DHEA Supplements: Benefits, Risks, and Alternatives for Women

Dehydroepiandrosterone (DHEA) plays a crucial role in maintaining hormonal balance. This natural hormone is an intermediate for male and female sex hormones, like progesterone, estrogen, and testosterone. 

As we get older, our DHEA levels decline, which can lead to various physical and mental symptoms. As a result, DHEA supplements have been more common for peri- and postmenopausal women. However, excessive supplementation may lead to unwanted side effects or disruptions in hormonal balance.  

If you’re approaching or past menopause, you may be considering DHEA supplements. So, what exactly is DHEA, what can it do, and are DHEA supplements right for you?

What is DHEA? 

Dehydroepiandrosterone (DHEA) is a foundational element in sex hormone production. Essential hormones like estrogen, progesterone, and testosterone depend on DHEA for their synthesis. This prehormone is made by the adrenal glands above the kidneys.

DHEA reaches its highest levels in early adulthood. Production gradually and naturally decreases starting in your twenties.  

Impacts of DHEA on females  

DHEA specifically impacts estrogen and its ability to perform its functions, which range from regulating the menstrual cycle to maintaining bone strength.

Enzymes in specific tissues metabolize DHEA into metabolites that can be converted into estrogens (and androgens like testosterone), which then can bind to estrogen specific receptors. When estrogen binds to its specialized receptors inside cells, the actions and processes estrogen is involved in can begin.   

The impact of DHEA on estrogen levels varies depending on age, health conditions, and hormonal status. This precursor hormone interacts with estrogen in several ways. DHEA levels influence estrogen production by undergoing conversion through enzymes like aromatase.  

DHEA also affects estrogen balance by influencing the ratio of testosterone to estrogen in the body. Maintaining an appropriate balance of these hormones is critical for the proper functioning of many of the body's systems. Conditions like polycystic ovarian syndrome (PCOS) can develop from hormonal imbalances. 

>>RELATED: What Is Estrogen Dominance (And How Does It Affect My Fertility)?

Additionally, DHEA and estrogen share roles in various physiological functions like bone health, sex drive, mood, and estrogen-dependent cancers.  

What are optimal DHEA levels for women?  

DHEA peaks in your 20s, then gradually declines as you age. Typical DHEA levels in women are: 

What happens when DHEA declines?

DHEA levels naturally decline with age in both men and women. This can cause a variety of symptoms, including:

• Reduced energy levels
• Decreased sex drive
• Bone health issues
• Muscle loss
• Skin changes

It's important to note that while DHEA levels decrease with age, these symptoms aren't necessarily caused solely by low DHEA. Other factors, like lifestyle factors or underlying medical conditions, also play a role.

While the medical community does not fully understand DHEA’s functions beyond its associated with sex hormones, it is believed that it could potentially play a role in the menopause symptoms. During perimenopause and postmenopause, DHEA levels continue to decrease along with estrogen and progesterone. 

DHEA supplements: benefits and uses

Because a decline in DHEA is often associated with symptoms of aging, researchers have considered that DHEA supplements could be used to combat and treat these symptoms. For example, because a decline in DHEA can lead to symptoms like reduced energy levels and decreased sex drive, DHEA supplementation can potentially help address these issues.

DHEA supplementation has been used in treatments for:  

• Metabolic syndrome  
• Heart disease  
• Systemic lupus  
• Adrenal insufficiency  
• Addison's disease  
• Depression 
• Osteoporosis 
• Obesity  
• Erectile dysfunction  
• Low sex drive  
• HIV  
• Irritable bowel syndrome
• Perimenopause 

DHEA supplements for perimenopause symptoms

In recent years, there has been a growing focus on alleviating symptoms of perimenopause and exploring hormonal supplementation. DHEA has emerged in discussions related to menopause due to its significant role in the production of estrogen—a hormone which fluctuates during this phase of life for women, and can cause a range of difficult perimenopause symptoms.

So, do DHEA supplements work to relieve perimenopause symptoms? The results are mixed, and there’s more research to be done.

One study that focused on the impact of DHEA supplementation specifically on symptomatic perimenopausal women found that those receiving DHEA did not experience significant improvements in the severity of perimenopausal symptoms. The study noted that while supplementation did have noticeable effects on women’s hormone profiles (meaning increases in hormones DHEA produces), it might influence lipid profiles as well (meaning high cholesterol), and it did not lead to symptom improvement compared to the placebo group.  

A more recent literature review on the potential benefits and risks of androgen prohormones in women—including DHEA supplementation—concluded that there was evidence of small benefits in quality of life and mood for women with adrenal insufficiency or anorexia. But there were no consistent beneficial effects observed for menopausal symptoms, sexual function, cognition, or overall well-being in women with sufficient adrenal function. 

Are DHEA supplements safe?

While DHEA isn’t necessarily unsafe, you shouldn’t take DHEA supplements with consulting a provider. DHEA supplements have limited evidence of their benefits, and there’s concern about their side effects and long-term effects. 

One research review of DHEA supplementation concluded that supplementing a prehormone is closer to hormonal optimization than hormonal supplementation because you’re supplementing a hormonal product directly (e.g. estrogen supplements). It also noted that there are robust positive effects of DHEA on muscle, bone, cardiovascular disease, and sexual function; however, the review shared common concerns that most DHEA students aren’t large or long enough to conclude on the effects of DHEA on aging and age-related diseases.

Some of the unfavorable side effects of DHEA supplements for women are:  

• Oily skin and acne  
• Skin thickening  
• Hair loss  
• Stomach upset  
• High blood pressure  
• Changes in menstrual cycle  
• Facial hair 
• Deepening of voice 
• Fatigue  
• Nasal congestion  
• Headache  
• Heartbeat irregularities  
• Rapid heartbeat  
• Insomnia  
• Changes in cholesterol levels  

Should I take DHEA supplements?

If you are considering DHEA supplements, be sure to discuss your symptoms with your provider. Here are some questions you can ask to determine if DHEA supplementation is suitable for you:  

• Would I benefit from DHEA supplementation based on my symptoms?  
• Are there any medications I currently take that could interact with DHEA supplementation? 
• How long can I expect to benefit from DHEA supplementation?  
• What are the reputable brands or sources for purchasing DHEA supplements?  
• What potential adverse effects should I be aware of to report to you?  
• What other options do I have to address my symptoms besides DHEA supplementation? 

Alternatives to DHEA supplements

If you’re experiencing symptoms that may not benefit from DHEA supplements or your provider is concerned about DHEA side effects, there are other ways to balance your hormones and address symptoms. 

For example, lifestyle changes like eating a balanced diet, exercising regularly, using stress management techniques, and limiting the use of alcohol and other substances can be beneficial in balancing hormones and reducing symptoms of perimenopause.  

>>MORE: Perimenopause Treatment: 9 Ways to Find Relief (And How to Know It’s Working)

If you’re looking for medical intervention, hormone replacement therapy (HRT) can help manage symptoms by supplementing declining hormones. Be sure to consult with a healthcare provider to ensure HRT is right for you.

DHEA supplements: the bottom line

DHEA is a precursor hormone (pre-hormone) to key sex hormones such as estrogen, progesterone, and testosterone in both men and women. As DHEA declines naturally as we age, DHEA supplementation has gained a lot of attention as a potential remedy for aging — including perimenopause. 

While research has shown that DHEA supplementation can be beneficial for some individuals, comprehensive research on its long-term effects and efficacy in alleviating perimenopausal symptoms is limited. 

Make sure to talk with your healthcare provider to explore personalized DHEA supplementation or alternative treatment options for managing your symptoms.