View source for Prasterone

{{Short description|Medical usage of the prasterone compound}}
{{About|DHEA as a medication or supplement|the natural hormone|DHEA}}
{{Use dmy dates|date=December 2023}}
{{cs1 config |name-list-style=vanc |display-authors=6}}
{{Use PMID reference names|date=December 2023}}
{{Infobox drug
| Verifiedfields = verified
| Watchedfields = verified
| verifiedrevid = 443682301
| image = Dehydroepiandrosteron.svg
| image_class = skin-invert-image
| width = 225
| alt = 
| image2 = Dehydroepiandrosterone molecule ball.png
| width2 = 235
| alt2 = 
| caption =

<!-- Clinical data -->
| pronounce = 
| tradename = Intrarosa, others
| Drugs.com = {{drugs.com|monograph|prasterone}}
| MedlinePlus = a617012
| DailyMedID = Prasterone
| pregnancy_AU = D
| pregnancy_AU_comment = <ref name="Therapeutic Goods Administration (TGA)-2023">{{cite web | title=Intrarosa | website=Therapeutic Goods Administration (TGA) | date=26 June 2023 | url=https://www.tga.gov.au/resources/auspmd/intrarosa | access-date=10 September 2023}}</ref>
| pregnancy_category = 
| routes_of_administration = [[Oral administration|By mouth]], [[vaginal administration|vaginal]] ([[Rectal administration|rectal]]), [[intramuscular injection|intramuscular]] (as [[prasterone enanthate]]), [[injection (medicine)|injection]] (as [[prasterone sodium sulfate]])
| class = [[Androgen]]; [[Anabolic steroid]]; [[Estrogen]]; [[Neurosteroid]]
| ATC_prefix = G03
| ATC_suffix = XX01
| ATC_supplemental = <br />{{ATC|G03|EA03}} (combination with [[estrogen]])<br />{{ATCvet|A14|AA07}}

<!-- Legal status -->
| legal_AU = S4
| legal_AU_comment = <ref name="Therapeutic Goods Administration (TGA)-2023-2">{{cite web | title=Intrarosa (Theramex Australia Pty Ltd) | website=Therapeutic Goods Administration (TGA) | date=28 July 2023 | url=https://www.tga.gov.au/resources/prescription-medicines-registrations/intrarosa-theramex-australia-pty-ltd | access-date=10 September 2023}}</ref><ref>{{Cite web | title=AusPAR: Intrarosa {{!}} Therapeutic Goods Administration (TGA) | url=https://www.tga.gov.au/resources/auspar/auspar-intrarosa | archive-url=https://web.archive.org/web/20240331043534/https://www.tga.gov.au/resources/auspar/auspar-intrarosa | access-date=2025-04-05 | archive-date=2024-03-31}}</ref>
| legal_BR = C5
| legal_BR_comment = <ref name="Diário Oficial da União-2023">{{cite web |author=Anvisa |author-link=Brazilian Health Regulatory Agency |date=31 March 2023 |title=RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial |trans-title=Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control|url=https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |url-status=live |archive-url=https://web.archive.org/web/20230803143925/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |archive-date=3 August 2023 |access-date=15 August 2023 |publisher=[[Diário Oficial da União]] |language=pt-BR |publication-date=4 April 2023}}</ref>
| legal_CA = Schedule IV
| legal_CA_comment = <ref name="Health Canada-2014">{{cite web | title=Summary Basis of Decision (SBD) for Intrarosa | website=[[Health Canada]] | date=23 October 2014 | url=https://hpr-rps.hres.ca/reg-content/summary-basis-decision-detailTwo.php?linkID=SBD00466&lang=en | access-date=29 May 2022 | archive-date=31 May 2022 | archive-url=https://web.archive.org/web/20220531045451/https://hpr-rps.hres.ca/reg-content/summary-basis-decision-detailTwo.php?linkID=SBD00466&lang=en | url-status=live }}</ref>
| legal_DE = <!-- Anlage I, II, III or Unscheduled -->
| legal_DE_comment = 
| legal_NZ = <!-- Class A, B, C -->
| legal_NZ_comment = 
| legal_UK = <!-- GSL, P, POM, CD, CD Lic, CD POM, CD No Reg POM, CD (Benz) POM, CD (Anab) POM or CD Inv POM / Class A, B, C -->
| legal_UK_comment = 
| legal_US = Rx-only
| legal_US_comment = <ref name="DailyMed-2021">{{cite web | title=Intrarosa- prasterone insert | website=DailyMed | date=22 November 2021 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ada639d4-bac0-2ad0-e053-2a95a90afce7 | access-date=29 May 2022 | archive-date=31 May 2022 | archive-url=https://web.archive.org/web/20220531045451/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ada639d4-bac0-2ad0-e053-2a95a90afce7 | url-status=live }}</ref>
| legal_EU = Rx-only
| legal_EU_comment = 
| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV -->
| legal_UN_comment = 
| legal_status = <!-- For countries not listed above -->

