost-5-en-17-one hydrogen sulfate = (3β)-3-(Sulfooxy)androst-5-en-17-one. R: Sodium salt (1099-87-2). S: Astenile, Dehydroepiandrosterone sulfate sodium, DHA-S, DHEAS, KYH 3102, Mylis, PB 005, Prasterone sodium sulfate, Teloin|access-date=17 July 2017|archive-date=14 January 2023|archive-url=https://web.archive.org/web/20230114013506/https://books.google.com/books?id=zmpqAAAAMAAJ|url-status=live}}{{cite journal | vauthors = Jianqiu Y | year = 1992 | title = Clinical Application of Prasterone Sodium Sulfate | journal = Chinese Journal of New Drugs | volume = 5 | page = 015 }}{{cite journal | vauthors = Sakaguchi M, Sakai T, Adachi Y, Kawashima T, Awata N | title = The biological fate of sodium prasterone sulfate after vaginal administration. I. Absorption and excretion in rats | journal = Journal of Pharmacobio-Dynamics | volume = 15 | issue = 2 | pages = 67–73 | date = February 1992 | pmid = 1403604 | doi = 10.1248/bpb1978.15.67 | doi-access = free }}{{cite journal | vauthors = Sakai T, Sakaguchi M, Adachi Y, Kawashima T, Awata N | year = 1992 | title = The Biological Fate of Sodium Prasterone Sulfate after Vaginal Administration II: Distribution after Single and Multiple Administration to Pregnant Rats | journal = 薬物動態 | volume = 7 | issue = 1| pages = 87–101 | doi=10.2133/dmpk.7.87}}

{{See also|Prasterone enanthate|Prasterone sulfate|Estradiol valerate/prasterone enanthate|Testosterone propionate/testosterone cypionate/prasterone}}

Prasterone was previously marketed as a pharmaceutical medication under the brand name Diandrone in the form of a 10 mg oral tablet in the United Kingdom.{{cite book| vauthors = Brotherton J |title=Sex Hormone Pharmacology|url=https://books.google.com/books?id=zt5sAAAAMAAJ|year=1976|publisher=Academic Press|isbn=978-0-12-137250-7|pages=19,336}}

Prasterone is produced naturally in the human body, but the long-term effects of its use are largely unknown. In the short term, several studies have noted few adverse effects. In a study by Chang et al., prasterone was administered at a dose of 200 mg/day for 24 weeks with slight androgenic effects noted.{{cite journal | vauthors = Chang DM, Lan JL, Lin HY, Luo SF | title = Dehydroepiandrosterone treatment of women with mild-to-moderate systemic lupus erythematosus: a multicenter randomized, double-blind, placebo-controlled trial | journal = Arthritis and Rheumatism | volume = 46 | issue = 11 | pages = 2924–2927 | date = November 2002 | pmid = 12428233 | doi = 10.1002/art.10615 | doi-access = free }} Another study utilized a dose up to 400 mg/day for 8 weeks with few adverse events reported.{{cite journal | vauthors = Rabkin JG, McElhiney MC, Rabkin R, McGrath PJ, Ferrando SJ | title = Placebo-controlled trial of dehydroepiandrosterone (DHEA) for treatment of nonmajor depression in patients with HIV/AIDS | journal = The American Journal of Psychiatry | volume = 163 | issue = 1 | pages = 59–66 | date = January 2006 | pmid = 16390890 | doi = 10.1176/appi.ajp.163.1.59 }} A longer-term study followed patients dosed with 50 mg of prasterone for 12 months with the number and severity of side effects reported to be small.{{cite journal | vauthors = Brooke AM, Kalingag LA, Miraki-Moud F, Camacho-Hübner C, Maher KT, Walker DM, Hinson JP, Monson JP | title = Dehydroepiandrosterone improves psychological well-being in male and female hypopituitary patients on maintenance growth hormone replacement | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 91 | issue = 10 | pages = 3773–3779 | date = October 2006 | pmid = 16849414 | doi = 10.1210/jc.2006-0316 | doi-access = free }} Another study delivered a dose of 50 mg of prasterone for 10 months with no serious adverse events reported.{{cite journal | vauthors = Villareal DT, Holloszy JO | title = DHEA enhances effects of weight training on muscle mass and strength in elderly women and men | journal = American Journal of Physiology. Endocrinology and Metabolism | volume = 291 | issue = 5 | pages = E1003–E1008 | date = November 2006 | pmid = 16787962 | doi = 10.1152/ajpendo.00100.2006 | s2cid = 8929382 }}

As a hormone precursor, there have been reports of side effects possibly caused by the hormone metabolites of prasterone.{{cite journal |vauthors=Tang J, Chen LR, Chen KH |title=The Utilization of Dehydroepiandrosterone as a Sexual Hormone Precursor in Premenopausal and Postmenopausal Women: An Overview |journal=Pharmaceuticals |volume=15 |issue=1 |date=December 2021 |page=46 |pmid=35056103 |pmc=8781653 |doi=10.3390/ph15010046 |doi-access=free}}

It is not known whether prasterone is safe for long-term use. Some researchers believe prasterone supplements might actually raise the risk of breast cancer, prostate cancer, heart disease, diabetes, and stroke. Prasterone may stimulate tumor growth in types of cancer that are sensitive to hormones, such as some types of breast, uterine, and prostate cancer. Prasterone may increase prostate swelling in men with benign prostatic hyperplasia (BPH), an enlarged prostate gland.

Prasterone is a steroid hormone. High doses may cause aggressiveness, irritability, trouble sleeping, and the growth of body or facial hair on women. It also may stop menstruation and lower the levels of HDL cholesterol, which could raise the risk of heart disease. Other reported side effects include acne, heart rhythm problems, liver problems, hair loss (from the scalp), and oily skin. It may also alter the body's regulation of blood sugar.

Prasterone may promote tamoxifen resistance in breast cancer. It may also increase the risk of uterine and prostate cancers due to metabolism into estrogens and androgens, respectively. Patients on hormone replacement therapy may have more estrogen-related side effects when taking prasterone. This supplement may also interfere with other medicines, and potential interactions between it and drugs and herbs are possible.{{cite book |publisher=American Cancer Society |title=American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies |year=2009 |isbn=978-0-944235-71-3 |veditors=Ades TB |pages=[https://archive.org/details/americancancerso0000unse/page/729 729–33] |chapter=DHEA |edition=2nd |chapter-url=https://archive.org/details/americancancerso0000unse/page/729 }}

Prasterone is possibly unsafe for individuals experiencing pregnancy, breastfeeding, hormone sensitive conditions, liver problems, diabetes, depression or mood disorders, polycystic ovarian syndrome (PCOS), or cholesterol problems.{{cite web|title=DHEA: Side effects and safety |url=http://www.webmd.com/vitamins-supplements/ingredientmono-331-DHEA.aspx?activeIngredientId=331&activeIngredientName=DHEA |website=WebMD |access-date=24 July 2012|archive-date=24 July 2012|archive-url=https://web.archive.org/web/20120724115346/http://www.webmd.com/vitamins-supplements/ingredientmono-331-DHEA.aspx?activeIngredientId=331&activeIngredientName=DHEA|url-status=live}}

Prasterone has been reported to possess few or no side effects even at very high dosages (e.g., 50 times the recommended over-the-counter supplement dosage).{{cite book| vauthors = McKeag D, Moeller JL |title=ACSM's Primary Care Sports Medicine |url=https://books.google.com/books?id=KoeRrA_-td0C&pg=PA616|year=2007|publisher=Lippincott Williams & Wilkins|isbn=978-0-7817-7028-6 |pages=616–}} However, it may cause masculinization and other androgenic side effects in women and gynecomastia and other estrogenic side effects in men.

