Dehydroepiandrosterone Decline in Aging Males as a Predictor of Erectile Dysfunction and Mood Disorders in Patients with Benign Prostate Hyperplasia Undergoing Dutasteride Treatment

Age-related decline in dehydroepiandrosterone (DHEA) and its sulfate metabolite, dehydroepiandrosterone-sulfate
(DHEAS), affects steroid synthesis in men. DHEA(S) acts as a direct neurosteroid and weak androgen and is the unique
steroid unaffected by dutasteride’s inhibitory effect on 5a reductases. This study examined the relationship between
dutasteride’s side effects, specifically erectile dysfunction (ED) and mood disorders, and the age-related decline in
DHEAS. The study included 250 patients with benign prostatic hyperplasia (BPH), divided into two age groups (\60
and 60 years), and treated with tamsulosin or tamsulosin plus dutasteride. DHEAS levels were measured, and patients
were assessed for ED and mood disorders using standardized questionnaires. Some patients experienced worsening ED
and mood disorders during the 6-month follow-up period. The study found a correlation between DHEAS levels and
erectile function and mood status in both age groups receiving dutasteride combination therapy (p\.05). Regression
analyses showed that DHEAS was a positive predictor for ED in older patients treated with tamsulosin
(p\.001) and in both age groups receiving dutasteride combination therapy (p\.001). In addition, DHEAS was a significant negative predictor for mood changes in both age groups receiving combination therapy (p\.001). This study
suggests that baseline DHEAS levels can predict changes in erectile function and mood status in BPH patients treated
with dutasteride therapy. It is, therefore, recommended to perform DHEAS assessment before starting dutasteride
treatment in order to reduce the risk of ED and mood disorders.