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Exogenous dehydroepiandrosterone at physiologic replacement doses of 50 mg/day orally (15) is incapable of providing adequate blood testosterone for androgen replacement in men but produces dose-dependent increases in circulating estradiol in men (44, 45) and hyperandrogenism in women (14). Unlike in women where adrenal androgens are the major source of biologically active androgen precursors, endogenous adrenal androgens contribute negligibly to direct virilization of men (13) and residual circulating and tissue androgens after medical or surgical castration have minimal biologic effect on androgen-sensitive prostate cancer (43). After male puberty, over 95% of circulating testosterone is derived from testicular secretion with the remainder arising from extragonadal conversion of precursors with negligible intrinsic androgenic potency such as dehydroepiandrosterone and androstenedione. 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