{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:47:50Z","timestamp":1777855670890,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Mens Health"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>\n                    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\u2019s inhibitory effect on 5\u03b1 reductases. This study examined the relationship between dutasteride\u2019s 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 (&lt;60 and \u226560\u2009years), 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 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.05). Regression analyses showed that DHEAS was a positive predictor for ED in older patients treated with tamsulosin (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001) and in both age groups receiving dutasteride combination therapy (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001). In addition, DHEAS was a significant negative predictor for mood changes in both age groups receiving combination therapy (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001). 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.\n                  <\/jats:p>","DOI":"10.1177\/15579883251365091","type":"journal-article","created":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T11:31:54Z","timestamp":1755948714000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dehydroepiandrosterone Decline in Aging Males as a Predictor of Erectile Dysfunction and Mood Disorders in Patients With Benign Prostate Hyperplasia Undergoing Dutasteride Treatment"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7857-6056","authenticated-orcid":false,"given":"Maja Sofronievska","family":"Glavinov","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences, Goce Delcev University, Stip, North Macedonia Urology Department, University Surgery Hospital St.Naum Ohridski, Skopje, North Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Senol","family":"Tahir","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Goce Delcev University, Stip, North Macedonia Visceral Surgery Department, University Surgery Hospital St.Naum Ohridski, Skopje, North Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Arsov","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Goce Delcev University, Stip, North Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,23]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"crossref","unstructured":"Basar M. M. Aydin G. Mert H. C. Keles I. Caglayan O. Orkun S. Batislam E. (2005). Relationship between serum sex steroids and Aging Male Symptoms score and International Index of Erectile Function. Urology 66(3) 597\u2013601. https:\/\/doi.org\/10.1016\/j.urology.2005.03.060","DOI":"10.1016\/j.urology.2005.03.060"},{"key":"e_1_3_4_3_1","doi-asserted-by":"crossref","unstructured":"Canguven O. Burnett A. L. (2008). The effect of 5 alpha-reductase inhibitors on erectile function. Journal of Andrology 29(5) 514\u2013523. https:\/\/doi.org\/10.2164\/jandrol.108.005025","DOI":"10.2164\/jandrol.108.005025"},{"key":"e_1_3_4_4_1","doi-asserted-by":"crossref","unstructured":"Chung E. (2019). Sexuality in ageing male: Review of pathophysiology and treatment strategies for various male sexual dysfunctions. Medical Sciences (Basel Switzerland) 7(10) 98. https:\/\/doi.org\/10.3390\/medsci7100098","DOI":"10.3390\/medsci7100098"},{"key":"e_1_3_4_5_1","doi-asserted-by":"crossref","unstructured":"Clark R. V. Hermann D. J. Cunningham G. R. Wilson T. H. Morrill B. B. Hobbs S. (2004). Marked suppression of dihydrotestosterone in men with benign prostatic hyperplasia by dutasteride a dual 5alpha-reductase inhibitor. The Journal of Clinical Endocrinology and Metabolism 89(5) 2179\u20132184. https:\/\/doi.org\/10.1210\/jc.2003-030330","DOI":"10.1210\/jc.2003-030330"},{"key":"e_1_3_4_6_1","doi-asserted-by":"crossref","unstructured":"Dean R. C. Lue T. F. (2005). Physiology of penile erection and pathophysiology of erectile dysfunction. The Urologic Clinics of North America 32(4) 379\u2013395. https:\/\/doi.org\/10.1016\/j.ucl.2005.08.007","DOI":"10.1016\/j.ucl.2005.08.007"},{"key":"e_1_3_4_7_1","doi-asserted-by":"crossref","unstructured":"El-Sakka A. I. (2018). Dehydroepiandrosterone and Erectile Function: A review. The World Journal of Men\u2019s Health 36(3) 183\u2013191. https:\/\/doi.org\/10.5534\/wjmh.180005","DOI":"10.5534\/wjmh.180005"},{"key":"e_1_3_4_8_1","doi-asserted-by":"crossref","unstructured":"Feldman H. A. Goldstein I. Hatzichristou D. G. Krane R. J. McKinlay J. B. (1994). Impotence and its medical and psychosocial correlates: Results of the Massachusetts male aging study. Journal of Urology 151(1) 54\u201361. https:\/\/doi.org\/10.1016\/S0022-5347(17)34871-1","DOI":"10.1016\/S0022-5347(17)34871-1"},{"key":"e_1_3_4_9_1","doi-asserted-by":"crossref","unstructured":"Gravas S. Gacci M. Gratzke C. Herrmann T. R. W. Karavitakis M. Kyriazis I. Malde S. Mamoulakis C. Rieken M. Sakalis V. I. Schouten N. Speakman M. J. Tikkinen K. A. O. Cornu J.