What is the optimal level of Dehydroepiandrosterone (DHEA) for women?

From the Guidelines

The optimal DHEA level for women is not strictly defined, but typical ranges are between 130-980 ng/dL (4.5-34 nmol/L) for premenopausal women and 30-260 ng/dL (1-9 nmol/L) for postmenopausal women, with supplementation considered on a case-by-case basis for those with low levels and symptoms, under medical supervision 1.

Key Considerations

• DHEA levels naturally decline with age, peaking in early adulthood and decreasing by about 2% per year.
• Supplementation should only be initiated after blood testing confirms low levels and under medical supervision, due to potential side effects like acne, hair loss, and hormone-sensitive cancers.
• Vaginal DHEA has been shown to be effective in reducing dyspareunia in postmenopausal individuals, but its use should be approached with caution in survivors receiving aromatase inhibitor therapy, as it may impact treatment efficacy 1.

Supplementation Guidelines

• Typical starting doses for DHEA supplementation range from 5-25 mg daily, taken in the morning.
• Regular monitoring through blood tests every 3-6 months is essential to maintain appropriate levels and adjust dosing as needed.
• The body's response to supplementation varies significantly between individuals, making personalized monitoring and adjustment crucial.

Safety and Efficacy

• The safety of vaginal hormones, including DHEA, has not been firmly established in survivors of estrogen-dependent cancers, and their use should be carefully considered and monitored 1.
• Alternative treatments, such as ospemifene and flibanserin, may be considered for women with sexual dysfunction, depending on their individual needs and medical history.

From the Research

Optimal Level of DHEA for Women

The optimal level of DHEA for women is not clearly established, as it varies depending on factors such as age, menopausal status, and individual health conditions.

• DHEA levels naturally decline with age, and supplementation has been considered to alleviate symptoms associated with aging 2, 3, 4.
• Studies have shown that DHEA supplementation can be beneficial for women with adrenal insufficiency, low bone mineral density, and sexual disorders 3, 4.
• However, the effectiveness of DHEA supplementation for postmenopausal women with normal hormone levels is still controversial, and more research is needed to determine its potential benefits and risks 2, 5.

Benefits and Risks of DHEA Supplementation

• Potential benefits of DHEA supplementation for women include:
  • Improved quality of life and mood 2
  • Enhanced sexual function and libido 3, 4
  • Increased bone mineral density 3, 4
  • Improved metabolic parameters and insulin sensitivity 3, 4
• Potential risks and side effects of DHEA supplementation include:
  • Androgenic and estrogenic side effects 2
  • Increased risk of cardiovascular disease and all-cause mortality with high doses or long-term use 4

Current Recommendations and Future Research

• Current recommendations for DHEA supplementation in women are limited, and more research is needed to establish its safety and efficacy 3, 6.
• Large-scale randomized controlled trials are necessary to determine the optimal dosing protocols and indications for DHEA supplementation in women 4.
• The potential value of oral DHEA therapy for postmenopausal women is still uncertain, and vaginal administration may be a more effective approach for improving vaginal atrophy and sexual function 5.