***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: CONTEXT Changes in and rogen levels across the adult female life span and the effects of natural menopause and oophorectomy have not been clearly established . OBJECTIVE The objective of this study was to document the effects of age on and rogen levels in healthy women and to explore the effects of natural and surgical menopause . DESIGN , SETTING , AND PARTICIPANTS A cross-sectional study was conducted of 1423 non-healthcare-seeking women , aged 18 - 75 yr , r and omly recruited from the community over 15 months . MAIN OUTCOME MEASURES Serum levels by age of total testosterone ( T ) , calculated free T , dehydroepi and rosterone sulfate , and and rostenedione in a reference group of women free of confounding factors . Women in the reference group had no usage of exogenous steroid therapy ; no history of tubal ligation , hysterectomy , or bilateral oophorectomy ; and no hyperprolactinemia or polycystic ovarian syndrome . The effects of natural and surgical menopause on sex steroid levels were also examined . RESULTS In the reference population ( n = 595 ) , total T , calculated free T , dehydroepi and rosterone sulfate , and and rostenedione declined steeply with age ( P < 0.001 ) , with the decline of each being greater in the earlier than the later decades . Examination of serum and rogen levels by year in women aged 45 - 54 yr showed no independent effect of menopausal status on and rogen levels . In women aged 55 yr or older , those who reported bilateral oophorectomy and were not on exogenous steroids had significantly lower total T and free T levels than women 55 yr or older in the reference group . CONCLUSIONS We report that serum and rogen levels decline steeply in the early reproductive years and do not vary because a consequence of natural menopause and that the postmenopausal ovary appears to be an ongoing site of testosterone production . These significant variations in and rogens with age must be taken into account when normal ranges are reported and in studies of the role of and rogens in women The levels of dehydroepi and rosterone ( DHEA ) and its sulfate ester DHEAS decrease with age after a peak around 25 yr . Animal studies as well as the first studies in humans have generated the idea that DHEA replacement in elderly subjects may have beneficial effects on well-being and cognitive functions . In the present experiment 40 healthy elderly men and women ( mean age , 69 yr ) participated in a double blind , placebo-controlled DHEA substitution study . For 2 weeks subjects took 50 mg DHEA daily , followed by a 2-week wash-out period and a 2-week placebo period . The treatment sequence was r and omized in a cross-over design . After 2 weeks of DHEA or placebo , psychological and physical well-being as well as cognitive performance were assessed using several question naires and neuropsychological tests . All subjects had low DHEAS baseline levels .  DHEA substitution lead to a 5-fold increase in DHEAS levels in women ( from 0.67 + /- 0.1 to 4.1 + /- 0.4 micrograms/mL ; P < 0.001 ) and men ( from 0.85 + /- 0.1 to 4.5 + /- 0.4 micrograms/mL ; P < 0.001 ) . DHEA , and rostenedione , and testosterone levels also increased significantly in both sexes ( all P < 0.001 ) . No significant changes were observed in insulin-like growth factor I or insulin-like growth factor-binding protein-3 levels .  DHEA replacement had no strong beneficial effect on any of the measured psychological or cognitive parameters . Only women tended to report an increase in well-being ( P = 0.11 ) and mood ( P = 0.10 ) , as assessed with question naires . They also showed better performance in one of six cognitive tests ( picture memory ) after DHEA . However , after Bonferroni alpha adjustment , this difference was no longer significant . No such trend was observed in men ( P > 0.20 ) . Likewise , no beneficial effects of DHEA substitution could be observed in any of the other tests of the neuropsychological test battery in either sex ( all P > 0.20 ) . In conclusion , the present data do not support the idea of strong beneficial effects of a physiological DHEA substitution on well-being or cognitive performance in healthy elderly individuals