Increased DHEAS and Decreased Total Testosterone Serum Levels in a Subset of Men with Early-Onset Androgenetic Alopecia: Does a Male PCOS-Equivalent Exist?

Int J Endocrinol. 2020 Feb 12;2020:1942126. doi: 10.1155/2020/1942126. eCollection 2020.
Increased DHEAS and Decreased Total Testosterone Serum Levels in a Subset of Men with Early-Onset Androgenetic Alopecia: Does a Male PCOS-Equivalent Exist?
Cannarella R1, Condorelli RA1, Dall'Oglio F2, La Vignera S1, Mongioì LM1, Micali G2, Calogero AE1.

BACKGROUND:
Increased dehydroepiandrosterone sulfate (DHEAS) levels have been reported in men with early-onset (<35 years) androgenetic alopecia (AGA). It has been suggested that a male polycystic ovarian syndrome- (PCOS-) equivalent, defined as an endocrine syndrome with a metabolic background and a PCOS-like hormonal pattern, predisposing to type II diabetes mellitus (DM II), cardiovascular and prostate diseases later in life, may occur in at least a part of these men. The gonadal function, including sperm parameters and total testosterone (TT) levels, has been investigated in a low number of these men.

OBJECTIVE:
The aim of the study was to assess gonadal and adrenal function in a subset of men with early-onset AGA and controls.

METHODS:
43 men with early-onset AGA and 36 controls were screened for DHEAS, TT, glycaemia, insulin, gonadotropins, 17α-hydroxyprogesterone (17α-hydroxyprogesterone (17n = 21), as those with at least one of the following parameters: body mass index (BMI) >25 kg/m2, insulin resistance (IR), and/or SHBG <25 nmol/l.

RESULTS:
Patients with early-onset AGA had higher mean (±SD) BMI (25.5 ± 3.8 vs. 23.7 ± 3.0 kg/m2; P < 0.05) and 17α-hydroxyprogesterone (17P < 0.05) and 17P < 0.05) and 17P < 0.05) and 17P < 0.05) and 17μg/dl; P < 0.05) and 17P < 0.05) and 17P < 0.05) and 17P < 0.05) and 17.

CONCLUSION:
Men with early-onset AGA and at least one among BMI >25 kg/m2, IR, and SHBG <25 nmol/l have increased DHEAS levels and a worse gonadal steroidogenesis. They might have a greater risk to develop gonadal dysfunction later in life. These criteria may be used to define male PCOS-equivalent.

Full Study:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037881/

Very interesting, thanks. How could one normalize DHEAS and improve gonadal steroidogenesis?

Biffy wrote:Very interesting, thanks. How could one normalize DHEAS and improve gonadal steroidogenesis?

To be clear, looking at DHEA levels alone is a not enough in this context. So based on age, the relative SHBG, insulin levels, and evidence of poor insulin resistance should be looked at as a whole.

When it comes to how to fix it, there are lots of ways. But it simply depends on the issues at hand and the person. Listing some examples could be misleading since it maybe inappropriate.