What is the role of Dehydroepandelrosterone (DHEA) in a woman with perimenopause?

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From the Guidelines

DHEA should be considered as a potential treatment option for women with perimenopause, particularly for those experiencing vaginal dryness or pain with sexual activity, as it has been shown to reduce dyspareunia in postmenopausal individuals 1. When considering DHEA for perimenopausal symptoms, it is essential to weigh the potential benefits against the limited safety data, particularly for survivors of hormonally mediated cancers.

  • Key benefits of DHEA include:
    • Reducing dyspareunia in postmenopausal individuals
    • Improving sexual desire, arousal, pain, and overall sexual function
  • However, it is crucial to use DHEA with caution in survivors receiving aromatase inhibitor therapy, as it may impact the activity of these medications. Some studies have shown that DHEA can be effective in reducing symptoms, but the evidence is not yet conclusive, and more research is needed to fully understand its effects 1. In clinical practice, DHEA may be considered as an option for women with perimenopause who are experiencing vaginal dryness or pain with sexual activity, but it is essential to carefully evaluate the potential risks and benefits and monitor hormone levels and overall health closely 1.

From the Research

Role of Dehydroepandelrosterone (DHEA) in Women with Perimenopause

  • DHEA is one of the main precursors of androgens, which are converted to testosterone and estrogens 2.
  • The administration of DHEA may increase estrogen and testosterone levels in peri- and postmenopausal women to alleviate their symptoms and improve general wellbeing and sexual function 2.
  • DHEA has been found to improve sexual function in postmenopausal women compared to placebo, with a standardized mean difference of 0.31 2.
  • However, DHEA was found to be associated with androgenic side effects, mainly acne, when compared to placebo 2.

Effectiveness of DHEA in Perimenopausal Women

  • The effectiveness of DHEA in premenopausal women remains unclear, while in postmenopausal women with coexisting estrogen deficiency, it is controversial 3.
  • DHEA supplementation may be effective in women with adrenal insufficiency, postmenopausal women with low bone mineral density and/or osteoporosis, premenopausal women with sexual disorders and low libido, and in women with vulvovaginal atrophy due to menopause or genitourinary syndrome of menopause 3.
  • No serious adverse effects have been reported with DHEA supplementation 3.

Specific Benefits of DHEA

  • DHEA may be beneficial for postmenopausal women with osteoporosis, as it has been shown to improve bone mineral density 4.
  • Local administration of DHEA has been shown to benefit vulvovaginal atrophy in postmenopausal women 5.
  • DHEA may also have benefits for women with primary or secondary adrenal insufficiency, or anorexia, in terms of quality of life and mood 6.

Risks and Side Effects of DHEA

  • High physiologic or pharmacologic use of DHEA can lead to androgenic and estrogenic side effects, which are of concern for long-term administration 6.
  • DHEA was found to be associated with androgenic side effects, mainly acne, when compared to placebo 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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