What Is DHEA?

Dehydroepiandrosterone (DHEA) is the most abundant circulating steroid in the human body. It is made primarily in the adrenal glands, small glands at the top of your kidneys. You can also get DHEA from dietary supplements. DHEA converts to male and female sex hormones, such as estrogen and testosterone.

Levels of DHEA naturally decrease as people age, and by age 70, they can be as low as 10-20% of the levels found in a 25-year-old. Proponents suggest that taking DHEA in supplement form can boost your levels of the hormones estrogen and testosterone and—in turn—protect against health problems associated with hormone imbalances and/or aging-related declines in hormone levels.

This article explains the possible benefits and risks of using DHEA supplements, as well as how to take supplements safely and effectively.

Uses of DHEA

Although it has been suggested to improve everything from sexual function to physical strength and mood, data supporting the use of over-the-counter DHEA supplements is limited. Here’s the latest clinical research on some potential benefits of DHEA.

Pain During Sex

The FDA approved synthetic DHEA in 2016 as a prescription product called Intrarosa (prasterone), a vaginal insert used once a day after menopause to reduce pain during sex. Intrarosa effectively decreased vaginal dryness and pain during sex without causing systemic (body-wide) side effects.

Osteoporosis

Scientific studies evaluating DHEA's effects on bone health have yielded mixed results.

A meta-analysis showed an increased bone mineral density in the hip area in females who were given DHEA. However, this result was not seen in males. More research is needed to assess the potential benefits of DHEA for bone health.

In one study, researchers measured the bone mineral density of healthy males and females. The study found those with the highest blood levels of DHEA had higher bone mineral density (compared to those with the lowest DHEA levels) in the femur (thigh) bone.

Depression

DHEA may help people being treated for depression. A meta-analysis of 15 randomized controlled trials found that, in general, DHEA offered more benefits than a placebo (sugar pill) but not enough to recommend it as a first-line treatment. The analyzed trials were mostly small and had such varying results that more data is needed to recommend DHEA for depression. Doses used in the trials were between 25 and 400 milligrams (mg) per day, with 50 milligrams (mg) daily being the most common regimen. Also, long-term data is lacking, as 12 months was the maximum duration of treatment in the research.

Infertility

A randomized controlled trial of 77 infertile females undergoing in-vitro fertilization (IVF) showed that those over the age of 38 given DHEA supplements were more likely to get pregnant than those who did not receive supplementation. The DHEA dose in this trial was 25 milligrams (mg) three times a day for at least eight weeks before an IVF cycle. Only 20 of the 77 participants received supplementation. More data is needed to support DHEA for this use.

A meta-analysis showed DHEA was associated with an increase in pregnancy versus placebo but had no effect on rate of miscarriage. It's typically suggested that people undergoing the IVF process take DHEA for at least six to eight weeks before the cycle starts and often continue to use it until they become pregnant.

Other Uses

DHEA has been studied for conditions such as aging skin, lupus, adrenal insufficiency, irritable bowel disease, and asthma--but for the most part, trials have been small or inconclusive.

DHEA is said by some to slow the aging process, improve sports performance, address symptoms of sexual dysfunction, and bolster the immune system. These claims are so far not supported by research.

In addition, DHEA supplements are frequently marketed as testosterone-boosting agents and used for such purposes as changing body composition- for instance, increasing muscle mass and reducing fat. Despite aggressive marketing, DHEA's effects on body composition, increased athletic performance, or improved sexual function are inconclusive.

And importantly, the FDA has not approved DHEA as a supplement for treating any condition, although the prescription product has been approved for a specific indication- painful sex after menopause.

What Are the Side Effects of DHEA?

DHEA is a hormone. It should only be used under the supervision of a qualified, licensed healthcare provider. If not used under a healthcare provider's care or if dosed incorrectly, DHEA can cause side effects.

Common Side Effects

Side effects occurred in up to 25% of people in studies who took DHEA for depression and seemed more common in females than males. Common side effects appeared transient (reversible when the supplement is discontinued). They include:

• Greasy or oily skin
• Acne
• Hair loss
• Abnormal or excessive hair growth (hirsutism)

In trials of the prescription vaginal insert Intrarosa, typical side effects include:

• Vaginal discharge 
• Abnormal Pap smears

Severe Side Effects

Case reports have shown the following rare side effects:

• Numbness or paresthesia of the upper extremities
• Restlessness
• Insomnia
• Dry eyes

Additionally, there is a risk of severe side effects such as:

• Prostate cancer 
• Breast cancer
• Gynecomastia or male breast enlargement

It’s recommended that people taking DHEA supplements have blood work done yearly to minimize cancer risk.

