2018 Update: This has been one of my most popular articles over the years, and the data for DHEA and women has only improved since writing it circa 2010. For example, a recent study (J.Endocrine. 2018 Oct 11.) found DHEA supplements improved sexual function in premenopausal women, mostly likely due to the bump in testosterone levels, although DHEA may have additional benefits not directly associated with it’s conversion to T in women. I have posted that new study at the end of this article for those interested.
DHEA; The Most Underrated Supplement For Women?
Have you ever noticed if a supplement, drug, etc is tried in men, and fails to work, it’s written off as being ineffective? Although improving, it’s well known that men have been the standard subjects in research, with the results often being applied to women as an afterthought. In recent years, that situation has improved and women are viewed as the physiologically distinct people they are from men, and studies looking at specific effects in women – using women as the test subjects – has grown dramatically. That’s the good news at least. The bad news is, there’s still plenty of research out there done on men, being applied to women, sometimes to the detriment of women. Obviously, men and women are not so different that a great deal of research fails to be perfectly applicable to both sexes, but the fact remains a great deal of prior research was done looking at men, and the results, good or bad, applied to women more as an after thought.
Such is the case with DHEA in my view…
What is it?
Dehydroepiandrosterone (DHEA) has been around as a supplement for a long time, so I’m not going to go into great depth on in this article as there’s a ton of info out there already on DHEA and it’s fully covered in my ebooks. To quickly summarize: DHEA is a hormone produced primarily in the adrenal glands with minor amounts produced by the testes. It is found in both men and women. DHEA is the most abundant steroid hormone in the human body, and like all steroid hormones, ultimately comes from cholesterol. Most DHEA in the body is found as DHEA-sulphate (DHEA-S). DHEA is a major precursor to other steroid hormones. That’s the basic run down of DHEA.
From a strictly health perspective…
From a strictly health perspective – for those deficient due to aging or other causes – DHEA appears beneficial when used as a supplement for general health and well being in both sexes. It’s well established that DHEA levels fall off as we age, and the research on health uses of DHEA justifies using small amounts to counter this age related drop off or deficiencies from other causes. DHEA levels rise slowly till they peak at around 30 years of age, and decline steadily after age 35, with levels reduced by 70-80% by age 75. This effect is one of the most consistent and predictable changes in aging known with lower endogenous levels of DHEA/DHEA-sulfate found in advancing age strongly correlated with a myriad of health conditions best avoided.(1) For example, levels of DHEA and or DHEA-s in older men is strongly predictive of death by cardio vascular disease .(2)
Only blood tests will tell a person what their DHEA/DHEA-s levels are and where they are compared to others in their age group. As this is not an article focused on the potential health benefits of DHEA in deficient populations, that’s all I’m going to say on the matter here.
What about DHEA as a “muscle builder” in healthy young men?
DHEA often gets marketed as a “muscle builder” to men. As a muscle building supplement in young healthy men, DHEA is essentially worthless, and high intakes may in fact be counter–productive to gaining muscle as high doses also cause an increase in estrogen and the effects on testosterone are minimal. Studies have been conflicting in this area at best, and most “real world” users report no improvements in strength, muscle mass, etc from using DHEA. So, for healthy young men with normal DHEA levels, it’s a bust as a “muscle builder” due to the fact it converts to testosterone poorly and raises estrogens levels when used at high doses.
“What About Us Women Will?!”
OK, this finally brings us to women and DHEA after the long winded intro above, but finally, here we are! Although the research in men using DHEA has been unimpressive and contradictory, such is not the case with women. In women, research using DHEA is much more consistent and compelling and there appears to be some gender specific responses to DHEA use.(3)
As a supplement that can improve mood, libido, memory, and possibly alter body composition (i.e., increase muscle, improve bone density, and reduce bodyfat), DHEA appears to be a winner for women. Most of the research has been done in DHEA deficient populations, but data – and real world experience- suggests it’s also a benefit to women not medically deficient in this hormone. Although the benefits of this hormone to women comes predomently from its conversion to testosterone, it also appears some of the effects may be due to other mechanisms.(4). One recent study concluded:
“The use of DHEA therapy may also be discussed in women of any age when a trial of androgen supplementation seems justified because of the existence of an inhibited sexual desire or a sexual arousal disorder associated with documented androgen deficiency. The rather weak conversion of DHEA into testosterone protects from the risk of overdosing associated with testosterone preparations.”
Side Bar: Testosterone myths. Testosterone is often viewed as a “male” hormone. Although testosterone is the dominant androgen in men, it’s a hormone essential to the health and well being of both sexes, just as men produce and require some estrogen. How important can this hormone be to women? Karlis Ullis, MD, a faculty member of the UCLA School of Medicine, who treats women with hormone imbalances states:
“It is clear to me, both from my clinical practice and from research, that testosterone is vital for women to preserve their lean mass and to prevent obesity. Not only will testosterone help mobilize body fat and negate some of the fat storing effects of estrogen, it is also extremely effective in building lean mass in women – even at small doses. Hormone replacement therapy that only includes estrogen and progesterone but leaves out testosterone is a curse of many a women’s fat loss program. This is not only a concern for postmenopausal women. Young women should think twice about using birth control pills. Birth control pills elevate estrogen and progesterone levels while drastically lowering testosterone levels. This is reason why many women experience large gains in fat as well as a decreased libido when using birth control pills.”