-N. (2023). Summary paper on the 2023 European Association of Urology Guidelines on the management of non-neurogenic male lower urinary tract symptoms. European Urology 84(2) 207\u2013222. https:\/\/doi.org\/10.1016\/j.eururo.2023.04.008","DOI":"10.1016\/j.eururo.2023.04.008"},{"key":"e_1_3_4_10_1","doi-asserted-by":"crossref","unstructured":"Haque N. Masumori N. Sakamoto S. Ye Z. Yoon S.-J. Kuo H.-C. Brotherton B. Wilson T. Muganurmath C. McLaughlin M. Manyak M. (2018). Superiority of dutasteride 0.5 mg and tamsulosin 0.2 mg for the treatment of moderate-to-severe benign prostatic hyperplasia in Asian men. International Journal of Urology: Official Journal of the Japanese Urological Association 25(11) 944\u2013951. https:\/\/doi.org\/10.1111\/iju.13785","DOI":"10.1111\/iju.13785"},{"key":"e_1_3_4_11_1","doi-asserted-by":"crossref","unstructured":"Kroenke K. Spitzer R. L. Williams J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine 16(9) 606\u2013613. https:\/\/doi.org\/10.1046\/j.1525-1497.2001.016009606.x","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_3_4_12_1","doi-asserted-by":"crossref","unstructured":"Labrie F. B\u00e9langer A. Cusan L. Candas B. (1997). Physiological changes in dehydroepiandrosterone are not reflected by serum levels of active androgens and estrogens but of their metabolites: Intracrinology. The Journal of Clinical Endocrinology & Metabolism 82(8) 2403\u20132409. https:\/\/doi.org\/10.1210\/jcem.82.8.4161","DOI":"10.1210\/jcem.82.8.4161"},{"key":"e_1_3_4_13_1","doi-asserted-by":"crossref","unstructured":"Mellon S. H. Griffin L. D. Compagnone N. A. (2001). Biosynthesis and action of neurosteroids. Brain Research. Brain Research Reviews 37(1\u20133) 3\u201312. https:\/\/doi.org\/10.1016\/s0165-0173(01)00109-6","DOI":"10.1016\/S0165-0173(01)00109-6"},{"key":"e_1_3_4_14_1","doi-asserted-by":"crossref","unstructured":"Michael A. Jenaway A. Paykel E. S. Herbert J. (2000). Altered salivary dehydroepiandrosterone levels in major depression in adults. Biological Psychiatry 48(10) 989\u2013995. https:\/\/doi.org\/10.1016\/S0006-3223(00)00955-0","DOI":"10.1016\/S0006-3223(00)00955-0"},{"key":"e_1_3_4_15_1","doi-asserted-by":"crossref","unstructured":"Miernik A. Gratzke C. (2020). Current treatment for benign prostatic hyperplasia. Deutsches Arzteblatt International 117(49) 843\u2013854. https:\/\/doi.org\/10.3238\/arztebl.2020.0843","DOI":"10.3238\/arztebl.2020.0843"},{"key":"e_1_3_4_16_1","doi-asserted-by":"crossref","unstructured":"Morales A. Heaton J. P. W. Carson C. C. (2000). Andropause: A misnomer for a true clinical entity. Journal of Urology 163(3) 705\u2013712. https:\/\/doi.org\/10.1016\/S0022-5347(05)67788-9","DOI":"10.1016\/S0022-5347(05)67788-9"},{"key":"e_1_3_4_17_1","doi-asserted-by":"crossref","unstructured":"Orentreich N. Brind J. L. Rizer R. L. Vogelman J. H. (1984). Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood. The Journal of Clinical Endocrinology and Metabolism 59(3) 551\u2013555. https:\/\/doi.org\/10.1210\/jcem-59-3-551","DOI":"10.1210\/jcem-59-3-551"},{"key":"e_1_3_4_18_1","doi-asserted-by":"crossref","unstructured":"Roehrborn C. G. Boyle P. Nickel J. C. Hoefner K. Andriole G. & ARIA3001 ARIA3002 and ARIA3003 Study Investigators. (2002). Efficacy and safety of a dual inhibitor of 5-alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology 60(3) 434\u2013441. https:\/\/doi.org\/10.1016\/s0090-4295(02)01905-2","DOI":"10.1016\/S0090-4295(02)01905-2"},{"key":"e_1_3_4_19_1","doi-asserted-by":"crossref","unstructured":"Roehrborn C. G. Siami P. Barkin J. Dami\u00e3o R. Major-Walker K. Morrill B. Montorsi F. & CombAT Study Group. (2008). The effects of dutasteride tamsulosin and combination therapy on lower urinary tract symptoms in men with benign prostatic hyperplasia and prostatic enlargement: 2-Year results from the CombAT study. The