DHEA Supplementation
Restoration of dehydroepiandrosterone levels to support hormone synthesis, immunity, and healthy aging.
Evidence Summary
DHEA (dehydroepiandrosterone) is an adrenal prohormone whose blood levels fall roughly 80% between early adulthood and older age, which is the rationale often cited for replacement. The strongest evidence is for LOCAL intravaginal DHEA (prasterone), an FDA-approved therapy for the genitourinary syndrome of menopause: a 2026 systematic review and meta-analysis of 5 randomized controlled trials (n=1,611 postmenopausal women) found significant improvement in vaginal dryness (mean difference -0.23, 95% CI -0.35 to -0.11) and dyspareunia (-0.40, 95% CI -0.66 to -0.15), with only mild, infrequent adverse effects (Lemos et al., Menopause 2026). Evidence for SYSTEMIC/oral DHEA as an anti-aging therapy is weaker and mixed: replacement can modestly raise downstream androgen and estrogen levels, but randomized trials have not consistently shown benefit for cognition (a 2023 systematic review of RCTs found no cognitive benefit in postmenopausal women; Sultana et al., Menopause 2023), and effects on body composition, bone density and mood are inconsistent. In assisted reproduction, DHEA priming for poor ovarian response is investigational: a 2025 meta-analysis of 16 trials (n=1,973) reported greater endometrial thickness (+0.93 mm) and higher clinical pregnancy odds (OR 1.34, 95% CI 1.08-1.67) but rated the certainty of evidence low and found insufficient evidence for live-birth improvement (Huang et al., J Ovarian Res 2025). A 2026 pilot crossover RCT in pulmonary arterial hypertension (EDIPHY, n=26) found DHEA safe and well tolerated with mixed effects on right-ventricular function (Sanders et al., Ann Am Thorac Soc 2026). Overall: a well-established replacement for a documented age-related decline, with a clear role in menopausal genitourinary symptoms, but systemic longevity benefits remain unproven. DHEA is a hormone and is not a treatment for any disease; use under physician supervision with monitoring.
Evidence Scale
Mechanism of Action
DHEA and its sulfated form DHEA-S are among the most abundant circulating steroids, produced mainly by the adrenal glands. They act as prohormones, converted in peripheral tissues into androgens (including testosterone) and estrogens, and they also modulate immune, neurosteroid and endothelial signalling. Circulating DHEA-S peaks in the third decade of life and declines progressively with age (by roughly 70-80% by the seventh-eighth decade), paralleling some features of hormonal aging. Given locally as intravaginal prasterone, DHEA is converted within vaginal tissue into androgens and estrogens that restore epithelial thickness and lubrication while keeping systemic hormone exposure low. Given orally/systemically, DHEA raises downstream sex-hormone levels, but the translation of these biochemical changes into anti-aging benefit has been inconsistent across randomized trials.
Who Is This For?
Low DHEA-S levels, adrenal fatigue, post-menopausal support, aging optimization.
Protocol & Dosing
Dose
25-50mg daily for women, 50-100mg daily for men.
Frequency
Daily
Duration
Ongoing with monitoring
Protocol Summary
Two distinct uses. (1) Local: intravaginal DHEA (prasterone 6.5 mg, e.g., Intrarosa) nightly for the genitourinary syndrome of menopause — the best-evidenced indication. (2) Systemic: oral micronized DHEA, commonly 25-50 mg/day for women and 50-100 mg/day for men, taken in the morning, used to restore an age-related decline; evidence for systemic anti-aging benefit is limited. Baseline and follow-up monitoring of DHEA-S and downstream sex hormones (and, in men, PSA/hematocrit where relevant) is advised. Avoid in pregnancy; use caution with hormone-sensitive cancers. Physician supervision recommended.
Latest Evidence · reviewed Sep 10, 2026
2023–2026: where DHEA’s evidence is strongest
DHEA is an adrenal prohormone whose blood levels fall roughly 80% between early adulthood and older age — the rationale often cited for replacement. Its best-evidenced use is local intravaginal DHEA (prasterone), an FDA-approved therapy for the genitourinary syndrome of menopause: a 2026 systematic review and meta-analysis of 5 randomized controlled trials (n=1,611) found significant improvement in vaginal dryness and dyspareunia with only mild, infrequent side effects. Evidence for systemic, oral DHEA as an anti-aging therapy is weaker and mixed — a 2023 systematic review of randomized trials found no cognitive benefit in postmenopausal women, and effects on body composition, bone and mood are inconsistent. In assisted reproduction, DHEA priming for poor ovarian response is investigational: a 2025 meta-analysis of 16 trials (n=1,973) reported greater endometrial thickness and higher clinical pregnancy odds, but rated the certainty of evidence low. A 2026 pilot crossover trial in pulmonary arterial hypertension found DHEA safe and well tolerated with mixed effects on right-ventricular function.
DHEA is a hormone, not a cure, and is not a treatment for any disease. Systemic anti-aging benefits remain unproven. Use under physician supervision with appropriate monitoring; avoid in pregnancy and use caution with hormone-sensitive conditions. Educational information, not medical advice.
Human RCT Meta-analysis · n=1,611
Intravaginal DHEA vs placebo: pooled symptom improvement
Pooled data from 5 randomized controlled trials (n=1,611 postmenopausal women). Intravaginal DHEA (prasterone) significantly reduced vaginal dryness (mean difference −0.23, 95% CI −0.35 to −0.11) and dyspareunia (−0.40, 95% CI −0.66 to −0.15) versus placebo, with mild, infrequent adverse effects; a negative value favors DHEA. This local, FDA-approved form is DHEA’s best-evidenced use — systemic/oral DHEA for anti-aging remains unproven. Source: Lemos et al., Menopause 2026 (doi:10.1097/GME.0000000000002736).
Key References
- Lemos et al. Intravaginal DHEA for vulvovaginal atrophy: systematic review & meta-analysis. Menopause (2026).
- Huang et al. DHEA and endometrial thickness in IVF/ICSI: meta-analysis (16 trials). J Ovarian Res (2025).
- Sultana et al. DHEA and cognitive performance in postmenopausal women: systematic review of RCTs. Menopause (2023).
- Sanders et al. DHEA in pulmonary hypertension (EDIPHY): randomized crossover trial. Ann Am Thorac Soc (2026).
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Interactions & Precautions
Contraindications
- Hormone-sensitive cancers
- PCOS
Potential Risks
- •Hormone imbalance
- •Androgenic effects
- •Unknown long-term effects
Potential Side Effects
Practitioner Notes
Clinical annotations from Dr. Goel
Monitor DHEA-S, testosterone, and estrogen levels. Often low in chronic stress. Consider 7-keto DHEA for non-hormonal benefits.
Dr. Sanjeev Goel
Chief Medical Officer, Peak Human
Cost & Access
Cost Range
$
Accessibility
Availability varies by location
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