What is Dehydroepiandrosterone (DHEA)?

From the Guidelines

Dehydroepiandrosterone (DHEA) is a hormone that can be considered for vaginal dryness or pain with sexual activity, particularly in postmenopausal individuals, as it has been shown to be effective at reducing dyspareunia.

Definition and Use of DHEA

DHEA is a hormone naturally produced by the adrenal glands that serves as a precursor to both male and female sex hormones, including testosterone and estrogen. As a supplement or medication, DHEA is used to address age-related hormone decline, improve energy levels, enhance immune function, or support sexual health. The body converts DHEA into other hormones as needed, which is why some people take it for various purposes, including sexual dysfunction.

Efficacy and Safety of DHEA

While DHEA supplements may benefit certain individuals with adrenal insufficiency or those with significantly low levels, scientific evidence for its effectiveness in healthy adults remains mixed 1. A randomized controlled trial of 464 survivors of breast or gynecologic cancer showed that vaginal DHEA led to significant improvements in sexual desire, arousal, pain, and overall sexual function 1. However, safety data for the use of androgen-based therapy in survivors of hormonally mediated cancers are limited, and DHEA should be used with caution in survivors receiving AI therapy 1.

Potential Side Effects and Interactions

Potential side effects of DHEA include acne, hair loss, hormone-dependent cancers, and interactions with medications. Before starting DHEA supplementation, consulting with a healthcare provider is essential to determine if it's appropriate based on your hormone levels, medical history, and current medications 1. In women with primary adrenal insufficiency (PAI), adrenal androgen can be replaced by oral DHEA tablets, often 25 mg as a single daily dose guided by serum DHEA sulphate (DHEAS), androstenedione and testosterone levels 1.

Key Considerations

• DHEA can be effective for reducing dyspareunia in postmenopausal individuals.
• Safety data for androgen-based therapy in survivors of hormonally mediated cancers are limited.
• DHEA should be used with caution in survivors receiving AI therapy.
• Consulting with a healthcare provider is essential before starting DHEA supplementation.

From the FDA Drug Label

Dehydroepiandrosterone (DHEA) ACTIVE INGREDIENTS Dehydroepiandrosterone (DHEA)

• Dehydroepiandrosterone (DHEA) is a medication used for the temporary relief of various symptoms, including hot flashes and decreased sexual desire 2.
• Key points about DHEA include:
  • It is an active ingredient in certain medications 2
  • Its use is indicated for temporary relief of specific symptoms 2

From the Research

Definition and Production of DHEA

• Dehydroepiandrosterone (DHEA) is an androgen produced by the zona reticularis of the adrenal gland 3.
• It is also secreted in smaller amounts by the brain, skin, testes, and ovaries 4.
• DHEA is the most abundant circulating steroid in humans and can be converted into other hormones, including estrogen and testosterone 4.

Role and Effects of DHEA

• DHEA plays a crucial role in a wide range of physiological responses, including metabolism, quality of life, and sexuality 3, 5.
• It has been characterized as a pleiotropic "buffer hormone" with receptor sites in the liver, kidney, and testes 4.
• DHEA deficiency is associated with morbidity, including adverse impacts on metabolic function, quality of life, and sexuality 3.
• Beneficial effects of DHEA supplementation have been demonstrated, including improved quality of life, body composition, bone health, and metabolic markers 3, 6.

DHEA Supplementation and Replacement

• DHEA supplementation is not considered essential for life and is therefore not routinely replaced in adrenal failure 3.
• However, replacement of zona reticularis function by DHEA is of considerable interest, particularly in patients with adrenal insufficiency (AI) 6.
• Available studies have demonstrated beneficial effects of DHEA on health perception, vitality, fatigue, and (in women) sexuality 6.
• The optimal dose and duration of DHEA replacement in adrenal failure are still unclear, and large trials are needed to fully explore its role in the treatment of AI 6.