{{See also|Dehydroepiandrosterone#Biological activity|Dehydroepiandrosterone#Biochemistry}}Oral uptake of prasterone is excellent. Its volume of distribution is 17.0-38.5L (whereas it is 8.5-9.3L for its active metabolite DHEA-S). Prasterone (DHEA) has a biological half-life of 15-38 min (whereas it is 7-22h for DHEA-S). 51-73% of DHEA-S and its metabolites are excreted via the renal route.{{cite journal | vauthors = Pepping J | title = DHEA: dehydroepiandrosterone | journal = American Journal of Health-System Pharmacy | volume = 57 | issue = 22 | pages = 2048–2056 | date = November 2000 | pmid = 11098305 | doi = 10.1093/ajhp/57.22.2048 | doi-access = free }}File:Testosterone levels following a single oral dose of 300 mg crystalline or micronized DHEA in premenopausal women.png levels following a single oral dose of 300 mg crystalline (non-micronized) or micronized prasterone (DHEA) in premenopausal women.{{cite journal | vauthors = Casson PR, Straughn AB, Umstot ES, Abraham GE, Carson SA, Buster JE | title = Delivery of dehydroepiandrosterone to premenopausal women: effects of micronization and nonoral administration | journal = American Journal of Obstetrics and Gynecology | volume = 174 | issue = 2 | pages = 649–653 | date = February 1996 | pmid = 8623801 | doi = 10.1016/S0002-9378(96)70444-1 }}]]

File:Estradiol and dehydroepiandrosterone levels after a single intramuscular injection of Gynodian Depot in women.png | location = Stuttgart, Germany | language = de | isbn = 978-3-13-700801-9 | page = 122}}{{cite journal | vauthors = Düsterberg B, Wendt H | title = Plasma levels of dehydroepiandrosterone and 17 beta-estradiol after intramuscular administration of Gynodian-Depot in 3 women | journal = Hormone Research | volume = 17 | issue = 2 | pages = 84–89 | date = 1983 | pmid = 6220949 | doi = 10.1159/000179680 | doi-broken-date = 13 December 2024 }}{{cite journal | vauthors = Rauramo L, Punnonen R, Kaihola LH, Grönroos M | title = Serum oestrone, oestradiol and oestriol concentrations in castrated women during intramuscular oestradiol valerate and oestradiolbenzoate-oestradiolphenylpropionate therapy | journal = Maturitas | volume = 2 | issue = 1 | pages = 53–58 | date = January 1980 | pmid = 7402086 | doi = 10.1016/0378-5122(80)90060-2 }}]]

Prasterone is metabolized into androgens and estrogens in the body,{{cite book | vauthors = Burtis CA, Ashwood ER,, Bruns DE |url=https://books.google.com/books?id=BBLRUI4aHhkC&pg=PA1856 |title=Tietz Textbook of Clinical Chemistry and Molecular Diagnostics - E-Book |date=14 October 2012 |publisher=Elsevier Health Sciences |isbn=978-1-4557-5942-2 |pages=1856–}} including androstenedione, testosterone, estrone, estradiol, and estriol. The transformation of prasterone into androgens and estrogens is tissue-specific, for instance occurring in the liver, fat, vagina, prostate gland, skin, and hair follicles (as well as other tissues).{{cite journal | vauthors = Labrie F, Martel C, Bélanger A, Pelletier G | title = Androgens in women are essentially made from DHEA in each peripheral tissue according to intracrinology | journal = The Journal of Steroid Biochemistry and Molecular Biology | volume = 168 | pages = 9–18 | date = April 2017 | pmid = 28153489 | doi = 10.1016/j.jsbmb.2016.12.007 | s2cid = 2620899 }}

Prasterone is also reversibly transformed into its active metabolite prasterone sulfate (DHEA-S) by steroid sulfotransferase (specifically SULT1E1 and SULT2A1), which in turn can be converted back into prasterone by steroid sulfatase.{{cite journal | vauthors = Mueller JW, Gilligan LC, Idkowiak J, Arlt W, Foster PA | title = The Regulation of Steroid Action by Sulfation and Desulfation | journal = Endocrine Reviews | volume = 36 | issue = 5 | pages = 526–563 | date = October 2015 | pmid = 26213785 | pmc = 4591525 | doi = 10.1210/er.2015-1036 }} Interconversion takes place in both adrenal and peripheral tissues.

It is transformed into androstenedione by 3β-hydroxysteroid dehydrogenase (3β-HSD), and into androstenediol by 17β-hydroxysteroid dehydrogenase (17β-HSD). Then, androstenedione and androstenediol can be converted into testosterone by 17β-HSD and 3β-HSD, respectively. Subsequently, testosterone can be metabolized into dihydrotestosterone by 5α-reductase.

In addition, androstenedione and testosterone can be converted into estrone and estradiol by aromatase, respectively.

At a high dosage of 1,600 mg/day orally for 4 weeks, treatment of postmenopausal women with prasterone has been found to increase serum levels of DHEA by 15-fold, testosterone by 9-fold, DHEA-S, androstenedione, and DHT all by 20-fold, and estrone and estradiol both by 2-fold.{{cite journal | vauthors = Schwartz AG, Pashko LL | title = Dehydroepiandrosterone, glucose-6-phosphate dehydrogenase, and longevity | journal = Ageing Research Reviews | volume = 3 | issue = 2 | pages = 171–187 | date = April 2004 | pmid = 15177053 | doi = 10.1016/j.arr.2003.05.001 | s2cid = 11871872 }}{{cite journal | vauthors = Mortola JF, Yen SS | title = The effects of oral dehydroepiandrosterone on endocrine-metabolic parameters in postmenopausal women | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 71 | issue = 3 | pages = 696–704 | date = September 1990 | pmid = 2144295 | doi = 10.1210/jcem-71-3-696 }}

Although prasterone can reliably increase testosterone levels in women, this isn't similarly the case in men. A high dosage of 1,600 mg/day prasterone in men for 4 weeks was found to increase DHEA and androstenedione levels but did not significantly affect testosterone levels.