<!-- Pharmacokinetic data -->
| bioavailability = 50%<ref name="Cupp-2002" />
| protein_bound = 
| metabolism = [[Liver]]<ref name="Cupp-2002" />
| metabolites = • [[Androsterone]]<ref name="Cupp-2002" /><br />• [[Etiocholanolone]]<ref name="Cupp-2002" /><br />• [[Dehydroepiandrosterone sulfate|{{abbr|DHEA|Dehydroepiandrosterone}} sulfate]]<ref name="Cupp-2002" /><br />• [[Androstenedione]]<ref name="Cupp-2002" /><br />• [[Androstenediol]]<ref name="Cupp-2002" /><br />• [[Testosterone]]<ref name="Cupp-2002" /><br />• [[Dihydrotestosterone]]<br />• [[Androstanediol]]<ref name="Cupp-2002" /><br />• [[Estrone]]<br />• [[Estradiol]]
| onset = 
| elimination_half-life = {{abbr|DHEA|Dehydroepiandrosterone}}: 25&nbsp;minutes<ref name="Oddens-1996">{{cite book|vauthors=Oddens BJ, Vermeulen A|title=Androgens and the Aging Male|url=https://books.google.com/books?id=efEnI1VdmtsC&pg=PA5|date=15 November 1996|publisher=CRC Press|isbn=978-1-85070-763-9|pages=5–|access-date=17 July 2017|archive-date=14 January 2023|archive-url=https://web.archive.org/web/20230114013439/https://books.google.com/books?id=efEnI1VdmtsC&pg=PA5|url-status=live}}</ref><br />{{abbr|DHEA-S|Dehydroepiandrosterone sulfate}}: 11&nbsp;hours<ref name="Oddens-1996" />
| duration_of_action = 
| excretion = [[Urine]]

<!-- Identifiers -->
| CAS_number_Ref = {{cascite|correct|CAS}}
| CAS_number = 53-43-0
| CAS_supplemental = 
| PubChem = 5881
| IUPHAR_ligand = 2370
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB01708
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 5670
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = 459AG36T1B
| KEGG = D08409
| ChEBI_Ref = {{ebicite|correct|EBI}}
| ChEBI = 28689
| ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 90593
| NIAID_ChemDB = 
| PDB_ligand = 
| synonyms = EL-10; GL-701; KYH-3102; Androst-5-en-3β-ol-17-one; 3β-Hydroxyandrost-5-en-17-one; 5,6-Didehydroepiandrosterone;<ref name="Devillers-2009">{{cite book| vauthors = Devillers J |title=Endocrine Disruption Modeling|url=https://books.google.com/books?id=bWHMBQAAQBAJ&pg=PA339|date=27 April 2009|publisher=CRC Press|isbn=978-1-4200-7636-3|pages=339–}}</ref> Dehydroisoepiandrosterone<ref name="Elks-2014" />

