Quiz time: Do you know what the body needs to make estrogen and androgens (male hormones)?

Answer: It’s a hormone we don’t discuss as much as we should: dehydroepiandrosterone or DHEA. This hormone plays several roles in perimenopause and menopause, so let’s see what they are and how you can take advantage of its benefits.

Read about perimenopause: what women should know

What is DHEA?

DHEA is a hormone made primarily in the adrenal glands (small amounts are made in the ovaries and testes) and transformed to estrogen and testosterone in many of the body’s tissues. The DHEA in the bloodstream exists mainly as DHEAS, which is its sulfated form. Because levels of DHEAS remain stable all day, it's the form that's measured in a blood test.  

Levels of DHEA peak around age 25 and decline significantly between the ages of 20 and 30 and again between 40 and 50. Overall, DHEA levels drop about 80 percent between the ages 25 and 75. Because DHEA is converted to estrogen and androgens, the decline in DHEA-S blood levels explains why menopausal women have low estrogen and often low testosterone levels as well. This is also why use of DHEA supplements may provide some notable benefits for women in their menopausal and postmenopausal years, providing relief from menopausal symptoms. 

If you'd like to learn more about DHEA and its levels, please listen to my podcast interview with Dr. Chris Shade. It's episode #55.

Testing for DHEAS

Before you take any supplements for DHEA, it’s a good idea to have your DHEA levels identified. This involves a blood draw that your doctor can order. The test can be performed any time of the day as DHEAS levels tend to be stable around the clock. You may need to stop taking specific supplements or medications before the test such as drugs for hypertension or diabetes, as they can raise DHEA-S levels. Vitamin E and fish oil may lower them.

Women with high DHEAS levels may experience hair loss, infertility, severe acne, vaginal atrophy, abnormal menstruation, and excessive hair growth. High DHEAS may indicate noncancerous or cancerous adrenal tumors, ovarian cancer, polycystic ovary syndrome (PCOS), or congenital adrenal hyperplasia. Low DHEAS is associated with salt cravings, sexual dysfunction, dizziness, unexplained weight loss, nausea, and vomiting, as well as indicate Addison’s disease or pituitary adenomas. 

Because different labs can use different techniques that affect the test results, you should consult with your doctor on what your results mean. The normal ranges for varying age groups are wide: for example, for women 45 to 54, the range is 41.2 to 243.7 ug/dL (micrograms per deciliter); for women 75 and older, it is 13.9 to 142.8 ug/dL. (Note: These are U.S. measurements, Canadian DHEAS numbers are measured in mcg/dL).

DHEA supplements: studies

Experts have conducted multiple studies on the effect of DHEA supplementation on postmenopausal women. Many studies involve the use of a 50 mg/day dose. However, discussing dosing with a knowledgeable healthcare professional who can individualize the management course for you based on DHEAS and sex hormone levels is important.

Read about postmenopause: what women should know

In one study, for example, the authors found that DHEA supplementation at 50 mg/day for six months improved both physical and psychological menopause symptoms, including hot flashes, vaginal dryness, and more. The improvements were more significant in women in the early postmenopause group (age 50-55 years) than those in the late postmenopause group (60-65 years). Levels of the stress hormone cortisol also decreased in both groups.

Another study showed that DHEA supplements improved depression among both perimenopausal and postmenopausal women. Dosing in this study was 90 mg/day and 450 mg/day.

Using DHEA supplements

DHEA supplements are available as drops, tablets, and capsules. Look for high-quality products. I love and take this one from QuickSilver Scientific (search DHEA in the search bar at the top left). Be sure to listen to my podcast with Dr. Chris Shade to see what he says about dosing and testing. It's episode #55.

Bottom line

DHEA is an important hormone to monitor during perimenopause, menopause, and postmenopausal years. Supplementing this hormone may help with menopause-related symptoms and enhance the quality of life. Always talk to a medical professional before using this supplement.