In clinical studies of prasterone supplementation, dosages have ranged from 20 to 1,600 mg per day.{{cite book | vauthors = Alesci S, Manoli I, Blackman MR | chapter = Dehydroepiandrosterone (DHEA) | veditors = Coates PM, Paul MC, Blackman M, Blackman MR, Cragg GM, Levine M, White JD, Moss J | chapter-url = https://books.google.com/books?id=Sfmc-fRCj10C&pg=PA169 |title=Encyclopedia of Dietary Supplements |date=29 December 2004 |publisher=CRC Press |isbn=978-0-8247-5504-1 |pages=169–}}

In people with adrenal insufficiency, oral dosages of 20 to 50 mg/day prasterone have been found to restore DHEA and DHEA-S levels to physiological levels seen in young healthy adults. Conversely, oral dosages of 100 to 200 mg/day prasterone have been found to result in supraphysiological levels of DHEA and DHEA-S.

Micronization of prasterone has been found to significantly increase levels of DHEA-S achieved with oral administration, but to produce no significant change in levels of DHEA or testosterone levels achieved.

{{See also|List of androgens/anabolic steroids}}

Prasterone, also known as androst-5-en-3β-ol-17-one, is a naturally occurring androstane steroid and a 17-ketosteroid. It is closely related structurally to androstenediol (androst-5-ene-3β,17β-diol), androstenedione (androst-4-ene-3,17-dione), and testosterone (androst-4-en-17β-ol-3-one). Prasterone is the δ⁵ (5(6)-dehydrogenated) analogue of epiandrosterone (5α-androstan-3β-ol-17-one), and is also known as 5-dehydroepiandrosterone (5-DHEA) or δ⁵-epiandrosterone. A positional isomer of prasterone which may have similar biological activity is 4-dehydroepiandrosterone (4-DHEA).{{cite book| vauthors = Josephy E, Radt F |title=Elsevier's Encyclopaedia of Organic Chemistry: Series III: Carboisocyclic Condensed Compounds|url=https://books.google.com/books?id=HqHzCAAAQBAJ&pg=PA2608|date=1 December 2013|publisher=Springer|isbn=978-3-662-25863-7|pages=2608–}}

{{See also|List of androgen esters#Esters of other natural AAS}}

Prasterone is used medically as the C3β esters prasterone enanthate and prasterone sulfate. The C19 demethyl analogue of prasterone is 19-nordehydroepiandrosterone (19-nor-DHEA), which is a prohormone of nandrolone (19-nortestosterone).{{cite book|author=NSCA-National Strength & Conditioning Association|title=NSCA'S Essentials of Tactical Strength and Conditioning|url=https://books.google.com/books?id=GHcBDgAAQBAJ&pg=PA130|date=27 January 2017|publisher=Human Kinetics|isbn=978-1-4504-5730-9|pages=130–}}{{cite book|vauthors=Thieme D, Hemmersbach P|title=Doping in Sports|url=https://books.google.com/books?id=R-hIC-caIn8C&pg=PA137|date=18 December 2009|publisher=Springer Science & Business Media|isbn=978-3-540-79088-4|pages=137–|access-date=12 April 2018|archive-date=14 January 2023|archive-url=https://web.archive.org/web/20230114013435/https://books.google.com/books?id=R-hIC-caIn8C&pg=PA137|url-status=live}} The 5α-reduced and δ¹ (1(2)-dehydrogenated) analogue of prasterone is 1-dehydroepiandrosterone (1-DHEA or 1-androsterone), which is a prohormone of 1-testosterone (δ¹-DHT or dihydroboldenone).{{cite journal | vauthors = Parr MK, Opfermann G, Geyer H, Westphal F, Sönnichsen FD, Zapp J, Kwiatkowska D, Schänzer W | title = Seized designer supplement named "1-Androsterone": identification as 3β-hydroxy-5α-androst-1-en-17-one and its urinary elimination | journal = Steroids | volume = 76 | issue = 6 | pages = 540–547 | date = May 2011 | pmid = 21310167 | doi = 10.1016/j.steroids.2011.02.001 | s2cid = 4942690 }} Fluasterone (3β-dehydroxy-16α-fluoro-DHEA) is a derivative of prasterone with minimal or no hormonal activity but other biological activities preserved.

DHEA was discovered, via isolation from male urine, by Adolf Butenandt and Hans Dannenbaum in 1934, and the compound was isolated from human blood plasma by Migeon and Plager in 1954. DHEA sulfate, the 3β-sulfate ester of DHEA, was isolated from urine in 1944, and was found by Baulieu to be the most abundant steroid hormone in human plasma in 1954. From its discovery in 1934 until 1959, DHEA was referred to by a number of different names in the literature, including dehydroandrosterone, transdehydroandrosterone, dehydroisoandrosterone, and androstenolone. The name dehydroepiandrosterone, also known as DHEA, was first proposed by Fieser in 1949, and subsequently became the most commonly used name of the hormone. For decades after its discovery, DHEA was considered to be an inactive compound that served mainly as an intermediate in the production of androgens and estrogens from cholesterol. In 1965, an association between DHEA sulfate levels and aging was reported by De Nee and Vermeulen. Following this, DHEA became of interest to the scientific community, and numerous studies assessing the relationship between DHEA and DHEA sulfate levels and aging were conducted.

