If you’ve been hearing more about DHEA lately, you’re not alone. Women are exploring it for energy, mood, libido, skin/hair support, and genitourinary symptoms of menopause (GSM). Below is a practical, clinician-written guide to what DHEA is, how it works in the body, where prescription and non-prescription options fit, and safety notes to help you decide—ideally with your clinician—whether it belongs in your plan.
What is DHEA
Dehydroepiandrosterone (DHEA) is a hormone primarily made by your adrenal glands and, to a lesser extent, the ovaries. It’s a prohormone—your tissues can locally convert it into small amounts of estrogens and androgens (like testosterone) as needed. This “local conversion” is called intracrine metabolism. Circulating DHEA levels peak in early adulthood and gradually decline with age, which is one reason it’s discussed in midlife health.
How does DHEA work
Inside target tissues (skin, vaginal epithelium, hair follicles, bone, brain), enzymes convert DHEA into estradiol/estrone and testosterone/dihydrotestosterone in tiny, localized amounts. Because much of this happens inside tissues, blood levels of estrogen/testosterone may not rise dramatically, yet symptoms in those tissues can improve.
Where DHEA may help
Evidence is evolving, but research and clinical experience suggest potential benefits for some women:
- GSM (vaginal dryness, discomfort, painful intercourse): Vaginal DHEA has strong evidence for improving lubrication and dyspareunia in postmenopause.
- Sexual function/libido: Some women report improvements, though responses vary and data are mixed in systemic (oral) use.
- Mood/energy/well-being: Studies show inconsistent results; if an effect occurs, it’s usually modest.
- Skin/hair: Intracrine effects in skin may influence texture and thickness; again, outcomes vary.
Important: DHEA is not a cure-all. Benefits, dosing, and risks should be reviewed with your doctor—especially if you have hormone-sensitive conditions.
OTC vs prescription status
- United States: DHEA is available over the counter (OTC) as a dietary supplement. Quality and dosing vary by brand.
- Many other countries: DHEA is prescription-only, reflecting tighter regulation.
- Bottom line: Even in the U.S., treat DHEA like a hormone—use with caution and medical guidance.
Product spotlights mentioned by patients
1) Julva® (DHEA cream for vulvar/vaginal use)
A topical DHEA cream marketed for external vulvar application to support comfort, moisture, and tissue integrity. Because it’s applied locally, many women like the targeted approach. It is not the same as prescription vaginal DHEA (see Intrarosa® below) and is typically considered a non-prescription option. If you have GSM symptoms, talk with your clinician about whether a local DHEA product fits your needs and how to apply it safely.
2) Well Products’ “Saw Palmetto for Women with DHEA + Biotin”
This is a supplement that combines:
- DHEA (a prohormone, as above),
- Saw palmetto (often discussed for its 5-alpha-reductase–modulating activity, which can influence androgen pathways, specifically reducing the conversion of testosterone to DHT). This enzymatic activity helps prevent hair loss that is associated with DHT, and
- Biotin (commonly included in hair/skin formulas).
Because DHEA can convert downstream to androgens/estrogens while saw palmetto may alter androgen signaling, pairing them is a strategy some women consider when balancing hair/skin and androgen-related concerns, specially to get the benefits of testosterone without the negative side effects of DHT. Results vary; supplements aren’t FDA-approved to treat disease, and quality control matters. Review ingredient amounts and interactions with your clinician—especially if you’re also on hormonal therapies.
3) Intrarosa® (prasterone) — Prescription vaginal DHEA
Intrarosa is a prescription 6.5 mg vaginal DHEA insert approved for moderate-to-severe dyspareunia due to GSM in postmenopausal women. Robust clinical trials show improved vaginal epithelial health and reduced pain with intercourse, with generally low systemic hormone levels. It’s an excellent discussion point if you prefer an FDA-approved, local option for GSM.
Typical dosing frameworks (general info, not personal advice)
- Oral DHEA: Often 5–25 mg/day for women in studies; some go up to 50 mg/day short-term under supervision. More is not necessarily better and can increase side effects.
- Local (vaginal) DHEA: Prescription Intrarosa 6.5 mg nightly at first, then often ongoing per label; non-prescription creams vary—follow product instructions and your physician’s guidance.
Always individualize with labs/history and symptom tracking.Potential side effects & caution
Because DHEA can convert to estrogen and androgens, side effects may mirror those hormones:
- Acne, oily skin, facial hair growth (hirsutism)
- Scalp hair shedding in susceptible individuals
- Mood changes, irritability
- Breast tenderness
- Menstrual changes (if not fully menopausal)
- Lipid changes (possible HDL reduction at higher doses)
- Liver enzyme shifts (uncommon; caution with high doses or pre-existing liver disease)
Avoid or use only with specialist input if you have:
- Current or prior hormone-sensitive cancers (breast, uterine)
- Unexplained vaginal bleeding
- Pregnancy or breastfeeding (contraindicated)
- Severe liver disease or uncontrolled endocrine disorders
Interactions: DHEA can interact with other hormones (estrogen/testosterone/progestins), some antidepressants, and may alter results of certain lab tests (e.g., androgens, SHBG). Bring all supplements/meds to your visit.
Practical tips if you’re considering DHEA
- Start low, go slow (e.g., 5–10 mg/day orally if appropriate) and reassess in 4–8 weeks.
- Pick reputable brands (third-party tested).
- Track symptoms + side effects (skin, hair, mood, sleep, libido, vaginal comfort).
- Coordinate with your physician—especially if you’re using Julva or Well Products’ DHEA-containing supplement alongside HRT or birth control.
- For GSM/dyspareunia, ask whether Intrarosa (prescription vaginal DHEA) or local estrogen might better match your needs and history.
The bottom line
DHEA is a versatile prohormone that midlife women may leverage—either locally (vulvar/vaginal) or systemically—for select goals. In the U.S. it’s OTC, but in many countries it’s prescription-only, a reminder that medical oversight matters. Options like Julva® and Well Products’ Saw Palmetto for Women with DHEA + Biotin exist in the supplement space, while Intrarosa® offers an FDA-approved prescription path for GSM. The “right” approach is personal—guided by your history, goals, and careful monitoring.
Selected references & further reading
- North American Menopause Society (NAMS). Position statements and clinical perspectives on management of GSM and midlife hormone therapies.
- Intrarosa® (prasterone) Prescribing Information—efficacy/safety data for intravaginal DHEA in postmenopausal dyspareunia.
- Labrie F, et al. Intracrinology and the role of DHEA as a precursor for local estrogen/androgen synthesis in postmenopausal tissues.
- Systematic reviews of oral DHEA in women: mixed outcomes for mood, sexual function, and well-being; emphasize individualized dosing and monitoring.
Educational only; not a substitute for medical care. Discuss any new hormone, supplement, or topical therapy with your clinician—especially if you have a history of hormone-sensitive conditions.