Journal of Urology 179(2) 616\u2013621. https:\/\/doi.org\/10.1016\/j.juro.2007.09.084","DOI":"10.1016\/j.juro.2007.09.084"},{"key":"e_1_3_4_20_1","doi-asserted-by":"crossref","unstructured":"Roehrborn C. G. Siami P. Barkin J. Dami\u00e3o R. Major-Walker K. Nandy I. Morrill B. B. Gagnier R. P. Montorsi F. & CombAT Study Group. (2010). The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-Year results from the CombAT study. European Urology 57(1) 123\u2013131. https:\/\/doi.org\/10.1016\/j.eururo.2009.09.035","DOI":"10.1016\/j.eururo.2009.09.035"},{"key":"e_1_3_4_21_1","doi-asserted-by":"crossref","unstructured":"Rosen R. Cappelleri J. Smith M. Lipsky J. Pe\u00f1a B. (1999). Development and evaluation of an abridged 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. International Journal of Impotence Research 11(6) 319\u2013326. https:\/\/doi.org\/10.1038\/sj.ijir.3900472","DOI":"10.1038\/sj.ijir.3900472"},{"key":"e_1_3_4_22_1","doi-asserted-by":"crossref","unstructured":"Saengmearnuparp T. Lojanapiwat B. Chattipakorn N. Chattipakorn S. (2021). The connection of 5-alpha reductase inhibitors to the development of depression. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie 143 112100. https:\/\/doi.org\/10.1016\/j.biopha.2021.112100","DOI":"10.1016\/j.biopha.2021.112100"},{"key":"e_1_3_4_23_1","doi-asserted-by":"crossref","unstructured":"Skolarus T. A. Wei J. T. (2009). Measurement of benign prostatic hyperplasia treatment effects on male sexual function. International Journal of Impotence Research 21(5) 267\u2013274. https:\/\/doi.org\/10.1038\/ijir.2009.26","DOI":"10.1038\/ijir.2009.26"},{"key":"e_1_3_4_24_1","doi-asserted-by":"crossref","unstructured":"St\u00e1rka L. Du\u0161kov\u00e1 M. Hill M. (2015). Dehydroepiandrosterone: A neuroactive steroid. The Journal of Steroid Biochemistry and Molecular Biology 145 254\u2013260. https:\/\/doi.org\/10.1016\/j.jsbmb.2014.03.008","DOI":"10.1016\/j.jsbmb.2014.03.008"},{"key":"e_1_3_4_25_1","doi-asserted-by":"crossref","unstructured":"Traish A. M. (2020). Post-finasteride syndrome: A surmountable challenge for clinicians. Fertility and Sterility 113(1) 21\u201350. https:\/\/doi.org\/10.1016\/j.fertnstert.2019.11.030","DOI":"10.1016\/j.fertnstert.2019.11.030"},{"key":"e_1_3_4_26_1","doi-asserted-by":"crossref","unstructured":"Traish A. M. Hassani J. Guay A. T. Zitzmann M. Hansen M. L. (2011). Adverse side effects of 5\u03b1-reductase inhibitors therapy: Persistent diminished libido and erectile dysfunction and depression in a subset of patients. The Journal of Sexual Medicine 8(3) 872\u2013884. https:\/\/doi.org\/10.1111\/j.1743-6109.2010.02157.x","DOI":"10.1111\/j.1743-6109.2010.02157.x"},{"key":"e_1_3_4_27_1","doi-asserted-by":"crossref","unstructured":"Valiengo L. da C. L. Stella F. Forlenza O. V. (2016). Mood disorders in the elderly: Prevalence functional impact and management challenges. Neuropsychiatric Disease and Treatment 12 2105\u20132114. https:\/\/doi.org\/10.2147\/NDT.S94643","DOI":"10.2147\/NDT.S94643"},{"key":"e_1_3_4_28_1","doi-asserted-by":"crossref","unstructured":"van Dijk M. M. de la Rosette J. J. M. C. H. Michel M. C. (2006). Effects of alpha(1)-adrenoceptor antagonists on male sexual function. Drugs 66(3) 287\u2013301. https:\/\/doi.org\/10.2165\/00003495-200666030-00002","DOI":"10.2165\/00003495-200666030-00002"},{"key":"e_1_3_4_29_1","doi-asserted-by":"crossref","unstructured":"Voznesensky M. Walsh S. Dauser D. Brindisi J. Kenny A. M. (2009). The association between dehydroepiandosterone and frailty in older men and women. Age and Ageing 38(4) 401\u2013406. https:\/\/doi.org\/10.1093\/ageing\/afp015","DOI":"10.1093\/ageing\/afp015"}],"container-title":["American Journal of Men's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15579883251365091","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15579883251365091","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15579883251365091","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:28:16Z","timestamp":1777505296000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15579883251365091"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1177\/15579883251365091"],"URL":"https:\/\/doi.org\/10.1177\/15579883251365091","relation":{},"ISSN":["1557-9883","1557-9891"],"issn-type":[{"value":"1557-9883","type":"print"},{"value":"1557-9891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"article-number":"15579883251365091"}}