What Is DHEA?

Dehydroepiandrosterone (DHEA), is a naturally occurring hormone produced by the adrenal glands that is sold in supplement form. The body uses DHEA to produce the female and male sex hormones estrogen and testosterone. As you age, levels of both start to decline, eventually measuring one-tenth to one-twentieth of what would be seen in a 25-year-old.

By taking DHEA in supplement form, some experts believe that you may be able to slow aging, increase muscle mass, improve fertility, or treat medical conditions like osteoporosis and depression. Clinical studies supporting these claims are generally weak.

This article explores the possible benefits and risks of taking DHEA supplements, including side effects and drug interactions. It also offers tips on how to DHEA supplements safely.

What Is DHEA Used For?

Although DHEA is purported to treat or prevent many unrelated medical conditions, the evidence supporting the benefit of DHEA supplements is limited.

Here is what some of the latest clinical research suggests:

Aging Skin

In theory, taking DHEA could slow aging by restoring estrogen and testosterone levels to where they were in your 20s. Both are known to stimulate the production of collagen in the skin. By doing so, the skin may be plumper and have far few wrinkles.

Some studies have suggested that DHEA supplements may help reduce or even reverse thinning skin, also known as skin atrophy. With that said, the studies are generally small—often as small as a single case study—making it hard to draw a reasonable conclusion.

A 2014 review in the journal Drugs could find no clear evidence of an anti-aging effect but stated that large-scale trials could help "support the notion that DHEA is not just an overrated dietary supplement."

Pain During Sex

In 2016, the U.S. Food and Drug Administration (FDA) approved a form of DHEA called Intrarosa (prasterone). This vaginal suppository is applied daily to reduce pain during sex in postmenopausal women.

In clinical studies, Intrarosa has proven to effectively decrease vaginal dryness and pain during sex without causing significant side effects.

Osteoporosis

Osteoporosis is the thinning of bones common in postmenopausal women due to steep drops in estrogen. By restoring estrogen levels, osteoporosis can hypothetically be delayed, prevented, or minimized by DHEA.

To date, studies evaluating the benefits of DHEA in people with osteoporosis have yielded mixed results.

A 2019 review of studies in Gynecology and Endocrinology suggests that DHEA may increase bone mineral density in the hip and thigh bones of females. This effect seemed to increase with the size of the dose.

Even so, not everyone on treatment showed improvement, and no benefits were reported in males. More research is needed.

Depression

DHEA may help some people with clinical depression.

A 2020 review of 15 randomized controlled studies concluded that DHEA had more of a positive effect on people with depression than a sham drug but not enough to recommend it as a treatment. The researchers reported that the quality of the studies was generally low.

Infertility

A 2021 study involving 77 women undergoing in-vitro fertilization (IVF) reported that those over the age of 38 given DHEA supplements were more likely to get pregnant than those who weren't.

The findings were limited by the small study size and the fact that only 20 of the 77 participants received DHEA. No effect was seen in women under 38.

A 2015 review in the Cochrane Database of Systematic Reviews concluded that DHEA may improve the birth rate in females who do not initially respond to IVF but that no other groups seemed to benefit.

Other Uses

DHEA has been studied in the treatment of many unrelated conditions, including lupus, adrenal insufficiency, irritable bowel disease, and asthma. Trials to date have been small, and the results have been inconclusive.

DHEA is said by some to improve sports performance, treat sexual dysfunction, and bolster the immune system. These claims are not supported by research.

DHEA supplements are frequently marketed as testosterone boosters that can help increase muscle mass and reduce fat. Despite aggressive marketing, no solid evidence of this has been found.

What Are the Side Effects of DHEA?

As will all supplements, DHEA can cause side effects. The main concern is the effect that it may have on estrogen or testosterone levels. Raising these hormones may have adverse effects.

Even so, DHEA is generally regarded as safe when taken at doses of 50 mg daily in adults. Higher doses may not be as safe.

Common side effects of DHEA include:

• Oily skin
• Acne
• Upset stomach

When taken at high doses or for longer periods of time, DHEA may cause:

• Male-pattern hair loss
• Abnormal hair growth (hirsutism)
• Abnormal breast growth in males (gynecomastia)
  

Among people who use Intrarosa vaginal suppositories, the most common side effect was a mild vaginal discharge.

Precautions for Taking DHEA

There are certain groups in whom DHEA should be used with caution or avoided entirely:

• Children and pregnant or nursing people should not take DHEA supplements due to the lack of safety research.
• People with a history of heart disease or stroke should avoid DHEA supplements.
• People with liver disease, diabetes, high cholesterol, thyroid disease, blood clotting disorders, and hormonal disorders should only use DHEA under the supervision of a healthcare provider.
• People with hormone-sensitive cancers such as prostate, breast, or ovarian should not take DHEA.
• High DHEA blood levels have been linked to psychotic behaviors. People with psychiatric disorders should only use DHEA under the supervision of a healthcare provider.
• DHEA may worsen symtoms of polycystic ovary syndrome (PCOS) and may need to be avoided.

Athletes who use DHEA can be eliminated from sports competitions according to regulations of the International Olympic Committee (IOC), National Collegiate Athletic Association (NCAA), and World Anti-Doping Agency (WADA).

DHEA Dosage: How Much Should I Take?

DHEA supplements are available in many forms, including capsules, tablets, liquids, tinctures, topical creams, and intravaginal suppositories. The DHEA used for supplements is manufactured in the lab from wild yams. Yams contain a plant-based steroid called diosgenin, which can be converted in the lab into DHEA.

There is no recommended dosage for oral DHEA supplements. Studies have found the following dosages to be safe and tolerable:

• Oral DHEA: 30 to 50 mg taken once daily by mouth
• Intrarose (prasterone): 0.25% to 1% applied once daily for 12 weeks

As a general rule, do not exceed the recommended dose on the product label. DHEA should be stored at room temperature and discarded by the expiration date.

Are There Interactions With Medications?

DHEA supplements should not be taken with the following drugs due to the risk of interactions:

• Medicines used to treat estrogen-sensitive cancers: Including aromatase inhibitors like Arimidex (anastrozole), Aromasin (exemestane), and Femara (letrozole) and estrogen-receptor agonists like Faslodex (fulvestrant) and Nolvadex (tamoxifen)
• Blood thinners: Including aspirin, heparin, warfarin, Plavix (clopidogrel), Eliquis (apixaban), and nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Celebrex (diclofenac)
• Herbal supplements affect blood clotting: Including fish oil, garlic, ginseng, ginkgo, and ginger
• Antidepressants: Includng Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Celexa (citalopram), Cymbalta (duloxetine), and others
• Drugs broken down by a liver enzyme called CYP450: Including Depakote (valproic acid), Mevacor (lovastatin), Zocor (simvastatin), Nizoral (ketoconazole), Viagra (sildenafil), Halcion (triazolam), and many others.
• Licorice: Which can increase DHEA levels along with the risk of side effects

Summary

DHEA is a naturally occurring hormone used to produce estrogen and testosterone. DHEA is also sold as a supplement, which some experts believe can reverse aging, treat osteoporosis and infertility, increase muscle mass, and promote weight loss. To date, the evidence supporting these claims is weak.

The one approved use of DHEA is an intravaginal suppository called Intrarosa (prasterone) used to treat painful intercourse in postmenopausal women.