Dehydroepiandrosterone (DHEA) is a naturally occurring hormone precursor. Its use as a supplement by women is a topic of ongoing discussion and research.
What is DHEA
DHEA, or dehydroepiandrosterone, is a steroid hormone primarily synthesized by the adrenal glands, located above the kidneys. Smaller amounts are also produced in the gonads and the brain. Its primary function is to act as a precursor, meaning it is converted by the body into other hormones, including androgens like testosterone and estrogens like estradiol.
DHEA is considered one of the most abundant circulating steroids in humans. Levels of DHEA naturally peak in early adulthood, typically in the mid-20s, and then gradually decline with age. By age 70, DHEA levels can be approximately 25% of their peak. This age-related decrease in DHEA has led to interest in supplementation to potentially restore hormone levels.
Common Reasons Women Use DHEA
DHEA supplementation is considered to address symptoms associated with aging. One area of interest is the improvement of menopausal symptoms, particularly vaginal atrophy, which can cause dryness and painful intercourse. Intravaginal DHEA has shown promise in improving these symptoms and sexual function in postmenopausal women, with some studies indicating improvements in desire, arousal, lubrication, and pain. However, research on oral DHEA for general menopausal symptoms like hot flashes has yielded mixed results.
DHEA’s potential to enhance libido and sexual function is another common reason for its use. Studies suggest that both intravaginal and, in some cases, oral DHEA may improve various aspects of sexual function, including desire and arousal, particularly in postmenopausal women and those with adrenal insufficiency.
Beyond sexual health, DHEA has been explored for its role in supporting bone density. DHEA is linked to androgens, which are important for bone health, and it may control the production of osteoblasts and insulin-like growth factor 1, which contribute to bone growth. While some research indicates DHEA may improve bone mineral density and help delay osteoporosis, other studies have shown mixed findings, suggesting more research is needed. DHEA’s effects on mood and energy have also been investigated, with some studies suggesting potential benefits for mood stability and reduced fatigue, especially in individuals with low DHEA levels or adrenal fatigue. Research on these specific benefits for mood and energy is still developing and not consistently conclusive.
Potential Side Effects and Safety Concerns
Despite potential benefits, DHEA supplementation carries a range of possible side effects, especially for women, due to its conversion into androgens and estrogens. Common androgenic side effects include oily skin, acne, and increased hair growth on the face or body (hirsutism). Women may also experience hair loss, voice deepening, and changes in their menstrual cycle. These effects can be particularly noticeable with higher doses.
A significant concern with DHEA supplementation is its potential to affect hormone-sensitive conditions. Because DHEA can increase levels of estrogen and testosterone, it may increase the risk of hormone-sensitive cancers, such as breast and ovarian cancers. Women with a history or elevated risk of these cancers are generally advised to avoid DHEA. DHEA may also worsen psychiatric disorders and potentially increase the risk of mania in individuals with mood disorders.
The long-term safety of DHEA supplementation is not yet fully understood, and more extensive research is needed. Short-term use, typically up to two years, with daily doses of around 50 mg has been considered possibly safe, but higher doses or prolonged use can increase the risk of serious side effects. DHEA can also reduce levels of high-density lipoprotein (HDL), which could impact cardiovascular health.
Key Considerations for DHEA Supplementation
Consult a healthcare professional before considering DHEA supplementation. A doctor can assess individual health needs, discuss potential benefits and risks, and determine if DHEA is appropriate. DHEA can interact with various medications, including antipsychotics, some seizure medications, and selective serotonin reuptake inhibitors (SSRIs), potentially reducing their effectiveness. Combining DHEA with other hormones like estrogen or testosterone can also lead to an excess of these hormones, resulting in additional side effects.
Proper dosage is another important consideration. Oral DHEA dosages in studies typically range from 25 mg to 50 mg daily, with some higher doses used for specific conditions under medical supervision. For intravaginal DHEA, commonly used dosages are lower, such as 0.5% or 1% cream, applied nightly. A healthcare provider can help determine a suitable starting dose and monitor hormone levels to minimize risks.
DHEA supplements are not regulated by the U.S. Food and Drug Administration (FDA) in the same way prescription drugs are. This means the quality, purity, and actual DHEA content of over-the-counter supplements can vary significantly, so choose reputable brands. Certain populations should avoid DHEA unless explicitly advised by a medical professional. This includes pregnant or nursing women, individuals with high cholesterol, and those with certain medical conditions like hormone-sensitive cancers or a history of blood clots.