Rather than simply looking at whether DHEA helped, Cipriani et al., explored the actual structure of the vaginal tissues to better understand what they might need in menopause and beyond...

The article explains that vaginal tissue contains androgen receptors, which means the vagina can respond directly to androgen hormones such as testosterone and dehydroepiandrosterone (DHEA). The researchers also describe evidence that vaginal cells contain the enzymes needed to convert hormone precursors into active hormones locally. This process, known as intracrinology, allows the vagina to produce small amounts of active estrogen and androgen inside the tissue.

According to the authors, this finding changes how scientists think about vaginal biology. Rather than being a passive tissue that only responds to circulating estrogen, the vagina functions as a locally active hormone environment that both produces and responds to sex hormones.

The review also examines how hormonal changes during menopause affect vaginal tissue. As estrogen and androgen levels decline with age, vaginal tissues can become thinner, less elastic, and less lubricated. These changes are associated with genitourinary syndrome of menopause, which can involve experiences such as dryness, irritation, discomfort with intercourse, and urinary changes.

Based on the research reviewed, the authors suggest that androgens may play a role in supporting overall vaginal comfort, suppleness, and lubrication. Because of this, supporting local androgen activity may contribute to vaginal comfort during menopause.

The article discusses intravaginal DHEA as one example of this approach. When applied locally, DHEA can be converted by vaginal cells into both estrogen and androgen within the tissue, allowing the vagina to generate the hormones it needs directly where they are required.

The authors conclude that understanding the vagina as both a source and target of androgens may help expand our knowledge of vaginal biology in midlife. Supporting local hormone activity in vaginal tissue may contribute to feelings of comfort and ease during intimacy and daily life.

You can view the full study, here: https://www.tandfonline.com/doi/abs/10.1080/136971...