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Prasterone sulfate, also known as dehydroepiandrosterone sulfate (DHEA-S), is a naturally occurring androstane steroid and the C3β-sulfate ester of prasterone (dehydroepiandrosterone; DHEA). It is marketed in Japan, Italy, Portugal, Argentina, and China under various brand names for use primarily as a labor inducer to treat insufficient cervical ripening and dilation during childbirth. Prasterone sulfate acts as a prohormone for DHEA and subsequently for both androgenic and estrogenic steroids. It also has intrinsic activity as a neurosteroid. Medically, it is administered via injection in the form of its sodium salt. Mechanistically, it serves as a precursor to more potent sex steroids through tissue-specific metabolism; it can be converted into androstenedione by 3β-hydroxysteroid dehydrogenase or into androstenediol by 17β-hydroxysteroid dehydrogenase—these metabolites are further transformed into testosterone or estrogens such as estradiol via aromatase. Prasterone/DHEA-S may also exert direct effects on plasma membrane receptors (including G-protein-coupled receptors), neuroreceptors (such as GABA-A, NMDA, sigma receptors), nuclear steroid hormone receptors (androgen receptor/estrogen receptor), peroxisome proliferator–activated receptor alpha (PPARα), constitutive androstane receptor (CAR), voltage-gated T-type calcium channels inhibition, and G-protein-coupled estrogen receptor 1 activation[1][4][5][6].
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