Intracrinology and dehydroepiandrosterone – a new perspective for the use of androgens in hormone replacement therapy in postmenopausal women

Abstract

Summary During menopausal transition not only ovarian production of estrogens but also marked decrease of adrenal androgen production are observed. Decreased secretion of adrenal DHEA and DHEA-S result in reduction of peripheral conversion of these steroids into active estrogens and androgens. Intracrinology describes the biosynthesis of active steroids in peripheral target tissues in which the action of theses steroids takes place, without release into the extracellular space or general circulation. DHEA administration to postmenopausal women significantly increases bone mineral density, decreases insulin resistance and amount of fat tissue and exerts an estrogenic effect on vaginal cytology in the absence of endometrial stimulation. Moreover, animal experiments proved that DHEA suppresses the growth of breast cancer, which is yet another reason to consider this steroid as a part of hormone replacement therapy in women.