Ten trials (n=264) were included in the review. Allocation concealment was reported in five trials. Blinding of patients was reported in all 10 trials. Two trials reported losses to follow-up of more than 20%. Unpublished data was included from one of the trials.
Pooled global HRQOL scores showed a small statistically significant benefit of DHEA treatment compared to placebo (SMD 0.21, 95% CI 0.08 to 0.33, I2 =32%; nine trials). Significant benefits of similar magnitude were also found for depression (SMD 0.23, 95% CI 0.04 to 0.42, I2 = 57%; seven trials). There were no statistically significant benefits found for anxiety (five studies) or sexual well being (four studies).
Five studies were included in an analysis of pooled data from each domain of the the SF-36. There was a statistically significant benefit of DHEA treatment compared to placebo for the physical subscale (SMD 4.2, 95% CI 0.04 to 8.3, I2=52%). No differences were reported between DHEA treatment and any other SF-36 subscale.
No serious adverse events were reported in any of the trials. Androgenic side effects reported included greasy skin, hirsutism, acne, scalp itching and increases in apocrine sweat and odour and were generally well tolerated.
There were no differences between groups reported for any of the subgroup analyses that evaluated effects of adrenal insufficiency type, dose and duration of intervention, study design and study quality.