The Role of DHEA-S and Estradiol in Erectile Function
Dehydroepiandrosterone sulfate (DHEA-S) and estradiol are two hormones that play crucial roles in male sexual function, particularly in relation to erectile dysfunction (ED). While testosterone often gets the most attention, these other hormones are also important factors to consider.
DHEA-S and Erectile Function
DHEA-S is a hormone produced primarily by the adrenal glands. It acts as a precursor that can be converted into testosterone and estrogen in target tissues[1]. Several studies have found that lower levels of DHEA-S are associated with a higher risk of ED in men, even in those with normal testosterone levels[2].
In fact, the Massachusetts Male Aging Study found that DHEA-S was the only one of 17 hormones investigated that was inversely correlated with ED prevalence[2]. Another study showed that younger men with ED had significantly lower DHEA-S levels compared to those without ED[2]. This suggests that diminished DHEA-S levels, especially in young men, may be either a cause or consequence of ED.
Interestingly, men treated with DHEA supplements showed statistically significant improvements in all domains of the International Index of Erectile Function (IIEF) compared to placebo[2]. Additionally, sildenafil citrate (Viagra) treatment led to increased DHEA-S levels in men with ED, especially those under 50 years old[2]. This indicates that DHEA-S may be an important factor in the pathway by which medications like sildenafil improve erectile function.
Estradiol and Erectile Function
Estradiol is the primary estrogen hormone in men. Like DHEA-S, it is produced in small amounts by the testes and adrenal glands. Estradiol also plays a role in male sexual function and has been associated with ED risk[3].
One study found that men with ED had lower levels of estradiol compared to those without ED[3]. The researchers hypothesized that estradiol depletion may interfere with cognitive processes involved in sexual function[3]. However, more research is needed to fully understand the relationship between estradiol and erectile dysfunction in men.
The Interplay of DHEA-S, Estradiol and Testosterone
DHEA-S, estradiol and testosterone work together in a complex hormonal system that influences male sexual function. DHEA-S can be converted into testosterone and estradiol in peripheral tissues[1][4]. Testosterone is the primary male sex hormone and is crucial for sexual desire and function. Estradiol also has beneficial effects on erectile function, likely through both cognitive and vascular mechanisms[3].
As men age, levels of all three hormones tend to decline. This age-related hormonal shift may contribute to the increased prevalence of ED in older men[2][4]. However, the exact interplay between DHEA-S, estradiol and testosterone in the development of ED is still an area of active research.
In summary, DHEA-S and estradiol, in addition to testosterone, appear to be important factors in male sexual function and the development of erectile dysfunction. Maintaining adequate levels of these hormones may help preserve erectile function as men age. However, more longitudinal studies are needed to clarify the complex relationships between adrenal and gonadal hormones in the regulation of male sexual health.
Citations:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427309/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119841/
[3] https://www.nature.com/articles/s41598-022-20420-3
[4] https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-017-0028-4
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717665/
[6] https://my.clevelandclinic.org/health/diagnostics/22148-dheas-test-dhea-sulfate-test
[7] https://www.ucsfhealth.org/medical-tests/dhea-sulfate-test
[8] https://www.mountsinai.org/health-library/tests/dhea-sulfate-test
