From the Guidelines
DHEA (dehydroepiandrosterone) can be considered for women with perimenopause experiencing vaginal dryness or pain with sexual activity, as it has been shown to reduce dyspareunia in postmenopausal individuals. According to the NCCN guidelines 1, vaginal androgens like DHEA can be effective in reducing symptoms of vaginal dryness and pain. However, it's essential to use DHEA with caution, especially in survivors receiving aromatase inhibitor therapy, as it may impact the activity of these medications.
The benefits of DHEA in perimenopausal women include:
- Reducing dyspareunia (painful intercourse)
- Improving sexual desire, arousal, and overall sexual function, as shown in a randomized controlled trial of 464 survivors of breast or gynecologic cancer 1
- Potential improvements in vaginal atrophy, although the evidence is uncertain 1
When considering DHEA supplementation, it's crucial to:
- Use pharmaceutical-grade supplements for purity and consistency
- Monitor hormone levels through blood tests before starting and periodically during treatment
- Be aware of potential side effects, including acne, hair growth, and effects on hormone-sensitive conditions
- Use DHEA under medical supervision, as it is not FDA-approved for perimenopausal symptoms
In the context of perimenopause, DHEA may be a viable option for women experiencing sexual dysfunction, particularly those with vaginal dryness or pain. However, the decision to use DHEA should be made on a case-by-case basis, taking into account individual health status, medical history, and potential interactions with other medications.
From the FDA Drug Label
INDICATIONS: Temporarily supports the body to rebalance Adrenal and DHEA output. Symptoms of imbalanced Adrenal and DHEA may include: low energy, depression, anxiety, dry eyes, skin, and hair, loss of head hair. The role of DHEA in a woman with perimenopause is to temporarily support the body in rebalancing Adrenal and DHEA output, which may help alleviate symptoms such as:
- Low energy
- Depression
- Anxiety
- Dry eyes, skin, and hair
- Loss of head hair 2
From the Research
Role of Dehydroepiandrosterone (DHEA) in Perimenopause
- DHEA is one of the main precursors of androgens, which are converted to testosterone and estrogins 3.
- The administration of DHEA may increase estrogen and testosterone levels in peri- and postmenopausal women to alleviate symptoms and improve general wellbeing and sexual function 3.
- DHEA supplementation has been found to improve sexual function in postmenopausal women compared to placebo 3, 4.
- However, the effectiveness of DHEA in improving quality of life and menopausal symptoms is still uncertain 3, 5.
- DHEA supplementation may be beneficial for women with adrenal insufficiency, low bone mineral density, and sexual disorders 4.
- Vaginal DHEA has been proposed as a treatment for vaginal atrophy, but more independent studies are needed to confirm its effectiveness 6.
Potential Benefits and Risks
- DHEA supplementation may be associated with androgenic side effects, such as acne 3.
- There is no evidence that DHEA improves quality of life, but it may slightly improve sexual function compared to placebo 3.
- The use of DHEA is still controversial, and more research is needed to determine its effectiveness and safety 3, 4, 5.
- DHEA supplementation may affect the lipid profile, but does not improve perimenopausal symptoms or well-being compared to placebo 7.
Specific Groups of Women
- DHEA supplementation may be beneficial for women with the lowest circulating levels of DHEA and those with osteoporosis 5.
- Postmenopausal women with coexisting estrogen deficiency may benefit from DHEA supplementation, but the effectiveness is still controversial 4.
- Premenopausal women with sexual disorders and low libido may also benefit from DHEA supplementation 4.