DHEA Dosing for Women with Low DHEA Levels
For women with confirmed low DHEA levels, the recommended starting dose is 25 mg of DHEA once daily, with a typical dosing range of 10-50 mg daily based on clinical response and monitoring of hormone levels. 1
Patient Selection and Evaluation
- DHEA supplementation is most appropriate for women with persistent lack of libido and/or low energy levels who have confirmed low DHEA levels 2, 1
- Before initiating therapy, baseline hormone levels should be established, including serum DHEA sulphate (DHEAS), androstenedione, and testosterone 1
- DHEA replacement should be considered only after confirming low levels through laboratory testing 1
Dosing Protocol
- Start with 25 mg as a single daily morning dose 1
- Dose range is typically 10-50 mg daily, with adjustments based on clinical response and hormone levels 1
- Treatment should initially be offered as a 6-month trial therapy 1
- Morning measurements of hormone levels prior to DHEA ingestion provide the most accurate assessment for dose adjustment 1
Monitoring Protocol
- Follow-up hormone measurements should be taken in the morning before DHEA ingestion 1
- Serum DHEAS, androstenedione, and testosterone levels should be monitored to guide treatment efficacy 1
- Hormone levels should be maintained within the normal range 1
- Clinical effectiveness should be assessed after 6 months to determine whether to continue therapy 1
Expected Benefits
- Improvements in libido, energy levels, and overall quality of life may be observed in women 1
- DHEA supplementation has shown significant improvements in sexual desire, arousal, pain, and overall sexual function in clinical trials 1, 3
- In women with low DHEAS levels, DHEA supplementation may help improve sexual function compared to placebo 3
Safety Considerations and Side Effects
- Long-term effects of DHEA replacement therapy are not fully known, so treatment should be used with caution 1
- DHEA is associated with androgenic side effects, mainly acne 3
- At higher doses (100 mg daily), DHEA can increase serum levels of androgens above the normal range in women 4
- DHEA should be used with caution in women receiving aromatase inhibitor therapy 1
Special Considerations
- DHEA supplementation may be of particular benefit in two specific groups: women with the lowest circulating levels of DHEA and those for whom osteoporosis is a particular problem 5
- Low-dose DHEA (25 mg) has been shown to positively modulate several endocrine parameters in postmenopausal women, inducing increases in androgenic, estrogenic, and progestogenic hormones 6
- DHEA supplementation should not be prescribed to men who are currently trying to conceive 1
Alternative Options
- For women with sexual dysfunction, other options include flibanserin (FDA-approved for premenopausal women), pelvic physical therapy, and vaginal moisturizers/lubricants 1
- Medically supervised hormone replacement therapy may be a more appropriate approach for those with hormonal deficiencies 7
DHEA supplementation should be discontinued if no clinical benefit is observed after the 6-month trial period 1.