Supplement
DHEA
DHEA shows its strongest evidence for sexual function in menopause, with FDA-approved intravaginal prasterone proven effective for painful intercourse. Oral DHEA has mixed results for mood, bone density, and energy, with some studies showing benefits while others showing none. Since your body's DHEA production drops dramatically with age, targeted supplementation under medical guidance may be worth considering, especially if you're struggling with vaginal dryness or low libido.
30-second summary
DHEA shows its strongest evidence for sexual function in menopause, with FDA-approved intravaginal prasterone proven effective for painful intercourse. Oral DHEA has mixed results for mood, bone density, and energy, with some studies showing benefits while others showing none. Since your body's DHEA production drops dramatically with age, targeted supplementation under medical guidance may be worth considering, especially if you're struggling with vaginal dryness or low libido.
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Overall: Mixed evidence
Randomised controlled trials
Randomized trials show strong benefits for intravaginal DHEA but inconsistent results for oral supplementation across different symptoms.
Population studies consistently show declining DHEA levels with age correlate with various menopausal symptoms.
Reviews find compelling evidence for sexual function but weak or conflicting evidence for mood, cognition, and bone health.
Menopause-specific trials
Multiple studies specifically in menopausal women show clear benefits for vaginal health and modest effects on sexual function and well-being.
What we do not know
We don't know the optimal oral dose for menopausal women, as studies have used widely varying amounts from 25-200mg daily. Long-term safety data beyond two years is limited, especially for women with hormone-sensitive conditions. Most studies have been conducted on postmenopausal women, leaving gaps in evidence for perimenopause. The interaction between DHEA and hormone replacement therapy hasn't been thoroughly studied. We also lack evidence on whether higher baseline DHEA levels predict better response to supplementation.
How it is used
Common dose range
25-50mg daily oral, or as prescribed for intravaginal use
Notes on dosing
Best discussed with a doctor before starting. Intravaginal prasterone requires a prescription and has stronger evidence than oral supplementation.
Get it from food first
Food sources are better absorbed than most supplements and come with co-factors that support the same pathways. If you eat two or three of these consistently, you may not need a supplement at all.
Wild yam
Not applicable dietary
Despite marketing claims, contains diosgenin which cannot be converted to DHEA by the human body
Sweet potato
Not applicable dietary
Also contains diosgenin but cannot provide usable DHEA through diet
Mediterranean diet
May help maintain healthier hormone levels overall, though won't directly increase DHEA
Adequate protein intake
Supports the cholesterol-based hormone production pathways that create DHEA
What depletes DHEA
Chronic stress increases cortisol production, which can suppress DHEA synthesis. High alcohol intake, poor sleep, and extreme calorie restriction may also reduce DHEA production. Some medications including corticosteroids can lower DHEA levels.
Interactions and cautions
No significant interactions noted at recommended doses.
Rose bottom line
"Your body makes less DHEA as you age, and the vaginal form has solid evidence for painful sex. If you're considering oral DHEA for other symptoms, work with a healthcare provider who can test your levels and monitor your response—this isn't one to try on your own."