Journal / Hormone Replacement Therapy

What is DHEA?

Medically reviewed by Nancy L. Belcher Ph.D, MPA

Written by Winona Editorial Team

Last updated October 14, 2021

If you haven’t heard of DHEA (dehydroepiandrosterone) supplements before, don’t feel embarrassed. It’s not talked about a lot, but it has been used for a very long time to help people to regain muscle tone, fight the effects of aging, improve sex drive, increase energy, decrease depression, and enhance metabolism.1-4 There are many different thoughts about DHEA supplements and their effectiveness. 

We know that DHEA supplementation can improve testosterone concentrations in hormone-depleted women. Results also indicate that DHEA supplementation can also be used to decrease the BMI (the amount of fat we store), and where we store it which helps decrease the likelihood of long-term health conditions like diabetes and heart disease. This article aims to break down the research findings.

What Is DHEA?

DHEA is a ‘precursor’ or a ‘prohormone’ to the male and female sex hormones (testosterone and estrogen). It’s important to remember that both men and women make testosterone and estrogen, they just make them at different levels. When something is a precursor or prohormone, it means that it can be converted by the body into another substance or hormone. In this case, DHEA can be changed into a sex hormone, testosterone, or estrogen.

DHEA is a hormone naturally produced by your body’s adrenal glands. Like the DHEA provided by Winona, DHEA supplements can be made from vegetables. Women’s testosterone levels peak when they are 20 and decrease by 80% by the time they are 70 years old. The drop in DHEA is significantly starting at age 25! That is an incredible drop in a natural hormone that has so many important jobs in our bodies and our physiology.2-4

Natural DHEA production will peak in a woman’s mid-20’s and will gradually decline with age, just like testosterone and estrogen levels decrease as we age. When we take DHEA as a supplement it can increase the level of these hormones. For our purposes, we would like peri- and menopausal women to get a boost of testosterone to help with some of the symptoms they are struggling with. Some of the  potential health benefits may include:

  • Improving energy and decreasing fatigue 

  • Strengthening the immune system

  • Slowing natural changes in the body that come with age

  • Enhancing mood and memory

  • Regaining lost lean muscle and building up bone and muscle strength

Because women have such a significant drop in their testosterone as they age, it is important to consider increasing low serum testosterone with age. If we don’t replace the low testosterone (T) levels there can be real problems with energy, immunity, memory, muscle maintenance, libido, and many other debilitating effects on the quality of life. 

The overarching aim of many previous research studies that looked at the use of DHEA was to investigate the impact DHEA supplementation had on serum testosterone levels and body weight, mood, bones, libido, heart disease, and body mass index (BMI – levels of fat) and Lean Body Mass (LBM- lean tissues) in women over 45.

DHEA Supplements for Anti-Aging and Improving Health

Because DHEA levels will naturally decline with age, supplementing these falling levels of the DHEA and sex hormone can help fight to age. A number of very recent studies have shown positive anti-aging effects from the use of DHEA supplements.1

As for other conditions, the evidence suggests that DHEA can help with:1-3

  • Chronic Fatigue Syndrome

  • Sexual wellbeing, improved libido 

  • Alzheimer’s disease

  • Heart disease

  • Cervical cancer

  • Low bone density

  • Decreased metabolism 

  • Lost muscle mass

The most recent research has shown that DHEA may also be effective for improving aging skin in women.2,3

DHEA and Weight Loss

DHEA supplements have been shown in studies to reduce the accumulation of the kind of belly fat that is so often associated with aging. By reducing the amount of abdominal visceral (belly) fat you have, you can also protect against insulin resistance which can lead to type 2 diabetes. A recent study that included both men and women at middle age showed that DHEA therapy induced significant decreases in visceral fat and subcutaneous fat. So, both the fat deep in your tummy around your organs and the fat that you can grab onto was decreased.4-7

Overall Weight Loss

DHEA supplements have been widely promoted as an aid for reducing body fat and raising metabolism. Science shows that a leaner body (more muscle) will require more energy to maintain and add muscle which will, in turn, increase your metabolic rate. Fat doesn’t require any energy to be stored on your body, but muscles constantly twitch – even in your sleep!

Twitching requires calories, which burns energy. So, it makes sense that by increasing your muscle tone, and decreasing fat, you will have a higher metabolic rate and can burn more calories. In turn, this will make it easier to lose weight and keep it off.

