Improved Mood and Quality of Life, Preservation of Bone Mineral Density, Relief from Vulvovaginal Atrophy and Dyspareunia

Dehydroepiandrosterone or DHEA

1. Improved Mood and Quality of Life
In a double-blind, placebo-controlled crossover trial, 24 women with adrenal insufficiency received 50 mg DHEA daily for four months and showed significant improvements in overall well-being and reduced depression/anxiety scores compared to placebo (Arlt et al., 1999) [1].

2. Preservation of Bone Mineral Density
A 12-month RCT in older adults (aged 60–88 years) with low DHEA-S levels found that 50 mg daily DHEA increased total hip BMD by 1.0% (P=0.05) and lumbar spine BMD by 2.2% in women (P=0.04) versus placebo (Jankowski et al., 2006) [2].

3. Relief from Vulvovaginal Atrophy and Dyspareunia
Pooled data from three 12-week, randomized, double-blind, placebo-controlled trials of intravaginal prasterone (6.5 mg) in 436 postmenopausal women demonstrated a 49% greater reduction in the severity of dyspareunia, significant improvements in vaginal pH and cellular maturation index, and high acceptability with no serious side effects (Labrie et al., 2017) [3].

4. Potential Anti-Aging Effects on Skin
In a 4-month pilot study, topical application of 1% DHEA to facial and hand skin in 20 postmenopausal women increased sebum production, improved skin brightness, and counteracted epidermal atrophy compared to vehicle (Nouveau et al., 2008) [4].

5. Hormonal Balance and Libido (Mixed Evidence)
A systematic review and meta-analysis of 23 RCTs (1,188 women) found that systemic DHEA did not significantly improve libido or overall sexual function in postmenopausal women with normal adrenal function (Elraiyah et al., 2014) [5].

6. Emerging Metabolic and Immune Effects

• In obese rats, chronic DHEA administration upregulated muscular PPARα and PPARδ expression and lipid-metabolism genes—reducing visceral fat and increasing adiponectin—mirroring exercise effects (Horii et al., 2016) [6].

• DHEA and its sulfate form have diverse immunomodulatory actions (e.g., antiglucocorticoid effects, cytokine-profile modulation) that may support immunocompetence and attenuate inflammation (Prall & Muehlenbein, 2018) [7].

Note: Most strong clinical evidence is in specific populations (e.g., adrenal insufficiency, postmenopausal bone loss, vulvovaginal atrophy). Broader applications remain under study, and potential androgenic side effects should be weighed. Always consult a healthcare professional before starting DHEA.

References

1. Arlt W, Callies F, van Vlijmen JC, et al. Dehydroepiandrosterone replacement in women with adrenal insufficiency. N Engl J Med. 1999;341(14):1013–1020. doi:10.1056/NEJM199909303411401

2. Jankowski CM, Gozansky WS, Schwartz RS, et al. Effects of dehydroepiandrosterone replacement therapy on bone mineral density in older adults: a randomized, controlled trial. J Clin Endocrinol Metab. 2006;91(8):2986–2993. doi:10.1210/jc.2005-2484

3. Labrie F, Archer DF, Martel C, et al. Combined data of intravaginal prasterone against vulvovaginal atrophy of menopause. Menopause. 2017;24(11):1246–1256. doi:10.1097/GME.0000000000000910

4. Nouveau S, Bastien P, Baldo F, de Lacharrière O. Effects of topical DHEA on aging skin: a pilot study. Maturitas. 2008;59(2):174–181. doi:10.1016/j.maturitas.2007.12.004

5. Elraiyah T, Sonbol MB, Wang Z, et al. The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2014;99(10):3536–3542. doi:10.1210/jc.2014-2261

6. Horii N, Sato K, Mesaki N, Iemitsu M. DHEA administration activates transcription of muscular lipid metabolic enzymes via PPARα and PPARδ in obese rats. Horm Metab Res. 2016;48(3):207–212. doi:10.1055/s-0035-1564132

7. Prall SP, Muehlenbein MP. DHEA modulates immune function: a review of evidence. Vitam Horm. 2018;108:125–144. doi:10.1016/bs.vh.2018.01.023