DHEA is a hormone almost nobody talks about, except in the context of anti-ageing supplements you see in health food shops. But DHEA is genuinely important, particularly for women over 40.
DHEA (dehydroepiandrosterone) is a precursor hormone produced by your adrenal glands. Your body converts DHEA into testosterone and oestrogen, depending on what you need. It's the substrate for both. Essentially: low DHEA means your body has less raw material to manufacture either hormone.
And DHEA declines dramatically with age.
The decline: how dramatic is it?
Peak DHEA happens in your mid-20s. By age 40, you've lost roughly 50% of your peak levels. By age 70, you're at about 20% of peak. This is one of the most consistent hormonal declines in human ageing.
This decline is independent of ovarian ageing — it's an adrenal phenomenon. Your adrenal cortex simply produces less DHEA as you age. This happens in both men and women.
The practical consequence: if you're 45 and your testosterone is low, part of that might be direct ovarian failure, but part of it is DHEA insufficiency limiting your body's ability to synthesise testosterone.
What does low DHEA do?
The research on DHEA effects in women is more recent than in men, but the picture is becoming clear:
Libido and sexual function: DHEA is converted to testosterone and oestrogen locally in tissue. Low DHEA correlates with reduced sexual desire and arousal, particularly in post-menopausal women. Several trials show DHEA supplementation improves libido and sexual function.
Vaginal health: Post-menopausal women with low oestrogen experience vaginal atrophy — thinning, drying, and loss of elasticity of vaginal tissue. Intravaginal DHEA (the drug Prasterone, FDA-approved in the US) directly improves vaginal health and alleviates pain with intercourse. This isn't theoretical — it's well-proven.
Mood and motivation: DHEA is converted to testosterone, which drives dopamine. Low DHEA often presents as flatness, lack of motivation, and difficulty pushing yourself in training or work. Several women report renewed motivation and "snap" after starting DHEA.
Energy and fatigue: Similar mechanism — insufficient DHEA means insufficient testosterone and oestrogen to support metabolism and mitochondrial function. Women with low DHEA often report persistent fatigue despite adequate sleep.
Bone health: DHEA is protective for bone density. Lower levels correlate with higher fracture risk, particularly important as you age.
Cognitive function: Some evidence suggests DHEA supports memory and cognitive processing, though the effect is modest.
The evidence for oral DHEA supplementation
This is important to understand clearly: the evidence is strongest for intravaginal DHEA (the prescription product Prasterone), which is FDA-approved in the US but not widely available in the UK. That's specific, localised therapy.
For oral DHEA supplementation in post-menopausal women:
- Libido and sexual function improve modestly in roughly 50–60% of women who supplement (Panjari M & Davis SR, 2010, Maturitas)
- Vaginal dryness often improves
- Mood may improve (evidence is weaker here, but consistent)
- Energy sometimes improves, though this is more variable
- Bone density may be preserved or slightly improved with long-term supplementation
The effect sizes are modest, not transformative. But for women with low DHEA and significant symptoms, it can meaningfully improve quality of life.
Dosing
Standard oral DHEA supplementation: 25–50 mg daily. Some practitioners go up to 100 mg, but most evidence is in the 25–50 mg range.
Most protocols use oral DHEA-S (dehydroepiandrosterone sulphate), which is the sulphated form. It's better absorbed orally and is what most commercial supplements contain.
Timeline to effect
DHEA doesn't work acutely. Most studies show meaningful benefit over 6–12 weeks of consistent supplementation. If you try DHEA, commit to at least 8 weeks before deciding it's not working.
DHEA vs 7-keto DHEA
You might see 7-keto DHEA marketed as "safer" DHEA. Here's the distinction:
DHEA: Converted by your body into testosterone and oestrogen (it's a true substrate).
7-keto DHEA: A DHEA metabolite that isn't converted to testosterone or oestrogen. It's marketed as non-androgenic (meaning it doesn't have testosterone-like effects). Early research suggested it might boost metabolism, but the evidence is weak.
If you want DHEA for its testosterone and oestrogen effects (libido, energy, mood, bone health), regular DHEA is what you want. If you want to avoid any possibility of androgenic effects (acne, hair growth), 7-keto DHEA might appeal, but it probably won't help you for the reasons you're taking it.
Most evidence and most clinical use is with regular DHEA, not 7-keto.
Who might benefit from DHEA?
Post-menopausal women with:
- Low libido or sexual dysfunction
- Vaginal dryness or painful intercourse
- Persistent fatigue
- Low mood or lack of motivation
- Bone health concerns
Perimenopausal women with similar symptoms, particularly if other interventions haven't helped.
Women post-oophorectomy (surgical removal of ovaries). Surgical menopause is abrupt and severe; DHEA can help bridge the gap until HRT is optimised.
Cautions and side effects
DHEA is generally well-tolerated. Most women have no side effects. But androgenic effects are possible, particularly at higher doses:
Acne: Some women develop or worsen acne. Usually dose-dependent.
Facial hair or body hair growth: Uncommon but possible, particularly at doses above 50 mg.
Hair loss: Rare, but DHEA can theoretically exacerbate androgenic alopecia (pattern hair loss).
Mood changes: Rarely, women report mood elevation that feels excessive, or anxiety. This usually resolves with dose reduction.
These effects are generally reversible. If you develop acne or excessive hair growth, lower your dose or stop; the effects will resolve within a few weeks.
Who shouldn't take DHEA
- Women with oestrogen-sensitive cancers (breast cancer, particularly): DHEA is converted to oestrogen. If you have a history of oestrogen-sensitive cancer, discuss this with your oncologist before supplementing
- Women on certain medications: DHEA can interact with medications; check with your pharmacist
- Pregnancy: Don't supplement DHEA if you're pregnant or trying to conceive without medical supervision
UK availability
DHEA is available OTC as a supplement, not as a licensed medicine. You can purchase it from Bulk, MyProtein, Holland & Barrett, or specialist supplement retailers.
Quality varies. Look for third-party tested products (NSF Certified, USP verified) to ensure you're getting what the label says.
Micronised DHEA is absorbed somewhat better than standard DHEA. Micronised DHEA-S is probably optimal.
Note: DHEA is a controlled substance in some countries. In the UK, it's available as a supplement. If you're travelling, check local regulations.
The realistic picture
DHEA supplementation won't transform you. You won't feel like you're 25 again. But for women with genuinely low DHEA and related symptoms, it often provides meaningful improvement in libido, energy, and wellbeing.
It works best as part of a broader approach: solid sleep, regular training, adequate nutrition, stress management, and potentially HRT if you're perimenopausal or post-menopausal.
If you're over 45, experiencing fatigue or low libido, and you've ruled out thyroid dysfunction and iron deficiency, it's worth checking your DHEA level and considering supplementation if you're deficient.
Seb covers hormone optimisation and evidence-based health for adults over 30. He writes for maleoptimal.co.uk and maintains a focus on clinical evidence, practical implementation, and what actually works.