<!-- Chemical and physical data -->
| IUPAC_name = (3''S'',8''R'',9''S'',10''R'',13''S'',14''S'')-3-hydroxy-10,13-dimethyl-1,2,3,4,7,8,9,11,12,14,15,16-dodecahydrocyclopenta[''a'']phenanthren-17-one
| C=19 | H=28 | O=2
| SMILES = O=C3[C@]2(CC[C@@H]1[C@@]4(C(=C/C[C@H]1[C@@H]2CC3)\C[C@@H](O)CC4)C)C
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI = 1S/C19H28O2/c1-18-9-7-13(20)11-12(18)3-4-14-15-5-6-17(21)19(15,2)10-8-16(14)18/h3,13-16,20H,4-11H2,1-2H3/t13-,14-,15-,16-,18-,19-/m0/s1
| StdInChI_comment = 
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| StdInChIKey = FMGSKLZLMKYGDP-USOAJAOKSA-N
| density = 
| density_notes = 
| melting_point = 148.5
| melting_high = 
| melting_notes = 
| boiling_point = 
| boiling_notes = 
| solubility = 
| sol_units = 
| specific_rotation = 
}}

<!-- Definition and medical uses -->
'''Prasterone''', also known as '''dehydroepiandrosterone''' ('''DHEA''') and sold under the brand name '''Intrarosa''' among others, is a [[medication]] as well as [[over-the-counter]] [[dietary supplement]] which is used to correct DHEA deficiency due to [[adrenal insufficiency]] or [[aging|old age]], as a component of [[menopausal hormone therapy]], to treat [[dyspareunia|painful sexual intercourse]] due to [[vaginal atrophy]], and to prepare the [[cervix]] for [[childbirth]], among other uses.<ref name="Cupp-2002">{{cite book|vauthors=Cupp MJ, Tracy TS |title=Dietary Supplements: Toxicology and Clinical Pharmacology|url=https://books.google.com/books?id=vuqPBAAAQBAJ&pg=PA123|date=10 December 2002 |publisher=Springer Science & Business Media|isbn=978-1-59259-303-3|pages=123–147|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}}</ref><ref name="pmid25022952">{{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}}</ref> It is taken [[oral administration|by mouth]], [[transdermal administration|by application to the skin]], [[Intravaginal administration|in through the vagina]], or [[intramuscular injection|by injection into muscle]].<ref name="pmid25022952" />

<!-- Side effects and mechanism -->
[[Side effect]]s of prasterone in women include [[symptom]]s of [[virilization|masculinization]] like [[oily skin]], [[acne]], [[hirsutism|increased hair growth]], [[voice deepening|voice changes]], and increased [[libido|sexual desire]], [[headache]]s, [[insomnia]], and others.<ref name="Cupp-2002" /><ref name="pmid25022952" /> The compound is a [[natural product|naturally occurring]] [[prohormone]] of [[androgen]]s and [[estrogen (medication)|estrogen]]s and hence is an [[agonist]] of the [[androgen receptor|androgen]] and [[estrogen receptor]]s, the respective [[biological target]]s of androgens like [[testosterone]] and estrogens like [[estradiol]].<ref name="Cupp-2002" /><ref name="pmid26908835">{{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 }}</ref> Prasterone also has a variety of activities of its own, including [[neurosteroid]] and other activities.<ref name="pmid26908835" />

<!-- History, society, and culture -->
[[DHEA]], the [[active ingredient]] of prasterone, was discovered in 1934.<ref name="Cupp-2002" /><ref name="pmid25022952" /> An association between DHEA levels and aging was first reported in 1965.<ref name="Cupp-2002" /><ref name="pmid25022952" /> The compound started being used as a medication in the late 1970s and as a supplement in the early 1980s.<ref name="Cupp-2002" /><ref name="pmid25022952" /> The marketing of prasterone over-the-counter as a supplement is allowed in the [[United States]] but is banned in many other countries.<ref name="Cupp-2002" />

{{TOC limit|3}}

==Medical uses==

===Deficiency===
[[Dehydroepiandrosterone|DHEA]] and [[dehydroepiandrosterone sulfate|DHEA sulfate]] (DHEA-S) are produced by the [[adrenal gland]]s. 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.<ref name="pmid15261843">{{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 }}</ref><ref name="pmid19773400">{{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 }}</ref>

