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As women navigate midlife and the transition into menopause, interest in various supplements, including dehydroepiandrosterone (DHEA), often grows. DHEA is a hormone produced naturally by the body, and its levels tend to decline with age. For some women, DHEA supplementation is considered to support various aspects of well-being during this time.
However, like any supplement that influences hormonal balance, DHEA can be associated with potential side effects. Understanding what these might be, why they occur, and how they can be managed is crucial for informed decision-making. This article aims to provide an evidence-based overview of potential DHEA side effects specifically relevant to women in midlife and menopause.
Understanding DHEA’s Role and Potential for Side Effects
DHEA is a steroid hormone that serves as a precursor to other hormones, including androgens and estrogens [1]. Because DHEA can be converted into these hormones, its supplementation can influence hormonal levels in the body. This hormonal influence is the primary reason why potential side effects can arise, particularly those related to androgenic activity.
The response to DHEA supplementation can vary significantly among individuals, influenced by factors such as dosage, individual metabolism, and existing hormonal status. What might be well-tolerated by one woman could lead to noticeable changes in another. This variability underscores the importance of careful consideration and monitoring when using DHEA.
Commonly Reported DHEA Side Effects in Women
Many of the potential side effects associated with DHEA supplementation in women are linked to its conversion into androgens, which are male sex hormones. Even small increases in androgen levels can lead to noticeable changes in women, as their baseline androgen levels are typically much lower than men’s [2].
A systematic review of DHEA for women in the peri- or postmenopausal phase identified several potential adverse events, including acne, unwanted hair growth (hirsutism), and changes in hair distribution [3]. Other reported androgenic effects can include oily skin and, less commonly, voice deepening [1]. These effects are generally dose-dependent, meaning they are more likely to occur or be more pronounced with higher doses of DHEA.
While generally considered mild, these androgenic side effects can be a significant concern for some women, impacting their comfort and self-perception. It is important to be aware of these possibilities when considering DHEA supplementation.
Less Common or Specific DHEA Side Effects
Beyond the more common androgenic effects, other potential side effects have been noted, though they may be less frequent or require specific attention. Some women have reported experiencing headaches, fatigue, or mood changes, including irritability or anxiety, with DHEA supplementation [1]. However, the direct causal link and prevalence of these effects can be challenging to establish definitively across all studies.
There has been some discussion regarding DHEA’s potential impact on breast tissue due to its conversion to estrogens. While a comprehensive review did not find an increase in breast cancer events or endometrial cancer with DHEA supplementation in peri- or postmenopausal women, this area often warrants cautious monitoring, especially for individuals with a history of hormone-sensitive conditions [3].
It is also worth noting that DHEA has been explored for various purposes, including cognitive function, where a review concluded there was no convincing evidence of a beneficial effect in healthy elderly people and noted potential for minor androgenic side effects [4]. This highlights that even when a benefit is not strongly established, side effects can still occur.
Managing and Monitoring DHEA Side Effects
The most effective way to manage potential DHEA side effects is through careful monitoring and dose adjustment. Starting with a low dose and gradually increasing it, if appropriate and under guidance, can help identify the lowest effective dose while minimizing the likelihood of adverse reactions [1].
If androgenic side effects such as acne or unwanted hair growth occur, lowering the DHEA dose or discontinuing supplementation often leads to a resolution of these issues [1]. It is important to communicate any observed changes to a healthcare provider promptly. Some effects, like changes in hair growth patterns, may take longer to reverse than others.
Regular follow-up with a healthcare provider is important when using DHEA. This allows for monitoring of symptoms and, if deemed necessary, assessment of hormone levels to ensure DHEA levels remain within an appropriate range and to evaluate for any unexpected changes [5].
Important Safety Considerations and Contraindications
While DHEA is available over-the-counter, it is a hormone precursor, and its use should ideally be discussed with a healthcare provider, especially for women in midlife and menopause. A Polish expert panel position statement emphasizes that DHEA should not be used in individuals with hormone-dependent cancers, such as breast or prostate cancer, or in those with severe liver disease [5].
DHEA supplementation is also generally not recommended for women with polycystic ovary syndrome (PCOS) due to their already elevated androgen levels, which DHEA could further exacerbate [5]. Similarly, individuals with adrenal conditions, such as Addison’s disease, require very careful medical supervision due to the adrenal gland’s role in DHEA production [6].
It is also important to consider potential interactions with other medications. DHEA can influence the metabolism of certain drugs, and its use alongside other hormonal therapies or medications that affect hormone levels requires careful medical oversight. Always inform your healthcare provider about all supplements and medications you are taking.
References
- The use of dehydroepiandrosterone therapy in clinical practice. Treatments in endocrinology, 2005
- Androgens and antiandrogens. Annals of the New York Academy of Sciences, 2003
- Dehydroepiandrosterone for women in the peri- or postmenopausal phase. The Cochrane database of systematic reviews, 2015
- Dehydroepiandrosterone (DHEA) supplementation for cognitive function in healthy elderly people. The Cochrane database of systematic reviews, 2006
- Supplementation of dehydroepiandrosterone (DHEA) in pre- and postmenopausal women – position statement of expert panel of Polish Menopause and Andropause Society. Ginekologia polska, 2020
- [Addison’s disease]. Medizinische Klinik, Intensivmedizin und Notfallmedizin, 2012
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease. Content is for informational purposes only and is not medical advice; consult a qualified healthcare provider before starting any supplement. As an Amazon Associate we earn from qualifying purchases.