In women with established adrenal insufficiency, studies find 50mg DHEA corrects low serum concentrations of DHEA/DHEA-S, and brings testosterone into the “normal” range. With one recent study finding “DHEA treatment significantly improved overall wellbeing as well as scores for depression, anxiety, and their physical correlates. Furthermore, DHEA significantly increased both sexual interest and the level of satisfaction with sex.”(5)
Are there any side effects to DHEA use for women? Generally, they are easily dealt with by lowering the dose and “… are mostly mild and related to androgenic activity of DHEA in women and include increased sebum production, facial acne, and changes in hair status.” (6)
In my experience, the above is related to dose. The low-normal dose recommended (see below) rarely if ever causes side effects, but there’s no free lunch in biology, and adjusting any hormone up or down, comes with potential for side effects along with the benefits. The issue – as in the case with any drug, supplement, etc – is whether the benefits outweigh the risks/side effects. As the (potential) benefits of DHEA high, and the side effects at best mild to non existent, my opinion is the risk/benefit ratio is very much in favor of using DHEA, but everyone has to decide for themselves on that score.
Conclusions and Recommendations
Believe me, there’s a lot more research I could cover, but I hope the above covers the essential points regarding DHEA and it’s potential value to women specifically. So, let’s sum it all up: For women over 40, or those with diagnosed adrenal insufficiency (AI), DHEA could be of considerable value to general well being as well as libido, mood, etc. Typical doses are 25 – 50mg and working with a medical professional to fine tune dosages is recommended.
For “normal” women under 40, and or have not been diagnosed with AI, 25 – 50mg seems to do the trick, and starting at the lower dose and assessing over a few months is recommended. Most women will notice improvements in mood, libido, and possibly muscle mass and or bodyfat, at lower doses. The effect is increased at higher doses, but possible side effects mentioned above also become more common. At 50-100mg+, DHEA does act as a mild anabolic agent in women in my experience, and I have seen some fairly impressive results of increased muscle mass and decreased bodyfat at the higher doses, but it’s not dramatic compared to other anabolic hormones used by some female athletes. High doses of DHEA will also elevate estrogen levels, so that too should be kept in mind.
See you in the gym ladies!
(1,3) Cameron DR, Braunstein GD. The use of dehydroepiandrosterone therapy in clinical practice. Treat Endocrinol. 2005;4(2):95-114.
(2) XV International Symposium on Atherosclerosis.
(4) Buvat J. Androgen therapy with dehydroepiandrosterone..World J Urol. Nov;21(5):346-55. – 2003
(5) Arlt W, et al. DHEA replacement in women with adrenal insufficiency–pharmacokinetics, bioconversion and clinical effects on well-being, sexuality and cognition. Endocr Res. 2000 Nov;26(4):505-11.
(6) DHEA: why, when, and how much–DHEA replacement in adrenal insufficiency.Ann Endocrinol (Paris). 2007 Sep;68(4):268-73. Epub 2007 Aug 8.
Effects of dehydroepiandrosterone (DHEA) supplementation on sexual function in premenopausal infertile women.
Endocrine. 2018 Oct 11. doi: 10.1007/s12020-018-1781-3.
To investigate the effects of dehydroepiandrosterone (DHEA) supplementation on female sexual function in premenopausal infertile women of advanced ages.
This observational study was conducted in an academically affiliated private fertility center. Patients included 87 premenopausal infertile women, 50 of whom completed the study including the Female Sexual Function Index (FSFI) questionnaires and comprehensive endocrine evaluation before and 4-8 weeks after initiating 25 mg of oral micronized DHEA TID.
Age of patients was 41.1 ± 4.2 years, BMI 24.4 ± 6.1 kg/m2, 86% were married, and 42% were parous. Following supplementation with DHEA, all serum androgen levels increased (each P < 0.0001), while FSH levels decreased by 2.6 ± 4.4 from a baseline of 10.3 ± 5.4 mIU/mL (P = 0.009). The FSFI score for the whole study group increased by 7% (from 27.2 ± 6.9 to 29.2 ± 5.6; P = 0.0166). Domain scores for desire increased by 17% (P = 0.0004) and by 12% for arousal (P = 0.0122); lubrication demonstrated an 8% trend towards improvement (P = 0.0551), while no changes in domain scores for orgasm, satisfaction, or pain were observed. Women in the lowest starting FSFI score quartile (<25.7), experienced a 6.1 ± 8.0 (34%) increase in total FSFI score following DHEA supplementation. Among these women, improvements in domain categories were noted for desire (40%), arousal (46%), lubrication (33%), orgasm (54%), satisfaction (24%), and pain (25%).
This uncontrolled observational study implies that supplementation with DHEA improves sexual function in older premenopausal women with low baseline FSFI scores.