Prasterone, the proposed {{abbrlink|INN|International Nonproprietary Name}} and recommended {{abbr|INN|International Nonproprietary Name}} of DHEA and the term used when referring to the compound as a medication, were published in 1970 and 1978, respectively.{{cite journal | journal = WHO Chronicle | volume = 24 | issue = 3 | pages = 119–142 | title = International Nonproprietary Names for Pharmaceutical Substances | year = 1970 | pmid = 5439245 | url = https://cdn.who.int/media/docs/default-source/international-nonproprietary-names-(inn)/pl23.pdf?sfvrsn=ca3c0852_7&download=true | access-date = 1 April 2023 | archive-date = 1 April 2023 | archive-url = https://web.archive.org/web/20230401073741/https://cdn.who.int/media/docs/default-source/international-nonproprietary-names-(inn)/pl23.pdf?sfvrsn=ca3c0852_7&download=true | url-status = live }}{{cite journal | journal = WHO Chronicle | volume = 32 | issue = 3 Supplement | pages = 1–18 | url = https://cdn.who.int/media/docs/default-source/international-nonproprietary-names-(inn)/pl39.pdf?sfvrsn=cb90bc9f_7&download=true | title = International Nonproprietary Names for Pharmaceutical Substances | access-date = 1 April 2023 | archive-date = 1 April 2023 | archive-url = https://web.archive.org/web/20230401073738/https://cdn.who.int/media/docs/default-source/international-nonproprietary-names-(inn)/pl39.pdf?sfvrsn=cb90bc9f_7&download=true | url-status = live }} The combination of 4 mg estradiol valerate and 200 mg prasterone enanthate in an oil solution was introduced for use in menopausal hormone therapy by intramuscular injection under the brand name Gynodian Depot in Europe by 1978.{{cite journal | vauthors = Hoyme U, Baumueller A, Madsen PO | title = The influence of pH on antimicrobial substances in canine vaginal and urethral secretions | journal = Urological Research | volume = 6 | issue = 1 | pages = 35–42 | date = 1978 | pmid = 25506 | doi = 10.1007/bf00257080 | s2cid = 8266978 }}{{cite book | vauthors = Kopera H, Dhont M, Dienstl F, Gambrell RD, Gordan GS, Heidenreich J, Lachnit-Fixon U, Lauritzen C, Lebech PE, Sitruk-Ware RL, Utian WH |chapter=Effects, side-effects, and dosage schemes of various sex hormones in the peri- and post-menopause | veditors = Keep PA, Serr DM, Greenblatt RB |title=Female and Male Climacteric|year=1979|pages=43–67| publisher = Springer |doi=10.1007/978-94-011-9720-5_6|isbn=978-94-011-9722-9 }}{{cite journal | vauthors = Mattson LA, Cullberg G, Tangkeo P, Zador G, Samsioe G | title = Administration of dehydroepiandrosterone enanthate to oophorectomized women--effects on sex hormones and lipid metabolism | journal = Maturitas | volume = 2 | issue = 4 | pages = 301–309 | date = December 1980 | pmid = 6453267 | doi = 10.1016/0378-5122(80)90032-8 }}{{cite book|author=Muller|title=European Drug Index: European Drug Registrations, Fourth Edition|url=https://books.google.com/books?id=2HBPHmclMWIC&pg=PA566|date=19 June 1998|publisher=CRC Press|isbn=978-3-7692-2114-5|pages=566–}} In the early 1980s, prasterone became available and was widely sold over-the-counter as a non-prescription supplement in the United States, primarily as a weight loss aid.{{cite book| vauthors = Randolph Jr CW, James G |title=From Hormone Hell to Hormone Well: Straight Talk Women (and Men) Need to Know to Save Their Sanity, Health, and—Quite Possibly—Their Lives|url=https://books.google.com/books?id=dmGhAgAAQBAJ&pg=PA72|date=1 January 2010|publisher=Health Communications, Incorporated|isbn=978-0-7573-9759-2|pages=72–}} It was described as a "miracle drug", with supposed anti-aging, anti-obesity, and anti-cancer benefits. This continued until 1985, when the marketing of prasterone was banned by the Food and Drug Administration (FDA) due to a lack of evidence for health benefits and due to the long-term safety and risks of the compound being unknown at the time. Subsequently, prasterone once again became available over-the-counter as a dietary supplement in the United States following the passage of the Dietary Supplement Health and Education Act of 1994. Conversely, it has remained banned as a supplement in Canada, the United Kingdom, Australia, and New Zealand.{{cite book|vauthors=Dunford M, Doyle JA|title=Nutrition for Sport and Exercise|url=https://books.google.com/books?id=xRAeCgAAQBAJ&pg=PA442|date=7 February 2014|publisher=Cengage Learning|isbn=978-1-285-75249-5|pages=442–|access-date=4 March 2018|archive-date=14 January 2023|archive-url=https://web.archive.org/web/20230114013458/https://books.google.com/books?id=xRAeCgAAQBAJ&pg=PA442|url-status=live}}

In 2001, Genelabs submitted a New Drug Application of prasterone for the treatment of systemic lupus erythematosus (SLE) to the FDA. It had the tentative brand names Anastar, Aslera, and Prestara.{{cite book| vauthors = Blau S, Schultz D |title=Living With Lupus: The Complete Guide, 2nd Edition |url=https://books.google.com/books?id=ImpGzazIYN8C&pg=PT138|date=5 March 2009|publisher=Da Capo Press|isbn=978-0-7867-2985-2|pages=138–}} However, this application was not approved, and while development of prasterone for SLE in both the United States and Europe continued until up to 2010, the medication was ultimately never approved for the treatment of this condition. In 2016, the FDA approved prasterone in an intravaginal gel formulation for the treatment of painful sexual intercourse due to vulvovaginal atrophy in the United States under the brand name Intrarosa.{{cite journal |vauthors=Voelker R |title=Relief for Painful Intercourse |journal=JAMA |volume=317 |issue=1 |pages=18 |date=January 2017 |pmid=28030684 |doi=10.1001/jama.2016.19077}}{{cite journal |vauthors= |title=Prasterone (Intrarosa) for Dyspareunia |journal=JAMA |volume=318 |issue=16 |pages=1607–1608 |date=October 2017 |pmid=29067420 |doi=10.1001/jama.2017.14981 |s2cid=43211499}} This was the first prasterone-containing medication to be approved by the FDA in this country.

Prasterone is the generic name of DHEA in English and Italian and its International Nonproprietary Name, United States Adopted Name and Italian Common Name,{{cite book| vauthors = Morton IK, Hall JM |title=Concise Dictionary of Pharmacological Agents: Properties and Synonyms|url=https://books.google.com/books?id=tsjrCAAAQBAJ&pg=PA230|date=6 December 2012|publisher=Springer Science & Business Media|isbn=978-94-011-4439-1|pages=92,96,230}}{{cite web | url=https://www.drugs.com/international/prasterone.html | title=Prasterone | work=Drugs.com | access-date=17 July 2017 | archive-date=6 August 2020 | archive-url=https://web.archive.org/web/20200806112210/https://www.drugs.com/international/prasterone.html | url-status=live }}{{cite web | url=https://druginfo.nlm.nih.gov/drugportal/rn/53-43-0 | archive-url = https://web.archive.org/web/20170212015927/https://druginfo.nlm.nih.gov/drugportal/rn/53-43-0 | archive-date = 12 February 2017| title= Prasterone | work = Drug Information Portal - Quick Access to Quality Drug Information | publisher = U.S. National Library of Medicine }} while its generic name is prasteronum in Latin, prastérone in French and its French popular name, and prasteron in German.

In the United States, prasterone or prasterone sulfate have been advertised, under the names DHEA and DHEA-S, with claims that they may be beneficial for a wide variety of ailments. Prasterone and prasterone sulfate are readily available in the United States, where they are sold as over-the-counter dietary supplements.{{cite journal | vauthors = Calfee R, Fadale P | title = Popular ergogenic drugs and supplements in young athletes | journal = Pediatrics | volume = 117 | issue = 3 | pages = e577–e589 | date = March 2006 | pmid = 16510635 | doi = 10.1542/peds.2005-1429 | s2cid = 6559714 | quote = In 2004, a new Steroid Control Act that placed androstenedione under Schedule III of controlled substances effective January 2005 was signed. DHEA was not included in this act and remains an over-the-counter nutritional supplement. | doi-access = }}

In 1996, reporter Harry Wessel of the Orlando (Florida) Sentinel wrote about DHEA that "Thousands of people have gotten caught up in the hoopla and are buying the stuff in health food stores, pharmacies and mail-order catalogs" but that "such enthusiasm is viewed as premature by many in the medical field." He noted that "National publications such as Time, Newsweek and USA Today have run articles recently about the hormone, while several major publishers have come out with books touting it."{{cite web | url = https://www.newspapers.com/image/235171674 | title = Proponents Say DHEA Blunts Effects of Aging | work = Orlando Sentinel | date = 1 October 1996 | access-date = 19 July 2020 | archive-date = 19 July 2020 | archive-url = https://web.archive.org/web/20200719084458/http://www.newspapers.com/image/235171674/ | url-status = live }} His column was widely syndicated and reprinted in other U.S. newspapers.