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

Prasterone is sometimes used as an androgen in [[menopausal hormone therapy]].<ref name="pmid35254428">{{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 }}</ref><ref name="pmid35744033">{{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 }}</ref><ref name="Lobo-2007">{{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}}</ref> 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.<ref name="Drugs.com-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 }}</ref><ref name="Horsky-2012">{{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–}}</ref><ref name="Platt-2012">{{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}}</ref><ref name="Campbell-2012">{{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–}}</ref><ref name="Bagatell-2003">{{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}}</ref><ref name="pmid7616871">{{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}}</ref> The current evidence of any benefit of DHEA supplementation to menopausal and postmenopausal women is inconclusive.<ref name="pmid36444726">{{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}}</ref><ref name="pmid36470539">{{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}}</ref><ref name="pmid37543737">{{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}}</ref> 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.<ref name="pmid32016915">{{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|hdl=11380/1190105 |hdl-access=free }}</ref> 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.<ref name="pmid32016915"/>


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

===Vaginal atrophy===
Prasterone, under the brand name Intrarosa, is approved in the [[United States]] in a [[vaginal administration|vaginal]] [[suppository|insert]] formulation for the treatment of [[atrophic vaginitis]].<ref name="AdisInsight">{{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 }}</ref><ref name="FDA-2016">{{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=dead }}</ref> The [[mechanism of action]] of prasterone for this indication is unknown, though it may involve local [[metabolism]] of prasterone into androgens and estrogens.<ref name="FDA-2016" />

===Sexual desire===
Prasterone has been used [[oral administration|orally]] at a dosage of 10&nbsp;mg/day to increase [[sexual desire]] in women.<ref name="Brotherton-1976" />

===Childbirth===
{{See also|Prasterone sulfate}}

As the [[sodium]] [[salt (chemistry)|salt]] of [[prasterone sulfate]] (brand names Astenile, Mylis, Teloin),<ref name="Drugs.com-Prasterone Monograph for Professionals">{{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}}</ref><ref name="AdisInsight-2">{{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 }}</ref> an ester prodrug of prasterone, prasterone is used in [[Japan]] as an [[injection (medicine)|injection]] for the treatment of insufficient [[cervical effacement|cervical ripening]] and [[cervical dilation]] during [[childbirth]].<ref name="Elks-2014">{{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–}}</ref><ref name="Blunt-2007">{{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–}}</ref><ref name="Kleemann-2014">{{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}}</ref><ref name="Negwer-2001">{{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}}</ref><ref name="Jianqiu-1992">{{cite journal | vauthors = Jianqiu Y | year = 1992 | title = Clinical Application of Prasterone Sodium Sulfate | journal = Chinese Journal of New Drugs | volume = 5 | page = 015 }}</ref><ref name="pmid1403604">{{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 }}</ref><ref name="Sakai-1992">{{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}}</ref>

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

Prasterone was previously marketed as a [[pharmaceutical drug|pharmaceutical medication]] under the brand name Diandrone in the form of a 10&nbsp;mg [[oral administration|oral]] [[tablet (pharmacy)|tablet]] in the [[United Kingdom]].<ref name="Brotherton-1976">{{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}}</ref>

==Side effects==
Prasterone is produced naturally in the human body, but the long-term effects of its use are largely unknown.<ref name="Ades-2009"/><ref name="pmid35056103"/> 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&nbsp;mg/day for 24&nbsp;weeks with slight [[androgenic]] effects noted.<ref name="pmid12428233">{{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 }}</ref> Another study utilized a dose up to 400&nbsp;mg/day for 8&nbsp;weeks with few adverse events reported.<ref name="pmid16390890">{{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 }}</ref> A longer-term study followed patients dosed with 50&nbsp;mg of prasterone for 12&nbsp;months with the number and severity of side effects reported to be small.<ref name="pmid16849414">{{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 }}</ref> Another study delivered a dose of 50&nbsp;mg of prasterone for 10&nbsp;months with no serious adverse events reported.<ref name="pmid16787962">{{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 }}</ref>