BACKGROUND Age-related reductions in serum dehydroepi and rosterone ( DHEA ) concentrations may be involved in bone mineral density ( BMD ) losses . OBJECTIVE The objective was to determine whether DHEA supplementation in older adults improves BMD when co-administered with vitamin D and calcium . DESIGN In year 1 , a r and omized trial was conducted in which men ( n = 55 ) and women ( n = 58 ) aged 65 - 75 y took 50 mg/d oral DHEA supplements or placebo . In year 2 , all participants took open-label DHEA ( 50 mg/d ) . During both years , all participants received vitamin D ( 16 microg/d ) and calcium ( 700 mg/d ) supplements . BMD was measured by using dual-energy X-ray absorptiometry . Concentrations of hormones and bone turnover markers were measured in serum . RESULTS In men , no difference between groups occurred in any BMD measures or in bone turnover markers during year 1 or year 2 . The free testosterone index and estradiol increased in the DHEA group only . In women , spine BMD increased by 1.7 + /- 0.6 % ( P = 0.0003 ) during year 1 and by 3.6 + /- 0.7 % after 2 y of supplementation in the DHEA group ; however , in the placebo group , spine BMD was unchanged during year 1 but increased to 2.6 + /- 0.9 % above baseline during year 2 after the crossover to DHEA . Hip BMD did not change . Testosterone , estradiol , and insulin-like growth factor 1 increased in the DHEA group only . In both groups , serum concentrations of bone turnover markers decreased during year 1 and remained low during year 2 , but did not differ between groups . CONCLUSION DHEA supplementation in older women , but not in men , improves spine BMD when co-administered with vitamin D and calcium . This trial was registered at clinical trials.gov as NCT00182975 OBJECTIVE To demonstrate bioavailability of 3 weeks of oral micronized DHEA and to delineate changes induced on insulin sensitivity , morphometric indexes , and lipoprotein profiles . DESIGN Oral micronized DHEa ( 50 mg/d ) was administered in 3-week treatments to 11 postmenopausal women in a prospect i ve , placebo-controlled , r and omized , blinded , crossover trial with an interarm washout . After dose ( 23 hour ) serum DHEA , DHEAS , T , and cortisol levels were measured , as were fasting lipoproteins , oral glucose tolerance tests ( OGTT ) , T-lymphocyte insulin binding and degradation , and urine collagen cross-links . Morphometric changes were determined by hydrostatic weighing . RESULTS Dehydroepi and rosterone sulfate , DHEA , T , and free T increased up to two times premenopausal levels with treatment . Fasting triglycerides declined ; no change in collagen cross-links or morphometric indexes was noted . Oral glucose tolerance test parameters did not change , but both T-lymphocyte insulin binding and degradation increased with DHEA . CONCLUSION Fifty milligrams per day of oral DHEA gives suprahysiologic and rogen levels ; 25 mg/d may be more appropriate . Dehydroepi and rosterone enhanced tissue insulin sensitivity and lowered serum triglycerides . Rationale is provided for postmenopausal replacement therapy with this and rogen CONTEXT Alternative and over-the-counter medicines have become increasingly popular choices for many patients who prefer not to take traditional antidepressants . The adrenal and rogen and neurosteroid dehydroepi and rosterone ( DHEA ) is available as over-the-counter hormonal therapy and previously has been reported to have antidepressant-like effects . OBJECTIVE To evaluate the efficacy of DHEA as a monotherapy treatment for midlife-onset depression . DESIGN A double-blind , r and omized , placebo-controlled , crossover treatment study was performed from January 4 , 1996 , through August 31 , 2002 . Setting s The National Institute of Mental Health Midlife Outpatient Clinic in the National Institutes of Health Clinical Center , Bethesda , Md. Patients Men ( n = 23 ) and women ( n = 23 ) aged 45 to 65 years with midlife-onset major or minor depression participated in this study . None of the subjects received concurrent antidepressant medications . Intervention Six weeks of DHEA therapy , 90 mg/d for 3 weeks and 450 mg/d for 3 weeks , and 6 weeks of placebo . MAIN OUTCOME MEASURES The 17-Item Hamilton Depression Rating Scale