The product was being "widely marketed to and used by bodybuilders," Dr. Paul Donahue wrote in 2012 for King Features syndicate.{{cite web | url = https://www.newspapers.com/image/599711258/?terms=dhea&match=1 | title = DHEA Supplement a Help or Harm | work = Kenosha (Wisconsin) News | date = 18 March 2012 | access-date = 19 July 2020 | archive-date = 6 August 2020 | archive-url = https://web.archive.org/web/20200806145935/https://www.newspapers.com/image/599711258/?terms=dhea&match=1 | url-status = live }}

In Australia, a prescription is required to buy prasterone, where it is also comparatively expensive compared to off-the-shelf purchases in US supplement shops. Australian customs classify prasterone as an "anabolic steroid[s] or precursor[s]" and, as such, it is only possible to carry prasterone into the country through customs if one possesses an import permit which may be obtained if one has a valid prescription for the hormone.{{cite web | url = http://www.tga.gov.au/consumers/personal-importation-scheme.htm | work = Therapeutic Goods Administration | title = Personal Importation Scheme | access-date = 17 July 2017 | archive-date = 22 October 2014 | archive-url = https://web.archive.org/web/20141022051852/http://www.tga.gov.au/consumers/personal-importation-scheme.htm | url-status = live }}

In Canada, prasterone is a Controlled Drug listed under Section 23 of Schedule IV of the Controlled Drugs and Substances Act{{cite web | url = http://webprod.hc-sc.gc.ca/nhpid-bdipsn/ingredReq.do?id=4639&lang=eng | work = Health Canada | title = DHEA listing in the Ingredient Database | date = 26 July 2004 | access-date = 17 July 2017 | archive-date = 26 November 2020 | archive-url = https://web.archive.org/web/20201126205822/http://webprod.hc-sc.gc.ca/nhpid-bdipsn/ingredReq.do?id=4639&lang=eng | url-status = live }} and as such is available by prescription only.

Prasterone is listed as an anabolic steroid and is thus a class C controlled drug.

Prasterone is legal to sell in the United States as a dietary supplement. It is currently grandfathered in as an "Old Dietary Ingredient" being on sale prior to 1994. Prasterone is specifically exempted from the Anabolic Steroid Control Act of 1990 and 2004.{{cite web | url = http://www.deadiversion.usdoj.gov/fed_regs/rules/2005/fr1216.htm | title = Drug Scheduling Actions – 2005 | publisher = Drug Enforcement Administration | access-date = 17 July 2017 | archive-date = 16 February 2012 | archive-url = https://web.archive.org/web/20120216235259/http://www.deadiversion.usdoj.gov/fed_regs/rules/2005/fr1216.htm | url-status = dead }}

Prasterone is banned from use in athletic competition. It is a prohibited substance under the World Anti-Doping Code of the World Anti-Doping Agency,{{cite web | url = http://www.wada-ama.org/en/ | title = World Anti-Doping Agency | access-date = 17 July 2017 | archive-date = 1 May 2013 | archive-url = https://web.archive.org/web/20130501170232/http://www.wada-ama.org/en/ | url-status = live }} which manages drug testing for Olympics and other sports.

• Yulia Efimova, who holds the world record pace for both the 50-meter and 200-meter breaststroke, and won the bronze medal in the 200-meter breaststroke in the 2012 London Olympic Games, tested positive for prasterone in an out-of-competition doping test.{{cite web | url = http://en.ria.ru/sports/20140117/186628638/Russian-Olympic-Medal-Winning-Swimmer-Yefimova-Fails-Doping-Test.html | archive-url = https://web.archive.org/web/20140201174328/http://en.ria.ru/sports/20140117/186628638/Russian-Olympic-Medal-Winning-Swimmer-Yefimova-Fails-Doping-Test.html | archive-date = 1 February 2014 | title = Russian Olympic Medal-Winning Swimmer Efimova Fails Doping Test – Report | date = 17 January 2014 | work = RIA Novosti }}
• Rashard Lewis, then with the Orlando Magic, tested positive for prasterone and was suspended 10 games before the start of the 2009–10 season.{{cite web |url=http://www.commercialappeal.com/news/2011/jan/27/oj-mayo-suspended-10-games-violating-nba-anti-drug/ |title=Memphis Grizzlies' O. J. Mayo suspended 10 games for violating NBA anti-drug program |access-date=17 July 2017 |archive-date=1 February 2014 |archive-url=https://web.archive.org/web/20140201183459/http://www.commercialappeal.com/news/2011/jan/27/oj-mayo-suspended-10-games-violating-nba-anti-drug/ |url-status=dead }}
• In 2016 MMA fighter Fabio Maldonado revealed he was taking prasterone during his time with the UFC.{{cite web | url = http://www.bloodyelbow.com/2016/4/28/11528482/mma-news-fabio-maldonado-plans-to-use-dhea-for-fedor-match-admits-use-in-ufc | title = Fabio Maldonado plans to use DHEA for Fedor match, admits use in UFC | vauthors = Rezende L | date = 28 April 2016 | work = Bloody Elbow | publisher = Vox Media, LLC | access-date = 17 July 2017 | archive-date = 8 November 2020 | archive-url = https://web.archive.org/web/20201108134527/https://www.bloodyelbow.com/2016/4/28/11528482/mma-news-fabio-maldonado-plans-to-use-dhea-for-fedor-match-admits-use-in-ufc | url-status = live }}
• In January 2011, NBA player O. J. Mayo was given a 10-game suspension after testing positive for prasterone. Mayo termed his use of prasterone as "an honest mistake," saying the prasterone was in an over-the-counter supplement and that he was unaware the supplement was banned by the NBA.{{cite web | url = https://www.espn.com/nba/news/story?id=6065824 | title = Memphis Grizzlies' O. J. Mayo gets 10-game drug suspension | work = ESPN | date = 27 January 2011 | access-date = 17 July 2017 | archive-date = 12 May 2012 | archive-url = https://web.archive.org/web/20120512124448/http://sports.espn.go.com/nba/news/story?id=6065824 | url-status = live }} Mayo was the seventh player to test positive for performance-enhancing drugs since the league began testing in 1999.
• Olympic 400-meter champion Lashawn Merritt tested positive for prasterone in 2010 and was banned from the sport for 21 months.{{cite web | url = http://news.bbc.co.uk/sport1/hi/athletics/8638727.stm | title = US 400m star LaShawn Merritt fails drug test | publisher = BBC Sport | date = 22 April 2010 | access-date = 17 July 2017 | archive-date = 20 October 2021 | archive-url = https://web.archive.org/web/20211020034024/http://news.bbc.co.uk/sport2/hi/athletics/8638727.stm | url-status = live }}
• Tennis player Venus Williams had permission from the International Tennis Federation to use DHEA along with hydrocortisone as a treatment for "adrenal insufficiency," but it was revoked in 2016 by the World Anti-Doping Agency, which believed DHEA use would enhance Williams' athletic performance.{{cite web | url = https://www.newspapers.com/image/434929319/?terms=DHEA&match=1 | vauthors = Ruiz RR, Rothenberg B | title = Doping | work = Austin American-Statesman | location = Austin, Texas | date = 22 September 2016 | page = C12 | access-date = 19 July 2020 | archive-date = 6 August 2020 | archive-url = https://web.archive.org/web/20200806194659/https://www.newspapers.com/image/434929319/?terms=DHEA&match=1 | url-status = live }}

