Do Not Use Supplements to Increase Female Hormones
The Endocrine Society explicitly recommends against the generalized use of DHEA and testosterone supplements in women, and there is no evidence supporting other supplements for increasing female sex hormones 1, 2.
Why Supplements Are Not Recommended
DHEA (Dehydroepiandrosterone)
- The 2014 Endocrine Society guideline strongly recommends against generalized DHEA use in women due to inadequate indications and lack of efficacy and long-term safety data 1
- DHEA may only be considered in very specific circumstances: women with primary adrenal insufficiency who have persistent low libido, depression, or low energy despite optimized treatment 3
- Even in adrenal insufficiency, routine DHEA therapy is not recommended due to limited effectiveness and safety data 1, 3
- For healthy postmenopausal women, systematic reviews show DHEA does not provide substantial clinical benefit for libido or wellbeing 4
Testosterone
- There is no recognized "androgen deficiency syndrome" in healthy women - the Endocrine Society explicitly states this diagnosis should not be made because no well-defined syndrome exists and data correlating androgen levels with symptoms are unavailable 1
- Testosterone therapy is only suggested for one specific indication: postmenopausal women with hypoactive sexual desire disorder (HSDD) who have no other identifiable causes 1, 5
- For all other uses (infertility, cognitive function, cardiovascular health, metabolic function, bone health, or general wellbeing), testosterone is not recommended due to lack of clear indications and absence of long-term safety data 1
"Bioidentical" and Compounded Hormones
- Compounded "bioidentical" hormone preparations cannot be recommended because they lack FDA oversight, have no evidence for efficacy or safety, and contain inconsistent doses 6, 5
- These preparations are not subjected to quality control standards that pharmaceutical products must meet 6
What About Herbal Supplements?
While some research suggests potential benefits from certain botanicals, the evidence is weak:
- Tribulus terrestris showed some improvement in sexual function in meta-analysis, but this does not translate to "increasing female hormones" 7
- Phytoestrogens (soy-based supplements) have minimal effects - they may modestly reduce hot flashes by 10-20%, but do not reliably increase hormone levels and carry uncertain breast cancer risks 8
- Most herbal products claiming to boost female hormones lack rigorous safety and efficacy data 7, 9
Critical Pitfalls to Avoid
- Do not confuse symptom relief with hormone replacement - some supplements may improve specific symptoms without actually increasing hormone levels
- Avoid testosterone preparations formulated for men - these result in supraphysiologic levels and are explicitly not recommended 1, 5
- Do not use testosterone pellets or injections - these produce excessive, uncontrollable hormone levels 5
- Measuring hormone levels routinely is not recommended in healthy women because symptoms do not correlate reliably with testosterone levels 1
The Only Appropriate Approach
If a woman has bothersome symptoms potentially related to hormones:
- Identify the specific symptom (hot flashes, sexual dysfunction, mood changes)
- Rule out other medical causes before attributing symptoms to hormones
- For menopausal symptoms: FDA-approved menopausal hormone therapy (estrogen ± progesterone) is appropriate for women under age 60 or within 10 years of menopause without contraindications 10
- For sexual dysfunction: Only consider testosterone if diagnosed with HSDD after excluding other causes, using FDA-approved preparations that maintain physiologic female hormone ranges 1, 5
- For adrenal insufficiency: DHEA may be trialed only if libido/mood issues persist despite optimized glucocorticoid and mineralocorticoid replacement 3
Bottom line: Over-the-counter supplements marketed to "increase female hormones" are not supported by medical evidence and are explicitly recommended against by endocrine guidelines.