Learning Objectives and CME/Disclosure Information
This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Compare use of OTC DHEA with use of testosterone 2. Discuss key points regarding the safety of OTC DHEA
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Method of Participation and Request for Credit
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Jan 25 2023, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
Patient complaints regarding sexual functioning, either lowered levels of desire, or difficulty becoming aroused, are common. Currently, there are drugs, such as testosterone, that are being used ‘off label’ for this purpose. A patient may request a trial of a ‘more natural’ alternative, available over the counter (OTC) such as Dehydroepiandrosterone (DHEA). In this setting, consider discussing the following
Because DHEA converts into testosterone, ongoing use of DHEA may result in side effects associated with testosterone use
Side effects of DHEA are generally less severe than testosterone, although patients may experience some hair growth, oily skin or acne
In very high doses, more than 1600 milligrams daily, DHEA can have the same significant side effects as testosterone: hair growth, hair loss on the head, voice deepening and clitoral enlargement
Data support the positive role of androgens in female sexual function and ovarian physiology. However, the availability of approved testosterone formulations remains limited, particularly in the US. Therefore, patients may opt to obtain DHEA, the precursor hormone, in its stead. There is no positive guidance regarding the use of DHEA in women for sexual dysfunction because currently there remains a lack of well-designed studies demonstrating consistent clinical improvement.
DHEA will convert into estrogen as well as testosterone and therefore extra caution to avoid this hormone may be reasonable in women with a history of breast or uterine cancer
DHEA is not FDA approved as a drug and therefore what is packaged may not be reliably indicated on the bottle
In a small but well-designed pilot study that studied sleep patterns in healthy postmenopausal women, DHEA supplementation can cause sleep stimulation or inhibition
Systemic DHEA has been tested but has not shown efficacy in postmenopausal women for treatment of sexual interest and arousal disorders and, therefore, is not recommended for use
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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