A meta-analysis of intervention studies shows that prasterone supplementation in elderly men can induce a small but significant positive effect on body composition that is strictly dependent on prasterone conversion into its bioactive metabolites such as androgens or estrogens.{{cite journal | vauthors = Corona G, Rastrelli G, Giagulli VA, Sila A, Sforza A, Forti G, Mannucci E, Maggi M | title = Dehydroepiandrosterone supplementation in elderly men: a meta-analysis study of placebo-controlled trials | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 98 | issue = 9 | pages = 3615–3626 | date = September 2013 | pmid = 23824417 | doi = 10.1210/jc.2013-1358 | doi-access = free }} Evidence is inconclusive in regards to the effect of prasterone on strength in the elderly.{{cite journal | vauthors = Baker WL, Karan S, Kenny AM | title = Effect of dehydroepiandrosterone on muscle strength and physical function in older adults: a systematic review | journal = Journal of the American Geriatrics Society | volume = 59 | issue = 6 | pages = 997–1002 | date = June 2011 | pmid = 21649617 | doi = 10.1111/j.1532-5415.2011.03410.x | s2cid = 7137809 }} In middle-aged men, no significant effect of prasterone supplementation on lean body mass, strength, or testosterone levels was found in a randomized placebo-controlled trial.{{cite journal | vauthors = Wallace MB, Lim J, Cutler A, Bucci L | title = Effects of dehydroepiandrosterone vs androstenedione supplementation in men | journal = Medicine and Science in Sports and Exercise | volume = 31 | issue = 12 | pages = 1788–1792 | date = December 1999 | pmid = 10613429 | doi = 10.1097/00005768-199912000-00014 | doi-access = free }}

There is no evidence prasterone is of benefit in treating or preventing cancer.

A review in 2003 found the then-extant evidence sufficient to suggest that low serum levels of DHEA-S may be associated with coronary heart disease in men, but insufficient to determine whether prasterone supplementation would have any cardiovascular benefit.{{cite journal | vauthors = Thijs L, Fagard R, Forette F, Nawrot T, Staessen JA | title = Are low dehydroepiandrosterone sulphate levels predictive for cardiovascular diseases? A review of prospective and retrospective studies | journal = Acta Cardiologica | volume = 58 | issue = 5 | pages = 403–410 | date = October 2003 | pmid = 14609305 | doi = 10.2143/AC.58.5.2005304 | s2cid = 32786778 | url = https://lirias.kuleuven.be/handle/123456789/24919 }}

Prasterone may enhance G6PD mRNA expression, confounding its inhibitory effects.{{cite journal | vauthors = Hecker PA, Leopold JA, Gupte SA, Recchia FA, Stanley WC | title = Impact of glucose-6-phosphate dehydrogenase deficiency on the pathophysiology of cardiovascular disease | journal = American Journal of Physiology. Heart and Circulatory Physiology | volume = 304 | issue = 4 | pages = H491–H500 | date = February 2013 | pmid = 23241320 | pmc = 3566485 | doi = 10.1152/ajpheart.00721.2012 }}

There is some evidence of short-term benefit in those with systemic lupus erythematosus but little evidence of long-term benefit or safety.{{cite journal | vauthors = Crosbie D, Black C, McIntyre L, Royle PL, Thomas S | title = Dehydroepiandrosterone for systemic lupus erythematosus | journal = The Cochrane Database of Systematic Reviews | volume = 2007 | issue = 4 | pages = CD005114 | date = October 2007 | pmid = 17943841 | pmc = 8864970 | doi = 10.1002/14651858.CD005114.pub2 | veditors = Crosbie D }} Prasterone was under development for the treatment of systemic lupus erythematosus in the United States and Europe in the 1990s and 2000s and reached phase III clinical trials and preregistration for this indication, respectively, but ultimately development was not continued past 2010.{{cite web | url=http://adisinsight.springer.com/drugs/800013229 | title=Prasterone - Genelabs | work=AdisInsight | publisher=Springer Nature Switzerland AG | access-date=11 December 2017 | archive-date=15 October 2017 | archive-url=https://web.archive.org/web/20171015115918/http://adisinsight.springer.com/drugs/800013229 | url-status=live }}

Prasterone supplementation has not been found to be useful for memory function in normal middle aged or older adults.{{cite journal | vauthors = Evans JM, Malouf R, Huppert F, van Niekerk JK | title = Dehydroepiandrosterone (DHEA) supplementation for cognitive function in healthy elderly people | journal = The Cochrane Database of Systematic Reviews | volume = 2006 | issue = 4 | pages = CD006221 | date = October 2006 | pmid = 17054283 | pmc = 8988513 | doi = 10.1002/14651858.CD006221 | veditors = Malouf R | author-link1 = John Grimley Evans }} It has been studied as a treatment for Alzheimer's disease, but there is no evidence that it is effective or ineffective. More research is needed to determine its benefits.{{cite journal | vauthors = Fuller SJ, Tan RS, Martins RN | title = Androgens in the etiology of Alzheimer's disease in aging men and possible therapeutic interventions | journal = Journal of Alzheimer's Disease | volume = 12 | issue = 2 | pages = 129–142 | date = September 2007 | pmid = 17917157 | doi = 10.3233/JAD-2007-12202 }}

A few small, short term clinical studies have found that prasterone improves mood but its long-term efficacy and safety, and how it compares to antidepressants, was unknown as of 2015.{{cite journal | vauthors = Pluchino N, Drakopoulos P, Bianchi-Demicheli F, Wenger JM, Petignat P, Genazzani AR | title = Neurobiology of DHEA and effects on sexuality, mood and cognition | journal = The Journal of Steroid Biochemistry and Molecular Biology | volume = 145 | pages = 273–280 | date = January 2015 | pmid = 24892797 | doi = 10.1016/j.jsbmb.2014.04.012 | s2cid = 12382989 }}{{cite journal | vauthors = Maric NP, Adzic M | title = Pharmacological modulation of HPA axis in depression - new avenues for potential therapeutic benefits | journal = Psychiatria Danubina | volume = 25 | issue = 3 | pages = 299–305 | date = September 2013 | pmid = 24048401 | url = http://www.hdbp.org/psychiatria_danubina/pdf/dnb_vol25_no3/dnb_vol25_no3_299.pdf | access-date = 17 July 2017 | archive-date = 9 August 2017 | archive-url = https://web.archive.org/web/20170809022513/http://www.hdbp.org/psychiatria_danubina/pdf/dnb_vol25_no3/dnb_vol25_no3_299.pdf | url-status = dead }}