As a hormone precursor, there have been reports of side effects possibly caused by the hormone metabolites of prasterone.<ref name="pmid35056103">{{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}}</ref>

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]],<ref name="pmid35056103"/> 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.<ref name="pmid35056103"/> Prasterone may increase prostate swelling in men with [[benign prostatic hyperplasia]] (BPH), an enlarged prostate gland.<ref name="Ades-2009"/>

Prasterone is a [[steroid hormone]]. High doses may cause aggressiveness, irritability, trouble sleeping, and the growth of body or facial hair on women.<ref name="Ades-2009"/> It also may stop menstruation and lower the levels of [[High-density lipoprotein|HDL cholesterol]], which could raise the risk of heart disease.<ref name="Ades-2009"/> 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.<ref name="Ades-2009"/>

Prasterone may promote [[tamoxifen]] resistance in [[breast cancer]].<ref name="Ades-2009"/> It may also increase the risk of [[uterine cancer|uterine]] and [[prostate cancer]]s due to metabolism into estrogens and androgens, respectively.<ref name="McKeag-2007" /> 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.<ref name="Ades-2009">{{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 }}</ref>

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.<ref name="WebMD-DHEA">{{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}}</ref>

Prasterone has been reported to possess few or no side effects even at very high dosages (e.g., 50&nbsp;times the recommended over-the-counter supplement dosage).<ref name="McKeag-2007">{{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–}}</ref> However, it may cause [[virilization|masculinization]] and other [[androgen]]ic side effects in women and [[gynecomastia]] and other [[estrogen (medication)|estrogen]]ic side effects in men.<ref name="McKeag-2007" />

==Pharmacokinetics==
{{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.<ref name="pmid11098305">{{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 }}</ref>[[File:Testosterone levels following a single oral dose of 300 mg crystalline or micronized DHEA in premenopausal women.png|class=skin-invert-image|thumb|right|350px|[[Testosterone (medication)|Testosterone]] levels following a single [[oral administration|oral]] dose of 300&nbsp;mg [[crystalline]] (non-micronized) or [[micronization|micronized]] prasterone (DHEA) in [[premenopausal]] women.<ref name="pmid8623801">{{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 }}</ref>]]
[[File:Estradiol and dehydroepiandrosterone levels after a single intramuscular injection of Gynodian Depot in women.png|class=skin-invert-image|thumb|right|350px|Estradiol and {{abbr|DHEA|dehydroepiandrosterone}} levels after a single intramuscular injection of Gynodian Depot (4&nbsp;mg estradiol valerate, 200&nbsp;mg prasterone enanthate) in women.<ref name="Kuhl-1987">{{cite book | vauthors = Kuhl H, Taubert HD | title = Das Klimakterium – Pathophysiologie, Klinik, Therapie | trans-title = The Climacteric – Pathophysiology, Clinic, Therapy | year = 1987 | publisher = [[Thieme Medical Publishers|Thieme Verlag]] | location = Stuttgart, Germany | language = de | isbn = 978-3-13-700801-9 | page = 122}}</ref><ref name="pmid6220949">{{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 }}</ref><ref name="pmid7402086">{{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 }}</ref>]]

Prasterone is [[metabolism|metabolized]] into [[androgen]]s and [[estrogen (medication)|estrogen]]s in the body,<ref name="pmid26908835" /><ref name="Burtis-2012">{{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–}}</ref> including androstenedione, testosterone, estrone, estradiol, and estriol.<ref name="pmid11098305" /> The transformation of prasterone into androgens and estrogens is [[tissue selectivity|tissue-specific]], for instance occurring in the [[liver]], [[adipose tissue|fat]], [[vagina]], [[prostate gland]], [[skin]], and [[hair follicle]]s (as well as other [[tissue (biology)|tissue]]s).<ref name="pmid26908835" /><ref name="pmid28153489">{{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 }}</ref>

