Dehydroepiandrosterone (DHEA) is a precursor to testosterone and estrogen produced by the adrenal glands. There are definite pros and cons for the use of DHEA for women. Some of the positive reasons for taking this hormone may include improved energy, increased spinal bone density, easing of menopausal symptoms, and increased libido. The negative aspects of DHEA for women may include growth of facial hair, a deepening voice, an increased risk of breast cancer or heart disease, and acne and skin thickening. DHEA supplements are not generally recommended by doctors, and those who do prescribe them do so at much lower doses.
DHEA is at its highest when a person is in her 20s, and it declines with age. Scientists do not know exactly why this happens, but some think supplementing with the hormone may reduce the effects of aging. As part of a study done by the Mayo Clinic, men and women age 60 and over took DHEA for two years. Even though the participants' DHEA blood levels were comparable to those of a young adult, none of the test subjects showed improvement in insulin sensitivity, quality of life, percentage of body fat or physical performance, all of which are hallmarks of aging. Some nutritional companies still insist that this hormone will turn back the hands of time, but there is not much evidence to support this broad claim.
Increased energy and well-being may be a positive effect of DHEA for women. The University of Maryland Medical Center found that DHEA raised energy levels of women with chronic fatigue syndrome. The women in the study took 50 to 200 mg of DHEA daily. Research done by the University of Michigan Health System found that women with documented adrenal insufficiency and depleted DHEA levels may benefit from a 50-mg supplement every day.
Improved spinal bone density may be another good reason to recommend DHEA for women. Saint Louis University carried out a two-year study on the effects of DHEA on the bone density of the spine. The study revealed that bone density of study participants increased by 2 percent when DHEA was taken with vitamin D and calcium supplements. NYU Langone Medical Center found that the hormone might be beneficial for women over 70 who are fighting osteoporosis. It may also help prevent osteoporosis in women of all ages with anorexia.
DHEA for women may ease symptoms of menopause. The University of Michigan Health System found that DHEA for women particularly helps reduce the symptoms of emotional lability, or sudden mood swings, such as crying for no apparent reason. They hypothesize that the hormone allows the brain to be more responsive to a woman's natural endorphins—the "feel-good" hormones. Researchers caution that using the hormone for menopausal symptoms should only be done under the supervision of a doctor.
The New England Journal of Medicine reported on a German study in which scientists looked at the effects of DHEA on libido in women diagnosed with adrenal insufficiency. After four months of treatment with 50 mg of daily DHEA, the women reported a stronger sex drive and greater satisfaction as well as fewer episodes of anxiety and other psychological issues.
The downside of DHEA for women was evident in this German study when about 20 percent of participants reported side effects of acne, oily skin, unwanted body hair, and some loss of hair on the head. Most studies show side effects appear when women take 25 to 50 mg of the supplement per day. With 100 mg per day, the voice may deepen and facial hair may become thicker. Even higher doses may cause liver damage, an increased risk of breast or ovarian cancer, and heart disease. Interestingly, researchers who ran the two-year Mayo Clinic study found no side effects that they considered clinically significant.
Most doctors discourage the use of DHEA for women unless there is a documented hormonal deficiency. Alternative health care practitioners who prescribe DHEA recommend much lower doses than are available over-the-counter. Women often begin with a prescription of just 5 mg per day. Both conventional and alternative doctors advise taking the supplement only under the supervision of a medical professional.
What Does DHEA Do for Women With Autoimmune Diseases?
Autoimmune diseases, instances when a person's immune system attacks various parts of his or her own body, are widespread. Although these disorders of the immune system affect all sexes, they affect biological women at a much higher rate. Several studies and clinical trials have been completed and are ongoing to investigate the effectiveness of DHEA supplementation in the treatment of autoimmune disease. Although results are far from conclusive, DHEA does appear to have some potential benefits in mitigating symptoms that are common to the majority of autoimmune diseases.
DHEA and Inflammation
Systemic inflammation is an issue for those suffering from a wide swathe of autoimmune diseases including lupus, rheumatoid arthritis and Hashimoto's disease. In studies completed by the National Center for Biotechnology Information, supplementation with DHEA has shown some efficacy in addressing chronic inflammation by inhibiting inflammatory cytokines.
DHEA and Chronic Fatigue
Although increased and sometimes debilitating levels of fatigue have been directly associated with autoimmune disorders like chronic fatigue syndrome, it is a commonly reported symptom for many autoimmune diseases. This fatigue can be linked to adrenal fatigue which is common in autoimmune patients and has been linked to low levels of DHEA. In a recent pilot program using DHEA supplementation, the NCBI reported a 21% decrease in fatigue in CFS patients.
DHEA and Systemic Dryness
Vaginal dryness is a common complaint of menopausal women but is often experienced by women of all ages who are dealing with autoimmune issues. Many women hesitate to discuss this issue with their physicians; however, there are effective treatments that can help.