Precautions

• Children and pregnant or nursing people should not take DHEA supplements.
• Those with a history of heart disease or stroke should also avoid DHEA supplements.
• DHEA may also alter the production of cholesterol and hormones such as insulin, thyroid, and adrenal hormones.
• People with liver disease, diabetes, high cholesterol, thyroid disorders, blood clotting disorders, and hormonal disorders should take caution when using DHEA.
• People with hormone-sensitive cancers such as prostate, breast, or ovarian should not take DHEA as it converts into estrogen in the body.
• High DHEA levels have been associated with psychotic disorders. People with or at risk for psychiatric disorders should only use DHEA under the supervision of their healthcare provider.
• People with polycystic ovary syndrome (PCOS) as DHEA may worsen this condition.
• Athletes may be eliminated from competitions as DHEA is prohibited by regulating bodies such as the International Olympic Committee, National Collegiate Athletic Association (NCAA), and World Anti-Doping Agency (WADA).
  

Dosage: How Much DHEA Should I Take?

There is no recommended daily allowance for DHEA supplements. There is some evidence to suggest the following dosages for these specific conditions:

• Oral: 30 to 500 milligrams (mg) of DHEA taken by mouth daily for six to eight weeks, either alone or together with antidepressant drugs for depression
• Topical: 1% DHEA cream applied to the face and hands twice daily for up to four months for aging skin
• Vaginal inserts: 0.25% to 1% DHEA used once daily for 12 weeks for vaginal thinning (Intrarosa, a specific vaginal insert containing 0.5% DHEA, is a prescription medicine used for this condition.)

People should take DHEA at bedtime to stimulate the circadian overnight boost in DHEA levels.

What Happens If I Take Too Much DHEA?

Taking 50 milligrams (mg) daily DHEA for up to two years seems safe. But high doses (above 50 or 100 milligrams (mg) daily) or long-term use may increase the risk of severe side effects like cancer.

Interactions

DHEA supplements should not be taken with the following drugs, as they may cause reactions, be harmful to the liver, or interfere with the drug's effectiveness:

• Medicines that treat estrogen-sensitive cancers such as breast, uterine, and ovarian cancer. Examples include aromatase inhibitors- Arimidex (anastrozole), Aromasin (exemestane), and Femara (letrozole)- along with Faslodex (fulvestrant) and Nolvadex (tamoxifen). DHEA may increase estrogen levels in the body and make these cancer treatments less effective.
• Anticoagulant and antiplatelet drugs such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) like Cambia (diclofenac) and Advil (ibuprofen), heparin, Jantoven (warfarin), Plavix (clopidogrel), Eliquis (apixaban), and others. DHEA may also slow blood clotting, causing increased bleeding risk.
• Herbal supplements that change blood clotting, including fish oil, garlic, ginseng, ginkgo, and ginger. If taken with DHEA, these may also increase the risk of bleeding.
• Antidepressants such as Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Celexa (citalopram), Cymbalta (duloxetine), and others. Taking these with DHEA may increase the risk of side effects.
• Medications changed by a liver enzyme called CYP450 3A4, which also helps convert DHEA into sex hormones. Examples are Mevacor (lovastatin), Zocor (simvastatin), Nizoral (ketoconazole), Viagra (sildenafil), Halcion (triazolam), and many others. Taking these medicines with DHEA can increase the risk of side effects.
• Licorice may increase DHEA levels and increase side effects.

Too much DHEA has the potential to cause serious problems. Work with your healthcare provider to ensure that DHEA supplements will not interfere with other medication you might be taking and that you take the correct dose. It is essential to carefully read a supplement's ingredient list and nutrition facts panel to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.

How to Store DHEA

DHEA should be stored at room temperature and discarded based on the expiration date listed on the label. Follow the manufacturer's storage guidelines.

Similar Supplements

Supplements that have been studied for their use in depression include:

• St. John’s wort
• Omega-3 fatty acids
• Folic acid
• SAM-e

Supplements that have been advertised to increase testosterone, but don't necessarily have the scientific data to back that up, include:

• Tribulus terrestris
• Icariin
• Ashwagandha

Supplements that may be used to alleviate vaginal dryness or pain during sex:

• Vitamin C
• Vitamin E
  

Sources of DHEA & What To Look For

DHEA is typically found naturally in the body or in supplement form.

Food Sources of DHEA

There are no known food sources of DHEA.

DHEA Supplements

DHEA supplements are available in many forms--capsules, tablets, liquids, and tinctures. Additionally, people may use DHEA creams for aging skin and vaginal suppositories for vaginal dryness after menopause.

Summary

Low levels of DHEA, a hormone that turns into male and female sex hormones, are associated with various conditions, including depression and menopause symptoms. DHEA supplements can be made from wild yams in the lab, but the benefits of these supplements are not well known. 

Talk with your healthcare professional before using oral or topical treatments containing DHEA to help with depression, vaginal thinning, or improve your skin's appearance.

Be aware of possible interactions with other medications and the risks of taking too much DHEA, which can cause side effects from minor and severe.