Where the Fat is Deposited

Many of us will notice the accumulation of abdominal fat increases year after year as we age. We could resign ourselves to the fact that it’s a part of aging, but abdominal obesity increases the risk of developing insulin resistance, diabetes, and heart disease. 

While we may not be exercising enough, and maybe we eat a bit too much, it is the hormonal/metabolic changes that occur as we age that contribute the most to the increase in abdominal fat. These changes start in our 30s and only get more dramatic as we age. 

One change that impacts this type of weight gain is the decline in production of the adrenal hormone dehydroepiandrosterone (DHEA). Most women’s blood level of DHEA peaks at approximately 20 years of age and declines rapidly and markedly after age 25.7

Insulin resistance also reduced significantly when taking DHEA. Insulin’s job is to move sugar out of the blood and into the tissues that need it for energy. When your body is ‘resistant’ to insulin, the sugar stays in your blood and the levels may become too high which can cause diabetes.

We know that the heavier you are, especially in the abdomen,  the more likely you are to develop insulin resistance. The final conclusion of a study published in the Journal of the American Medical Association (JAMA) stated that “DHEA replacement could play a role in prevention and treatment of the metabolic syndrome associated with abdominal obesity.”6

It’s easy to see that being overweight or obese has a genetic component. Just look at any family photo. While we can try to fight the genetics behind weight gain with low-calorie diets and exercise, it can often feel exhausting to try and overcome our genetic predisposition to gaining weight.

The good news is that research studies show that both obesity due to genetics and obesity due to diet are decreased by using DHEA. When given DHEA, there was increased burning of fat (oxidation) and reduced-fat storage (deposition) 8

In a study providing DHEA replacement therapy, researchers found that DHEA induced significant decreases in both visceral (deep fat) and subcutaneous fat (the kind you can grab onto) in men and women.8 DHEA replacement also resulted in a significant improvement in insulin action that correlated with the reduction in visceral fat. 

These findings provide evidence that DHEA replacement may reverse the aging-related accumulation of abdominal fat in people with low serum levels of DHEA as we see with women in menopause. Long-term DHEA replacement therapy may reduce the accumulation of abdominal fat and protect against the development of metabolic/insulin resistance syndrome.

DHEA and Athletic Performance

DHEA supplements are sometimes used by athletes because of their ability to impact muscle tone and strength. Again, the way DHEA works is as a “prohormone” or a substance that can increase testosterone from ‘low’ back to the levels experienced in your 20s or 30s. 

Athletes have valued the ability of DHEA to improve their performance for decades. But, they used too much and it has since been banned for professional athletes. Previously, DHEA was abused by professional athletes who used it to increase their muscle strength and energy levels. In an effort to speed injury recovery and get stronger, they took extremely high levels of DHEA. Levels far higher than anything that would be suggested by your Winona physicians. 

Two takeaways from this ban: 1) DHEA really does work to improve muscle and performance 2) Don’t take too much. Consult your Winona physician about the appropriate levels. Winona only prescribes 50 mg/day at a maximum dose. Some athletes were taking well over 200 mg/day. 

DHEA and Heart Disease Prevention

Since DHEA concentrations decrease ~80% between ages 25 and 75 yr for women it’s important to understand the side effects of that loss.9 One important place that DHEA may play a role is in our arteries. Our arteries move blood to our cells and the heart to deposit oxygen as needed. Veins are the vessels we use to return the blood to pick up more oxygen and nutrients. 

The arteries need to stay supple in order to provide blood quickly. We also need to make sure the arteries stay wide open so the blood can flow evenly without obstructions. 

As we age our arterial walls become stiffer. As the arterial walls stiffen the risk of cardiovascular disease (CVD) increases and so does mortality (death). It is suggested that by adding DHEA supplements menopausal women could reduce arterial stiffness and prevent heart disease. Researchers reported improvements in arterial wall stiffness and suggest that DHEA replacement may partly reverse arterial aging and reduce CVD risk.8

DHEA and How it Impacts Mood

One promising research result showed that DHEA supplements show promise for easing mild to moderate depression.2 In studies performed by the National Institute of Mental Health, treatment with DHEA supplements helped relieve mild to moderate depression that often occurs in middle-aged women.7,8,9 

DHEA has been shown to provide possible antidepressant effects. In a recent study, DHEA significantly decreased depression. Patients already on antidepressants and additionally treated with DHEA showed a 50% decrease or greater in their depressive symptoms.3-4 These results, and many other studies, suggest that DHEA treatment may have antidepressant effects in some patients with major depression.