{{Reflist}}

{{refbegin}}

• {{cite journal | vauthors = Keppel Hesselink JM | title = [Prasterone (dihydroepiandrosterone): a modern source of eternal youth?] | language = nl | journal = Nederlands Tijdschrift voor Geneeskunde | volume = 141 | issue = 51 | pages = 2484–2487 | date = December 1997 | pmid = 9555138 }}
• {{cite journal | vauthors = Zelissen PM, Thijssen JH | title = [Role of prasterone (dehydroepiandrosterone) in substitution therapy for adrenocortical insufficiency] | language = nl | journal = Nederlands Tijdschrift voor Geneeskunde | volume = 145 | issue = 42 | pages = 2018–2022 | date = October 2001 | pmid = 11695098 }}
• {{cite book |vauthors=Pope JE, Cupp MJ, Tracy TS |chapter=Dehydroepiandrosterone (DHEA) (Prasterone) |title=Dietary Supplements |year=2003 |pages=123–147 |publisher=Humana Press |location=Totowa, NJ |doi=10.1007/978-1-59259-303-3_8 |chapter-url=https://books.google.com/books?id=vuqPBAAAQBAJ&pg=PA123 |isbn=978-1-59259-303-3 |doi-broken-date=1 November 2024 |access-date=4 March 2018 |archive-date=14 January 2023 |archive-url=https://web.archive.org/web/20230114013431/https://books.google.com/books?id=vuqPBAAAQBAJ&pg=PA123 |url-status=live}}
• {{cite journal | vauthors = Kocis P | title = Prasterone | journal = American Journal of Health-System Pharmacy | volume = 63 | issue = 22 | pages = 2201–2210 | date = November 2006 | pmid = 17090740 | doi = 10.2146/ajhp060100 }}
• {{cite journal | vauthors = Mendivil Dacal JM, Borges VM | title = [Dehydroepiandrosterone (DHEA), review of its efficiency in the managing of the libido decrease and other symtoms of aging] | language = es | journal = Actas Urologicas Espanolas | volume = 33 | issue = 4 | pages = 390–401 | date = April 2009 | pmid = 19579890 | doi = 10.4321/s0210-48062009000400009 | doi-access = free }}
• {{cite journal | vauthors = Alkatib AA, Cosma M, Elamin MB, Erickson D, Swiglo BA, Erwin PJ, Montori VM | title = A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 94 | issue = 10 | pages = 3676–3681 | date = October 2009 | pmid = 19773400 | doi = 10.1210/jc.2009-0672 | doi-access = free }}
• {{cite journal | vauthors = Panjari M, Davis SR | title = DHEA for postmenopausal women: a review of the evidence | journal = Maturitas | volume = 66 | issue = 2 | pages = 172–179 | date = June 2010 | pmid = 20089375 | doi = 10.1016/j.maturitas.2009.12.017 }}
• {{cite journal | vauthors = Oberbeck R, Kobbe P | title = Dehydroepiandrosterone (DHEA): a steroid with multiple effects. Is there any possible option in the treatment of critical illness? | journal = Current Medicinal Chemistry | volume = 17 | issue = 11 | pages = 1039–1047 | date = 2010 | pmid = 20156161 | doi = 10.2174/092986710790820570 }}
• {{cite journal | vauthors = Prati A, Santagni S, Rattighieri E, Campedelli A, Ricchieri F, Chierchia E, Despini G, Genazzani AR, Genazzani AD | title = [The putative role and use of DHEA and its association with the hormone replacement therapy] | language = it | journal = Minerva Ginecologica | volume = 66 | issue = 3 | pages = 313–324 | date = June 2014 | pmid = 24971788 }}
• {{cite journal | vauthors = Genazzani AR, Pluchino N | title = DHEA therapy in postmenopausal women: the need to move forward beyond the lack of evidence | journal = Climacteric | volume = 13 | issue = 4 | pages = 314–316 | date = August 2010 | pmid = 20540592 | doi = 10.3109/13697137.2010.492496 | s2cid = 5578070 }}
• {{cite journal | vauthors = Luci M, Valenti G, Maggio M | title = [Dehydroepiandrosterone [DHEA(S)]: anabolic hormone?] | language = it | journal = Recenti Progressi in Medicina | volume = 101 | issue = 9 | pages = 333–344 | date = September 2010 | pmid = 21268370 | hdl-access = free | hdl = 11381/2436727 }}
• {{cite journal | vauthors = Gleicher N, Barad DH | title = Dehydroepiandrosterone (DHEA) supplementation in diminished ovarian reserve (DOR) | journal = Reproductive Biology and Endocrinology | volume = 9 | pages = 67 | date = May 2011 | pmid = 21586137 | pmc = 3112409 | doi = 10.1186/1477-7827-9-67 | author-link1 = Norbert Gleicher | doi-access = free }}
• {{cite journal | vauthors = Davis SR, Panjari M, Stanczyk FZ | title = Clinical review: DHEA replacement for postmenopausal women | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 96 | issue = 6 | pages = 1642–1653 | date = June 2011 | pmid = 21411558 | doi = 10.1210/jc.2010-2888 | doi-access = free }}
• {{cite journal | vauthors = Panjari M, Davis SR | title = Vaginal DHEA to treat menopause related atrophy: a review of the evidence | journal = Maturitas | volume = 70 | issue = 1 | pages = 22–25 | date = September 2011 | pmid = 21733647 | doi = 10.1016/j.maturitas.2011.06.005 }}
• {{cite journal | vauthors = Traish AM, Kang HP, Saad F, Guay AT | title = Dehydroepiandrosterone (DHEA)--a precursor steroid or an active hormone in human physiology | journal = The Journal of Sexual Medicine | volume = 8 | issue = 11 | pages = 2960–82; quiz 2983 | date = November 2011 | pmid = 22032408 | doi = 10.1111/j.1743-6109.2011.02523.x | doi-access = free }}
• {{cite journal | vauthors = Savineau JP, Marthan R, Dumas de la Roque E | title = Role of DHEA in cardiovascular diseases | journal = Biochemical Pharmacology | volume = 85 | issue = 6 | pages = 718–726 | date = March 2013 | pmid = 23270992 | doi = 10.1016/j.bcp.2012.12.004 }}
• {{cite journal | vauthors = Labrie F, Labrie C | title = DHEA and intracrinology at menopause, a positive choice for evolution of the human species | journal = Climacteric | volume = 16 | issue = 2 | pages = 205–213 | date = April 2013 | pmid = 23126249 | doi = 10.3109/13697137.2012.733983 | s2cid = 6546179 }}