=== Metabolism ===
Prasterone is also reversibly transformed into its active metabolite<ref name="pmid11098305" /> [[prasterone sulfate]] (DHEA-S) by [[steroid sulfotransferase]] (specifically [[SULT1E1]] and [[SULT2A1]]), which in turn can be converted back into prasterone by [[steroid sulfatase]].<ref name="pmid26908835" /><ref name="pmid26213785">{{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 }}</ref> Interconversion takes place in both adrenal and peripheral tissues.<ref name="pmid11098305" />

It is [[biotransformation|transformed]] into [[androstenedione]] by [[3β-hydroxysteroid dehydrogenase]] (3β-HSD), and into [[androstenediol]] by [[17β-hydroxysteroid dehydrogenase]] (17β-HSD).<ref name="pmid26908835" /><ref name="Burtis-2012" /> Then, androstenedione and androstenediol can be converted into [[testosterone (medication)|testosterone]] by 17β-HSD and 3β-HSD, respectively.<ref name="pmid26908835" /><ref name="Burtis-2012" /> Subsequently, testosterone can be metabolized into [[androstanolone|dihydrotestosterone]] by [[5α-reductase]].<ref name="pmid26908835" /><ref name="Burtis-2012" />

In addition, androstenedione and testosterone can be converted into [[estrone (medication)|estrone]] and [[estradiol (medication)|estradiol]] by [[aromatase]], respectively.<ref name="pmid26908835" /><ref name="Burtis-2012" />

=== Dose-response of hormone levels ===
At a high dosage of 1,600&nbsp;mg/day orally for 4&nbsp;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.<ref name="pmid15177053">{{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 }}</ref><ref name="pmid2144295">{{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 }}</ref>

Although prasterone can reliably increase testosterone levels in women, this isn't similarly the case in men.<ref name="McKeag-2007" /> A high dosage of 1,600&nbsp;mg/day prasterone in men for 4&nbsp;weeks was found to increase DHEA and androstenedione levels but did not significantly affect testosterone levels.<ref name="McKeag-2007" />

=== Dosing ===
In clinical studies of prasterone supplementation, dosages have ranged from 20 to 1,600&nbsp;mg per day.<ref name="Alesci-2004">{{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–}}</ref>

In people with adrenal insufficiency, oral dosages of 20 to 50&nbsp;mg/day prasterone have been found to restore DHEA and DHEA-S levels to physiological levels seen in young healthy adults.<ref name="Alesci-2004" /> Conversely, oral dosages of 100 to 200&nbsp;mg/day prasterone have been found to result in [[wikt:supraphysiological|supraphysiological]] levels of DHEA and DHEA-S.<ref name="Alesci-2004" />

[[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.<ref name="pmid8623801" />

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

Prasterone, also known as androst-5-en-3β-ol-17-one, is a [[natural product|naturally occurring]] [[androstane]] [[steroid]] and a [[17-ketosteroid]]. It is closely related structurally to [[5-androstenediol|androstenediol]] (androst-5-ene-3β,17β-diol), [[4-androstenedione|androstenedione]] (androst-4-ene-3,17-dione), and [[testosterone]] (androst-4-en-17β-ol-3-one). Prasterone is the δ<sup>5</sup> (5(6)-[[dehydrogenation|dehydrogenated]]) [[structural analog|analogue]] of [[epiandrosterone]] (5α-androstan-3β-ol-17-one), and is also known as 5-dehydroepiandrosterone (5-DHEA) or δ<sup>5</sup>-epiandrosterone. A [[positional isomer]] of prasterone which may have similar [[biological activity]] is [[4-dehydroepiandrosterone]] (4-DHEA).<ref name="Josephy-2013">{{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–}}</ref>

