What is DHEA?

Dehydroepiandrosterone (DHEA) is a steroid hormone produced by the ovaries and the adrenal glands, and it plays a vital role in the body's hormone balance. DHEA is a precursor hormone that can be converted into other hormones, such as estrogen and testosterone, which play essential roles in the body. Otherwise known as a prohormone, DHEA is the most abundant naturally occurring base for hormones in the body. Humans make more and more DHEA from birth to about age 25. People make the most DHEA during their prime reproductive years – optimum health, energy, mental sharpness – between the ages of 18 to 25. This is when humans are naturally most fit to have children, think clearly, and have the physical strength to best care for their offspring (read: to help them deal with the traumatic experience that is raising a toddler…). At around 30, DHEA levels begin to decline for the remainder of life at a rate of about 2% per year. By age 70 to 80 years, DHEA levels can be as low as 20% to 10% compared to younger individuals. Because DHEA is important for many functions in the body, its decline correlates with the steady decline in many functions in the body – those often associated with the aging process and the increase in disease states.

How Does DHEA Help Health After Menopause?

DHEA supplementation may help alleviate some age-related symptoms, including:

1. Hot flashes and night sweats: Because DHEA supplementation can increase estrogen levels, DHEA supplementation may help alleviate hot flashes and night sweats.
2. Mood changes: DHEA supplementation may help improve mood and reduce symptoms of depression and anxiety by positively increasing dopamine and lowering cortisol levels..
3. Sexual function: DHEA supplementation may help improve sexual function, including increased libido and vaginal lubrication.
4. Bone density: DHEA supplementation may help improve bone density, reducing the risk of osteoporosis.
5. Heart Health: Recent studies have shown that DHEA can help with three factors for heart disease - atherosclerosis, endothelial dysfunction, and metabolic syndrome.

For a more complete look at what DHEA can do in the body, this diagram shows both the organ effects, as well as the whole body effects:

What are the Risks of DHEA Use?

DHEA can be used as we advance into our 60's and beyond. While DHEA supplementation may help alleviate some age-related symptoms, it's important to note that it's not without risks. Some potential risks of overuse of DHEA include:

1. Hormone-related cancers: Although DHEA has been shown to reduce cancer risk via it's immune effects, because it gets converted to estrogen, DHEA supplementation may increase the risk of hormone-related cancers, such as breast and ovarian cancer.
2. Acne and hair loss: DHEA supplementation may cause acne and hair loss in some women.
3. Hormone imbalance in women with pre-existing estrogen dominant conditions: DHEA supplementation will likely increase testosterone and estrogen; anyone with a history of estrogen dominance or estrogen related conditions like endometriosis, would likely want to avoid DHEA.
4. Liver toxicity: In high amounts, oral DHEA supplementation can result in increases in liver toxicity in some women. However, topical DHEA avoids being metabolized by the liver and, in small amounts, does not have that same impact on the liver. To read more about the difference between oral and topical DHEA use, check out this blog!

How Does DHEA Work?
DHEA use is complex, and we have a more comprehensive blog here all about how DHEA (and it’s cousin, DHEA-S) works in the body. Basically, your adrenals and ovaries make DHEA, and your body uses DHEA to make androgens and estrogens, the male and female sex hormones. These hormones are used in a variety of different ways throughout the body. Unlike other hormones, such as estriol, which remains as estriol in your body, DHEA actually is metabolized by enzymes in your body to convert into different hormones. It looks a little like this:

This diagram shows DHEA in the system (either natural or added). The first conversion is to testosterone, the testosterone is then converted to estrogen, and finally, the estrogen is converted into estriol (where it remains). Because all of our bodies are unique, the enzymes that convert DHEA to testosterone (or testosterone to estrogen, and so on) will vary in amounts in each of us. This means if you have a lot of those enzymes, your body may rapidly convert DHEA into testosterone, or into estrogen. If you have less, it may take longer. This will affect your overall hormone balance and which hormone you 'hold on' to more of. It is also why everyone has a unique experience on DHEA.

Should You Use DHEA for Age Related Symptoms?

DHEA supplementation may help alleviate some age-related symptoms. Because some of the DHEA will be converted to other hormones, it it wise to consult with your healthcare provider to determine if it's appropriate for you, and to determine if 5mg of topical DHEA is appropriate for you. There are two key things to remember about DHEA supplementation:

Firstly, DHEA is not necessary if you are under 55 years old! Many of the DHEA drawbacks come from using DHEA supplements when our bodies don't yet need supplementation. Secondly, your body produces small amounts of DHEA, and supplementation should mimic that. High does of DHEA are known as supraphysiologic - this means doses which are WAY higher than your body would naturally produce). We don't want to flood the body with DHEA; we want to mimic natural production levels!

In conclusion, DHEA is a hormone produced by the adrenal glands that plays a crucial role in the body's hormone balance. DHEA levels decline with age, and the decrease in DHEA production is associated with various age-related symptoms. DHEA supplementation may help alleviate some of these symptoms, including hot flashes, mood changes, sexual function, and bone density. However, DHEA use is not without risks and may increase the risk of hormone-related cancers, acne and hair loss, cardiovascular risks, hormone imbalance, and liver toxicity. Consult with your healthcare provider to determine if DHEA supplementation is appropriate for you, and to determine the appropriate dose.