To address vaginal dryness or atrophy, DHEA is commonly given in the form of a suppository and can offer significant relief without risking an unsafe rise in estrogen levels. Additionally, intravaginal DHEA treatment may offer a solution for the decreased levels of sexual sensitivity that often go hand in hand with vaginal atrophy; a benefit that is not produced with other hormonal supplementation or treatments.
How Much DHEA Should a Woman Take for Fertility?
Women should note that taken on its own, outside of an integrated fertility treatment plan, DHEA is not likely to have a significant effect on conception. When DHEA is used to address issues of infertility, it is commonly done under a doctor's supervision and as a precursor to IVF.
Since the most common cause of infertility in otherwise healthy women is a decrease in egg supply, the DHEA is suggested to help stimulate underactive ovaries in the weeks before an IVF procedure. The most commonly recommended dosage is 25mg taken three times daily to provide a consistent level of stimulation throughout the day, though a physician may well adjust that dosage depending on several factors affecting a specific patient.
Is DHEA Safe for Women?
Dhea is a naturally occurring substance in the body. Taken in low doses, the risks appear minimal; however, the studies that have identified potentially grave side effects should not be ignored. Women dealing with serious health issues such as depression, infertility or adrenal insufficiency who feel they may find some relief with DHEA should discuss with their doctors whether the benefits merit the risks.
Potential Drug Interactions
DHEA is suspected to have negative interactions with several prescription medications or to cause some pharmaceuticals to be less effective. Some contraindicated combinations might be:
- Combining DHEA with estrogen may lead to an overabundance of estrogen or estrogen dominance.
- It is not recommended to take DHEA when a patient is already supplementing their testosterone levels as it can cause imbalances that result in males or females taking on characteristics generally associated with the opposite sex.
- DHEA may make antipsychotics less effective
- Many anti-seizure medications may become less effective when combined with DHEA.
- Taking DHEA along with benzodiazepines may lead to potentially dangerous levels of sedation.
- Combining SSRIs with DHEA may result in the onset of manic behaviors.
If you are already on one or more medications, it is crucial that you speak with your physician before adding DHEA or any other supplement to your treatment regimen. Even natural substances have the potential to cause reactions and side effects or to reduce efficacy when taken with certain medications.
Possible Cancer Risks
Perhaps the most concerning side effect that has been posited by studies pertains to the possibility that DHEA supplementation has the potential to contribute to hormone-related cancers including breast cancer and ovarian cancer. Since DHEA is itself a steroid hormone as well as the precursor to other hormones, the Mayo clinic has suggested that it be avoided by women who currently have cancer, a family history of cancer or a genetic predisposition to cancer.
What Does DHEA Do for Women?
- Menopause — The research about DHEA and menopause is mixed. Some studies suggest that DHEA supplementation alleviates menopause symptoms. Other studies have shown no relief of menopause symptoms and an increased risk of hormone-related cancers such as breast, ovarian and uterine cancer.
- Metabolic disease — DHEA helps lower the amount of abdominal fat you have and improves your resistance to insulin. It can also decrease the inflammation in your arteries.
- Major depressive disorder — In a few studies, DHEA has been shown to improve the symptoms of depression.
- Improved libido — Studies have shown that DHEA vaginal suppositories can increase libido in older women.
- Lupus — DHEA increases the quality of life for lupus patients. It may lower the number of flare ups you have, increase your bone mass and improve your mental status.
- Adrenal insufficiency — DHEA is one of the hormones created in the adrenal glands. Many studies have shown that DHEA can improve your mood, reduce fatigue, and increase your sense of well-being. It can reduce feelings of anxiety and depression.
How Much DHEA Should a Woman Take Daily?
DHEA doses vary widely depending on what condition you’re trying to treat. Studies on DHEA supplements have used doses from 25 to 200 milligrams. It’s important to only take DHEA under a doctor’s care. Side effects can include:
- Hormonal changes — Women can start taking on more masculine traits, including facial and body hair or a lower voice.
- Hair loss — This may be another masculine trait. You may experience loss of your hair on top of your head.
- Worsening of mental illness — DHEA may have a profound effect on women who have mental illness. It can cause delusions, paranoia, psychosis, aggression, hypomania and disinhibition.
- Drug interactions — DHEA reacts badly with several types of medication, including:
- Antipsychotic medication, such as Abilify
- Benzodiazepines, such as Klonopin
- Anti-seizure medication, such as Tegretol
- Antidepressant SSRIs, such as Prozac
- Other hormones, such as estrogen
- Anti-coagulants, such as Cumadin
What Are the Symptoms of Low DHEA in Women?