In addition, with increased energy, many persons with low-level depression or mood disorder report improved outlook. DHEA, by improving energy levels, may improve mood by enabling the user to become more active.

DHEA, Sex and Libido

It is pretty clear that sexual desire and the ability to achieve climax are affected by the level of ‘sex hormones’ (e.g. estrogen and testosterone), and psychosocial factors. The changes in hormones with menopause often create sexual dysfunction that can go undiagnosed but can have huge impacts on healthy, happy sex life. 

Research studies evaluated the effects of hormonal replacement therapy (HRT) on sexual function, frequency of sexual intercourse, and quality of relationships in menopausal women.5The study showed that women receiving DHEA and/or HRT reported significant improvements in sexual function and desire.5 

In the same study, it was reported that there were significant increases in the numbers of episodes of sexual intercourse in women treated with DHEA, and HRT too.5 Daily DHEA therapy, and/or HRT can provide a significant improvement in sexual function and frequency of sexual intercourse in hormone deficient women.5

DHEA and Bone Loss Prevention

One thing we hear too much about is women in their later years breaking their hips. The question always is did their hip break and then they fell or did they fall and then they broke their hip. While it doesn’t really matter, it does express the need for healthy bones and to prevent osteoporosis. 

There is strong evidence to suggest that by ensuring optimal levels of DHEA, we may help to slow bone loss and guard against the crippling effects of osteoporosis.10 We have known for a long time that DHEA supplementation can slow age-related bone loss, and increase bone mass. By doing so we can promote bone health and guard against age-related bone deterioration and possible fractures.10

Safety of DHEA Supplements

At very high levels (over 200 mg/day) possible side effects of DHEA supplements are listed below. Winona does not prescribe doses over 50 mg per day, which would prevent these types of side effects. However, if taken in excess DHEA side effects can include:

  • Oily skin and acne, as well as skin thickening

  • Hair loss

  • Stomach upset

  • High blood pressure

  • Changes in the menstrual cycle

  • Facial in women

  • Deepening of the voice in women

  • Nasal congestion

  • Headache

  • Rapid or irregularhearbeat

  • Insomnia

  • Unfavorable changes in cholesterol levels

When DHEA was abused by professional athletes who used it to increase their muscle strength and energy levels they had some negative side effects. If you read about the risks associated with using any pre-steroid enhancer please take into consideration how much they are taking compared to what your Winona physician would prescribe for you. The higher the dose, the greater the risk. 

Possible side effects of taking excessive levels of DHEA include:

  • Aggressive behavior, known as “roid rage”

  • Higher blood pressure

  • Liver problems

  • Changes in level

  • Voice changes

  • Hair loss

  • Growth of facial 

Summary

DHEA can help improve the levels of a very important hormone in women, testosterone. Testosterone is often ignored in conversations about hormone replacement therapy. Female DHEA levels steadily decline after peaking in the ’20s and these reduced levels can have a significant impact on the quality of life. Replacement to achieve normal DHEA and testosterone levels in women is a very important part of any conversation about hormone replacement therapy.

The risk of over-replacement of DHEA testosterone to too high levels can be mitigated by using the levels prescribed by your Winona physician. These medications can gently return levels to normal without the risks of over-replacement minimizing any unwanted side effects. Winona specializes in keeping women feeling young and can help women fight off the side effects of aging by replacing hormones with youthful levels.

 “This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”

References:

  1. https://www.webmd.com/diet/dhea-supplements#1-3

  2. https://www.webmd.com/mental-health/default.htm

  3. https://www.webmd.com/depression/ss/slideshow-depression-overview

  4. https://pubmed.ncbi.nlm.nih.gov/10200751/

  5. https://pubmed.ncbi.nlm.nih.gov/21942655/

  6. https://jamanetwork.com/journals/jama/fullarticle/199765

  7. https://jamanetwork.com/journals/jama/fullarticle/199765#REF-JPC40105-5

  8. https://jamanetwork.com/journals/jama/fullarticle/199765#REF-JPC40105-13

  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444670/

  10. https://www.lifeextension.com/magazine/2006/11/report_dhea