and Center for Epidemiologic Studies Depression Scale . Additional measures included the Derogatis Interview for Sexual Functioning . Results were analyzed by means of repeated- measures analysis of variance and post hoc Bonferroni t tests . RESULTS Six weeks of DHEA administration was associated with a significant improvement in the 17-Item Hamilton Depression Rating Scale and the Center for Epidemiologic Studies Depression Scale ratings compared with both baseline ( P<.01 ) and 6 weeks of placebo treatment ( P<.01 ) . A 50 % or greater reduction in baseline Hamilton Depression Rating Scale scores was observed in 23 subjects after DHEA and in 13 subjects after placebo treatments . Six weeks of DHEA treatment also was associated with significant improvements in Derogatis Interview for Sexual Functioning scores relative to baseline and placebo conditions . CONCLUSION We find DHEA to be an effective treatment for midlife-onset major and minor depression Dehydroepi and rosterone ( DHEA ) , an and rogenic steroid hormone , exhibits an age-related decline . Perimenopausal women have only approximately 50 % of peak DHEA levels . Despite limited scientific data , DHEA has gained recognition as a dietary supplement to reduce the symptoms of aging and improve well-being . This r and omized , double-blind placebo-controlled trial examined the effects of 50 mg/day of oral DHEA supplementation , for 3 months , on 60 perimenopausal women with complaints of altered mood and well-being .  Changes in the serum endocrine profile of women in the DHEA group were significantly greater than the placebo group , including a 242 % [ 95 % confidence interval ( CI ) + 60.1 , + 423.9 ] increase in DHEAS , a 94.8 % ( 95 % CI + 34.2 , + 155.4 ) increase in testosterone , and a 13.2 % ( 95 % CI -27.88 , + 0.5 ) decline in cortisol compared to baseline . Women receiving DHEA had a 10.1 % ( 95 % CI -15.0 , -5.1 ) decline in high-density lipoprotein and an 18.1 % ( 95 % CI -32.2 , -3.9 ) decline in Lp(a ) from baseline , but these declines did not significantly differ from women who received placebo . Women receiving DHEA did not have any improvements significantly greater than placebo in the severity of perimenopausal symptoms , mood , dysphoria , libido , cognition , memory , or well-being .  DHEA supplementation significantly effects the endocrine profile , may affect the lipid profile , but does not improve perimenopausal symptoms or well-being compared to placebo OBJECTIVE Patients with fibromyalgia ( FM ) consistently have adrenal hyporesponsiveness and low dehydroepi and rosterone ( DHEA ) levels . DHEA is promoted for and used by patients with FM . We tested the efficacy and safety of DHEA supplementation in ameliorating the symptoms of FM . METHODS In a double-blind crossover study , postmenopausal women with FM were r and omized to DHEA supplementation  ( 50 mg/day ) or placebo for 3 months , with a one-month washout period in between . Patients were assessed monthly for well-being and pain and by medical evaluations at the beginning and the end of each treatment period . The primary outcome was well being ; secondary outcomes were pain , fatigue , cognition , sexuality , functional impairment , depression , and anxiety . RESULTS A total of 52 patients were r and omized , 47 patients completed the  DHEA  treatment period , and 45 the placebo treatment period . After 3 months of treatment with 50 mg of DHEA , median DHEA sulfate blood levels had tripled , but there was no improvement in well-being , pain , fatigue , cognitive dysfunction , functional impairment , depression , or anxiety , nor in objective measurements made by physicians . And rogenic side effects ( greasy skin , acne , and increased growth of body hair ) were more common during the DHEA treatment period ( p = 0.02 ) . CONCLUSION DHEA does not improve quality of life , pain , 
    Output:
    
There was also no significant effect of DHEA on serious adverse effects , serum lipids , serum glucose , weight , body mass index , or bone mineral density .
Evidence warranting low confidence suggests that DHEA administration does not significantly impact sexual symptoms or selected metabolic markers in postmenopausal women with normal adrenal function