Some of the symptoms of low DHEA in female patients include:
- Heart disease
- Memory loss
- Breast cancer
- Unexplained weight loss
- Nausea and vomiting
Older women may also experience thinning of the vaginal walls, decreased sex drive and bone loss. Studies are mixed, but some have shown that older women supplementing with DHEA have an increased libido.
Women with low DHEA levels may have one of two disorders that can be managed with medication and careful monitoring by medical professionals.
Addison’s is also known as adrenal insufficiency. It happens when your adrenal glands don’t produce enough hormones, including DHEA. If it gets bad enough, it can be life-threatening. Treatment involves taking medication, usually for the rest of your life.
Symptoms of Addison’s disease include:
- Severe fatigue
- Low blood pressure and fainting
- Nausea, diarrhea, and vomiting
- Sudden weight loss and lack of hunger
- Muscle and joint pain
Addison’s is usually diagnosed with blood and imaging tests. These tests include:
- Blood analysis
- An ACTH stimulation test, where this hormone is injected and your cortisol levels are measured
- An insulin-induced hypoglycemia test, where insulin is injected and your blood sugar and cortisol levels are checked
- A CT scan to let doctors look at your adrenal glands and check for abnormalities
Hypopituitarism occurs when your pituitary gland isn’t producing enough hormones. This can become serious quickly, depending on which of the seven hormones aren’t being produced in sufficient quantities. Treatment involves taking medication for the rest of your life.
Symptoms of hypopituitarism vary based on which hormone is lacking. They include:
- Muscle weakness
- Lack of ambition
- Lower sex drive
- Weight loss or gain
- Hot flashes
- Loss of pubic hair
- Irregular periods
Hypopituitarism is diagnosed with blood and imaging tests. These tests include:
- Blood tests to measure your hormone levels
- Stimulation testing, where you’re injected with hormones before having hormone levels checked
- CT and/or MRI of your brain to let doctors see your pituitary gland and determine whether there’s a tumor causing problems.
- Vision testing to see if a tumor may be causing impaired sight
Research on DHEA is mixed. Some studies show that using it is beneficial in treating different medical conditions. Other studies show it to cause life-threatening side effects such as cancer and an increase in psychological symptoms. Unfortunately, low DHEA can also cause life-threatening conditions such as heart disease and breast cancer. It’s clear that more analysis must be done to determine whether DHEA supplementation is a viable treatment option or if the side effects are just too severe.
How Much DHEA Should a Woman Take?
As a supplement, DHEA has a lot of benefits. Mainly, it can boost your estrogen and testosterone production, which can help combat a number of hormone-related health or aging problems.
There are a few different ways you can take DHEA. Most commonly, you’ll use a cream or oral tablet. However, some women choose to use vaginal inserts for specific issues. Other patients will inject it or take it intravenously.
Currently, there’s no set standard dosage for DHEA. Capsule sizes vary quite a bit, so the amount you’ll take will depend entirely on the ailment you want to treat. There are a few guidelines you can follow for certain conditions, though.
The most common dose is 25-50 mg per day. This is the dosage you’d take for some of the most common problems you’d use DHEA for, including anti-aging and depression. If you choose a cream, you can use a 1% DHEA cream twice a day.
DHEA for Women’s Libido?
Since DHEA directly affects your hormone levels, it’s a logical choice if you need to boost your libido. Specifically, it’s ideal for post-menopausal women currently suffering from broad hormonal changes that can affect libido.
Your body produces DHEA naturally through your adrenal gland. However, those natural levels of DHEA decline as you get older. For that reason, a supplement is a great way to replace what’s lost as you approach and go through menopause. In fact, studies show that it might adequately replace lost DHEA within a year.
For women approaching menopause, you might want to ask your doctor about a DHEA supplement if you feel your libido slipping. It’s possible a supplement might be able to get your DHEA levels back up to pre-menopausal levels, breathing life back into your sex drive.
It’s important to remember that studies show an increased sex drive in peri- and post-menopausal women who use DHEA. There’s little evidence to suggest younger women would have the same outcome. If you’re young and feel your sex drive is low, you should talk to your doctor about potential causes.
DHEA Supplements for Women
DHEA supplements come in many forms. Most women will take DHEA in pill form to treat a decreased libido, but there are certain risks and side effects to be aware of if you decide to do so.
First, since DHEA is a hormone, it can cause side effects similar to period symptoms. For example, you might experience a disrupted cycle, acne, mood imbalances, headaches, or fatigue.
Similarly, if you have heart, liver, or kidney problems, you should avoid DHEA until you talk with your doctor. Although it could be an excellent tool for increasing your libido, your doctor might have another path in mind that better suits your healthcare needs.
Finally, if you take any medications regularly, confirm with your doctor that there won’t be any negative interactions when you take a supplement. You want your DHEA to work to its full capacity. If it interacts negatively with an existing medication, you could see the exact opposite effect.