• {{cite journal | vauthors = Rutkowski K, Sowa P, Rutkowska-Talipska J, Kuryliszyn-Moskal A, Rutkowski R | title = Dehydroepiandrosterone (DHEA): hypes and hopes | journal = Drugs | volume = 74 | issue = 11 | pages = 1195–1207 | date = July 2014 | pmid = 25022952 | doi = 10.1007/s40265-014-0259-8 | s2cid = 26554413 }}
• {{cite journal | vauthors = Peixoto C, Devicari Cheda JN, Nardi AE, Veras AB, Cardoso A | title = The effects of dehydroepiandrosterone (DHEA) in the treatment of depression and depressive symptoms in other psychiatric and medical illnesses: a systematic review | journal = Current Drug Targets | volume = 15 | issue = 9 | pages = 901–914 | date = 2014 | pmid = 25039497 | doi = 10.2174/1389450115666140717111116 }}
• {{cite journal | vauthors = Elraiyah T, Sonbol MB, Wang Z, Khairalseed T, Asi N, Undavalli C, Nabhan M, Altayar O, Prokop L, Montori VM, Murad MH | title = Clinical review: The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 99 | issue = 10 | pages = 3536–3542 | date = October 2014 | pmid = 25279571 | pmc = 5393492 | doi = 10.1210/jc.2014-2261 }}
• {{cite journal | vauthors = Maggio M, De Vita F, Fisichella A, Colizzi E, Provenzano S, Lauretani F, Luci M, Ceresini G, Dall'Aglio E, Caffarra P, Valenti G, Ceda GP | title = DHEA and cognitive function in the elderly | journal = The Journal of Steroid Biochemistry and Molecular Biology | volume = 145 | pages = 281–292 | date = January 2015 | pmid = 24794824 | doi = 10.1016/j.jsbmb.2014.03.014 | s2cid = 33768697 }}
• {{cite journal | vauthors = Pluchino N, Drakopoulos P, Bianchi-Demicheli F, Wenger JM, Petignat P, Genazzani AR | title = Neurobiology of DHEA and effects on sexuality, mood and cognition | journal = The Journal of Steroid Biochemistry and Molecular Biology | volume = 145 | pages = 273–280 | date = January 2015 | pmid = 24892797 | doi = 10.1016/j.jsbmb.2014.04.012 | s2cid = 12382989 }}
• {{cite journal | vauthors = Warner M, Gustafsson JA | title = DHEA - a precursor of ERβ ligands | journal = The Journal of Steroid Biochemistry and Molecular Biology | volume = 145 | pages = 245–247 | date = January 2015 | pmid = 25125389 | doi = 10.1016/j.jsbmb.2014.08.003 | s2cid = 26043868 }}
• {{cite journal | vauthors = Lang K, Burger-Stritt S, Hahner S | title = Is DHEA replacement beneficial in chronic adrenal failure? | journal = Best Practice & Research. Clinical Endocrinology & Metabolism | volume = 29 | issue = 1 | pages = 25–32 | date = January 2015 | pmid = 25617170 | doi = 10.1016/j.beem.2014.09.007 }}
• {{cite journal | vauthors = Vuksan-Ćusa B, Šagud M, Radoš I | title = The role of dehydroepiandrosterone (DHEA) in schizophrenia | journal = Psychiatria Danubina | volume = 28 | issue = 1 | pages = 30–33 | date = March 2016 | pmid = 26938818 }}
• {{cite journal | vauthors = Prough RA, Clark BJ, Klinge CM | title = Novel mechanisms for DHEA action | journal = Journal of Molecular Endocrinology | volume = 56 | issue = 3 | pages = R139–R155 | date = April 2016 | pmid = 26908835 | doi = 10.1530/JME-16-0013 | doi-access = free }}
• {{cite journal | vauthors = Qin JC, Fan L, Qin AP | title = The effect of dehydroepiandrosterone (DHEA) supplementation on women with diminished ovarian reserve (DOR) in IVF cycle: Evidence from a meta-analysis | journal = J Gynecol Obstet Biol Reprod (Paris) | volume = 46 | pages = 1–7 | date = May 2016 | pmid = 27212610 | doi = 10.1016/j.jgyn.2016.01.002 }}
• {{cite journal | vauthors = Ohnaka K | title = [Dehydroepiandrosterone(DHEA)and bone metabolism] | language = ja | journal = Clinical Calcium | volume = 26 | issue = 7 | pages = 987–993 | date = July 2016 | pmid = 27346309 | url = https://kyushu-u.pure.elsevier.com/en/publications/dehydroepiandrosteronedheaand-bone-metabolism | access-date = 25 February 2018 | archive-date = 29 October 2020 | archive-url = https://web.archive.org/web/20201029112630/https://kyushu-u.pure.elsevier.com/en/publications/dehydroepiandrosteronedheaand-bone-metabolism | url-status = live }}
• {{cite journal | vauthors = Handelsman DJ, Matsumoto AM, Gerrard DF | title = Doping Status of DHEA Treatment for Female Athletes with Adrenal Insufficiency | journal = Clinical Journal of Sport Medicine | volume = 27 | issue = 1 | pages = 78–85 | date = January 2017 | pmid = 26844622 | doi = 10.1097/JSM.0000000000000300 | s2cid = 24168278 }}
• {{cite journal | vauthors = Qin JC, Fan L, Qin AP | title = The effect of dehydroepiandrosterone (DHEA) supplementation on women with diminished ovarian reserve (DOR) in IVF cycle: Evidence from a meta-analysis | journal = Journal of Gynecology Obstetrics and Human Reproduction | volume = 46 | issue = 1 | pages = 1–7 | date = January 2017 | pmid = 28403950 | doi = 10.1016/j.jgyn.2016.01.002 }}
• {{cite journal | vauthors = Labrie F, Martel C, Bélanger A, Pelletier G | title = Androgens in women are essentially made from DHEA in each peripheral tissue according to intracrinology | journal = The Journal of Steroid Biochemistry and Molecular Biology | volume = 168 | pages = 9–18 | date = April 2017 | pmid = 28153489 | doi = 10.1016/j.jsbmb.2016.12.007 | s2cid = 2620899 }}
• {{cite journal | vauthors = Triantafyllidou O, Sigalos G, Vlahos N | title = Dehydroepiandrosterone (DHEA) supplementation and IVF outcome in poor responders | journal = Human Fertility | volume = 20 | issue = 2 | pages = 80–87 | date = June 2017 | pmid = 27927044 | doi = 10.1080/14647273.2016.1262065 | s2cid = 3425127 }}
• {{cite journal | vauthors = Archer DF, Labrie F, Montesino M, Martel C | title = Comparison of intravaginal 6.5mg (0.50%) prasterone, 0.3mg conjugated estrogens and 10μg estradiol on symptoms of vulvovaginal atrophy | journal = The Journal of Steroid Biochemistry and Molecular Biology | volume = 174 | pages = 1–8 | date = November 2017 | pmid = 28323042 | doi = 10.1016/j.jsbmb.2017.03.014 | s2cid = 140206697 }}

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