Perimenopause can feel like a whirlwind—shifting hormones, unexpected mood swings, low energy, and diminishing libido are just a few common complaints. While estrogen and progesterone usually get the spotlight, another important player in hormonal health often gets overlooked: DHEA.
Short for dehydroepiandrosterone, DHEA is a hormone naturally produced by the adrenal glands. It serves as a building block for both estrogen and testosterone, making it highly relevant during perimenopause when these sex hormones begin to fluctuate.
Let’s explore what DHEA is, how it changes with age, its potential benefits for women in perimenopause, and how to use it safely.
What is DHEA and What Does It Do?
DHEA is often referred to as a precursor hormone because the body converts it into estrogen and testosterone—both critical for women’s reproductive and overall health. DHEA also supports other body functions, including:
-
Mood regulation
-
Energy levels
-
Cognitive function
-
Immune system support
-
Skin integrity
Because of its broad influence, DHEA is sometimes considered a part of natural hormone therapy. It’s available in supplement form, and some formulations are FDA-approved for specific medical uses, like treating vaginal atrophy in menopause.
How DHEA Levels Change with Age
Women typically reach peak DHEA production in their mid-to-late 20s, after which levels gradually decline—dropping by as much as 80% by the time they reach their 70s. This decline usually becomes noticeable in the late 30s and 40s, aligning with early perimenopausal changes.
The reduction in DHEA contributes to common perimenopausal symptoms:
-
Fatigue
-
Lower libido
-
Mood swings or irritability
-
Decreased bone density
Since DHEA helps maintain estrogen and testosterone production, its decline can amplify hormonal imbalances already occurring during perimenopause.
Potential Benefits of DHEA in Perimenopause
Supplementing with DHEA may help restore some balance and reduce uncomfortable symptoms. Here’s what some research and clinical observations suggest:
Mood Support:
DHEA may positively affect mood, especially for women experiencing mild depression or irritability linked to hormonal changes. It may improve mental clarity, stress resilience, and emotional stability.
Energy and Vitality:
Many women report increased energy and motivation when using DHEA, potentially due to its influence on mitochondrial function and cortisol regulation.
Libido Enhancement:
Because DHEA helps generate testosterone, it may improve sexual desire, arousal, and satisfaction, especially in women struggling with low libido during perimenopause.
Bone Health:
DHEA has been linked to bone density support, helping to counteract the loss of estrogen and reduce the risk of osteoporosis.
Skin and Aging:
Topical and oral DHEA formulations can improve skin hydration, thickness, and elasticity, making it a potential tool for anti-aging support during hormonal decline.
Risks and Who Should Avoid It
While DHEA shows promise, it’s not for everyone—and using it without guidance can lead to unwanted side effects.
Who Should Be Cautious or Avoid It
-
Women with PCOS (Polycystic Ovary Syndrome): DHEA can worsen androgen dominance and related symptoms like acne, hair growth, or irregular periods.
-
History of Hormone-Sensitive Cancer: If you’ve had breast, ovarian, or uterine cancer, DHEA may not be safe due to its role in estrogen/testosterone production.
-
Unmonitored Self-Dosing: High doses can lead to side effects such as acne, hair loss, irritability, and hormonal imbalances.
DHEA is a hormone, not just a supplement, and should be approached with the same caution as other hormonal therapies.
How to Talk to Your Doctor About Trying DHEA
If you’re curious about DHEA and its role in natural hormone therapy, the first step is an informed, open discussion with a healthcare provider. Connect with a qualified healthcare provider through Heally
Here’s what you can expect:
-
Lab testing: A simple blood or saliva test can measure your DHEA-S (the sulfated form of DHEA) levels.
-
Discussion symptoms and goals: Clarify what you’re experiencing—whether it’s fatigue, low libido, or mood swings.
-
Exploration safe supplementation: If your levels are low and your doctor believes DHEA is appropriate, they can help you find the right dose and form (oral, topical, or vaginal).
-
Monitoring: Hormone levels should be rechecked periodically to ensure safety and effectiveness.
Sources
- Cochrane Database of Systematic Reviews: Dehydroepiandrosterone for women in the peri- or postmenopausal period
- Menopause: Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness
- Menopause: Intravaginal dehydroepiandrosterone (Prasterone), a highly efficient treatment of vaginal atrophy
- Journal of Steroid Biochemistry and Molecular Biology: Comparison of intravaginal 6.5 mg prasterone, conjugated equine estrogens, and estradiol on symptoms of vulvovaginal atrophy
- Journal of Clinical Endocrinology & Metabolism: Neurobiology of DHEA and effects on sexuality, mood and cognition
- Springer Nature: Dehydroepiandrosterone sulphate and bone mineral density
- Journal of Clinical Endocrinology & Metabolism: Neurobiology of DHEA and effects on sexuality, mood and cognition
- Archives of Osteoporosis: DHEA in bone: the role in osteoporosis and fracture healing
- Journal of Women’s Health: Effect of dehydroepiandrosterone supplementation on bone mineral density in older adults
- Menopause: Higher DHEA-S levels are associated with depressive symptoms during the menopausal transition
Disclaimer
The information provided in this article is intended for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting, changing, or stopping any hormone therapy or treatment plan.
Hormone therapy may not be suitable for everyone. Certain medical conditions, family history, or medications may affect your treatment options. Use only prescribed progesterone under professional supervision.