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

Prasterone is used medically as the C3β [[ester]]s [[prasterone enanthate]] and [[prasterone sulfate]].<ref name="Elks-2014" /> The C19 [[nor-|demethyl]] analogue of prasterone is [[19-nordehydroepiandrosterone]] (19-nor-DHEA), which is a prohormone of [[nandrolone]] (19-nortestosterone).<ref name="Human Kinetics-2017">{{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–}}</ref><ref name="Thieme-2009">{{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}}</ref> The [[5α-reductase|5α-reduced]] and δ<sup>1</sup> (1(2)-[[dehydrogenation|dehydrogenated]]) analogue of prasterone is [[1-dehydroepiandrosterone]] (1-DHEA or 1-androsterone), which is a prohormone of [[1-testosterone]] (δ<sup>1</sup>-DHT or dihydroboldenone).<ref name="pmid21310167">{{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 }}</ref> [[Fluasterone]] (3β-dehydroxy-16α-fluoro-DHEA) is a derivative of prasterone with minimal or no hormonal activity but other biological activities preserved.<ref name="pmid15177053" />

==History==
DHEA was discovered, via [[wikt:isolation|isolation]] from male [[urine]], by [[Adolf Butenandt]] and [[:de:Hans Dannenbaum|Hans Dannenbaum]] in 1934, and the compound was isolated from human [[blood plasma]] by Migeon and Plager in 1954.<ref name="Cupp-2002" /><ref name="pmid25022952" /> 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.<ref name="Cupp-2002" /><ref name="pmid25022952" /> 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''.<ref name="pmid25022952" /> 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.<ref name="pmid25022952" /> For decades after its discovery, DHEA was considered to be an inactive compound that served mainly as an [[chemical intermediate|intermediate]] in the [[biosynthesis|production]] of androgens and estrogens from [[cholesterol]].<ref name="pmid25022952" /> In 1965, an association between DHEA sulfate levels and aging was reported by De Nee and Vermeulen.<ref name="Cupp-2002" /><ref name="pmid25022952" /> 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.<ref name="Cupp-2002" /><ref name="pmid25022952" />

''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.<ref name="pmid5439245">{{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 }}</ref><ref name="WHOChronicle1978">{{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 }}</ref> The combination of 4&nbsp;mg [[estradiol valerate]] and 200&nbsp;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.<ref name="pmid25506">{{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 }}</ref><ref name="Kopera-1979">{{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 }}</ref><ref name="pmid6453267">{{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 }}</ref><ref name="Muller-1998">{{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–}}</ref> 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.<ref name="Cupp-2002" /><ref name="pmid25022952" /><ref name="Randolph Jr-2010">{{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–}}</ref> It was described as a "miracle drug", with supposed anti-aging, anti-obesity, and anti-cancer benefits.<ref name="Cupp-2002" /> 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.<ref name="Cupp-2002" /><ref name="pmid25022952" /><ref name="Randolph Jr-2010" /> 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]].<ref name="Cupp-2002" /> Conversely, it has remained banned as a supplement in [[Canada]], the [[United Kingdom]], [[Australia]], and [[New Zealand]].<ref name="Cupp-2002" /><ref name="Dunford-2014">{{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}}</ref>

In 2001, Genelabs submitted a [[New Drug Application]] of prasterone for the treatment of [[systemic lupus erythematosus]] (SLE) to the FDA.<ref name="Cupp-2002" /><ref name="AdisInsight-3" /> It had the tentative brand names Anastar, Aslera, and Prestara.<ref name="Cupp-2002" /><ref name="Blau-2009">{{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–}}</ref><ref name="AdisInsight-3" /> 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.<ref name="Cupp-2002" /> 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.<ref name="pmid28030684">{{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}}</ref><ref name="pmid29067420">{{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}}</ref> This was the first prasterone-containing medication to be approved by the FDA in this country.<ref name="pmid28030684" />

==Society and culture==

===Generic names===
''Prasterone'' is the [[generic term|generic name]] of DHEA in [[English language|English]] and [[Italian language|Italian]] and its [[International Nonproprietary Name]], [[United States Adopted Name]] and [[Denominazione Comune Italiana|Italian Common Name]],<ref name="Elks-2014"/><ref name="Morton-2012">{{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}}</ref><ref name="Drugs.com-Prasterone">{{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 }}</ref><ref name="NIH-NLM">{{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 }}</ref> while its generic name is ''prasteronum'' in [[Latin language|Latin]], ''prastérone'' in [[French language|French]] and its [[Dénomination Commune Française|French popular name]], and ''prasteron'' in German.<ref name="Drugs.com-Prasterone" />

===Marketing===
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 supplement]]s.<ref name="pmid16510635">{{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 =  }}</ref>

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."<ref name="Orlando Sentinel-1996">{{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 }}</ref> His column was widely [[Print syndication|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.<ref name="Kenosha (Wisconsin) News-2012">{{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 }}</ref>

===Regulation===

====By country====

=====Australia=====
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.<ref name="Therapeutic Goods Administration">{{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 }}</ref>

=====Canada=====
In Canada, prasterone is a Controlled Drug listed under Section 23 of Schedule IV of the ''Controlled Drugs and Substances Act''<ref name="Health Canada-2004">{{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 }}</ref> and as such is available by prescription only.

=====United Kingdom=====
Prasterone is listed as an [[anabolic steroid]] and is thus a [[Drugs controlled by the UK Misuse of Drugs Act|class C controlled drug]].

=====United States=====
Prasterone is legal to sell in the United States as a dietary supplement. It is currently [[Grandfather clause|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.<ref name="Drug Enforcement Administration-2012">{{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 }}</ref>

====Sports and athletics====

Prasterone is banned from use in athletic competition.<ref name="Cupp-2002" /><ref name="pmid25022952" /><ref name="Randolph Jr-2010" /> It is a prohibited substance under the World Anti-Doping Code of the World Anti-Doping Agency,<ref name="World Anti-Doping Agency-2013">{{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 }}</ref> 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.<ref name="RIA Novosti-2014">{{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 }}</ref>
* Rashard Lewis, then with the Orlando Magic, tested positive for prasterone and was suspended 10 games before the start of the 2009–10 season.<ref name="Memphis Grizzlies-2014">{{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 }}</ref>
* In 2016 [[Mixed martial arts|MMA]] fighter [[Fabio Maldonado]] revealed he was taking prasterone during his time with the [[Ultimate Fighting Championship|UFC]].<ref name="Rezende-2016">{{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 }}</ref>
* In January 2011, [[National Basketball Association|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.<ref name="ESPN-2011">{{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 }}</ref> 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.<ref name="BBC Sport-2010">{{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 }}</ref>
* 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.<ref name="Ruiz-2016">{{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 <!-- | via = The New York Times --> | 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 }}</ref>

==Research==

===Anabolic uses===
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.<ref name="pmid23824417">{{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 }}</ref> Evidence is inconclusive in regards to the effect of prasterone on strength in the elderly.<ref name="pmid21649617">{{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 }}</ref> 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.<ref name="pmid10613429">{{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 }}</ref>

===Cancer===
There is no evidence prasterone is of benefit in treating or preventing [[cancer]].<ref name="Ades-2009"/>

===Cardiovascular disease===
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.<ref name="pmid14609305">{{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 | url-access = subscription }}</ref>

Prasterone may enhance [[G6PD]] mRNA expression, confounding its inhibitory effects.<ref name="pmid23241320">{{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 }}</ref>

===Lupus===
There is some evidence of short-term benefit in those with systemic lupus erythematosus but little evidence of long-term benefit or safety.<ref name="pmid17943841">{{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 }}</ref> Prasterone was under development for the treatment of systemic lupus erythematosus in the [[United States]] and [[Europe]] in the 1990s and 2000s and reached [[Phases of clinical research#Phase III|phase III]] [[clinical trial]]s and [[New Drug Application|preregistration]] for this indication, respectively, but ultimately development was not continued past 2010.<ref name="Cupp-2002" /><ref name="Blau-2009" /><ref name="AdisInsight-3">{{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 }}</ref>

===Memory===
Prasterone supplementation has not been found to be useful for memory function in normal middle aged or older adults.<ref name="pmid17054283">{{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 }}</ref> 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.<ref name="pmid17917157">{{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 }}</ref>

===Mood===
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.<ref name="pmid24892797">{{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 }}</ref><ref name="pmid24048401">{{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 }}</ref>

== References ==
{{Reflist}}

== Further reading ==
{{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 |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 }}
{{refend}}

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