DHEA
In meta-analyses DHEA added about 0.45 kg of lean mass and slightly lowered fat mass, but a 2-year trial in older adults found no body composition, strength or quality of life change. In menopausal women it slightly improved sexual function and raised acne odds. Intravaginal DHEA reduced pain at sex over 12 weeks.
Add to Bio HackChecked 2026-11-09
- Status
- Oral DHEA is sold as a dietary supplement in the US. Intravaginal prasterone is a prescription drug, FDA-approved for moderate to severe painful intercourse due to menopause.
- Also called
- dehydroepiandrosterone, prasterone, Intrarosa
- Taken for
- anti-aging, muscle, strength, fat loss, bone density, libido, menopause symptoms, vaginal dryness, quality of life, testosterone, IVF, fertility
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Shown to help6
- ModerateShown to raise lean mass by about 0.45 kg in adults, though a 2-year trial in older adults found no change in body composition.
- ModerateShown to improve sexual function slightly in menopausal women overall, though oral DHEA alone did not differ from placebo.
- ModerateShown to lower pain during sex and vaginal dryness in postmenopausal women using intravaginal DHEA. This applies to the vaginal form, not oral DHEA.
- ModerateShown to raise hip bone density in older women, with no similar effect in men in pooled trials. No trial counted fractures.
- ModerateShown to raise testosterone by about 24 ng/dL and estradiol by about 8 pg/mL in postmenopausal women.
- ModerateShown to raise clinical pregnancy rates and eggs retrieved in women having IVF or ICSI, on low-quality evidence. Live birth data were insufficient.
Reported risks2
What people take it for, and what was found
Shown to help6
Lean mass and fat mass
Shown to raise lean mass by about 0.45 kg in adults, though a 2-year trial in older adults found no change in body composition.
The numbers and sources
- Effect
- Pooled RCTs found DHEA raised lean body mass by 0.45 kg (95% CI 0.15 to 0.75) and lowered fat mass by 0.85% (95% CI 0.51 to 1.18). Body weight did not change [1]. In elderly men, fat mass fell by an SMD of -0.35 (95% CI -0.65 to -0.05), but the effect disappeared after adjusting for rises in testosterone and estradiol [2]. A 2-year RCT found no significant effect on body composition in men or women [3].
- Population
- Adults in randomized trials [1]; 1,353 elderly men in 25 placebo-controlled RCTs, mean follow-up 36 weeks [2]; 87 elderly men and 57 elderly women with low DHEA-S over 2 years [3].
- Sources
- [1], [2], [3]
- Caveats
- The pooled lean mass gain is small, and the one long trial did not find it.
Sexual function in menopause
Shown to improve sexual function slightly in menopausal women overall, though oral DHEA alone did not differ from placebo.
The numbers and sources
- Effect
- Compared with placebo, DHEA improved sexual function by an SMD of 0.31 (95% CI 0.07 to 0.55). Oral DHEA alone showed an SMD of 0.11 (95% CI -0.13 to 0.35), and one intravaginal trial 0.42 (95% CI 0.03 to 0.81) [5].
- Population
- Peri- and postmenopausal women, 5 trials with 261 women in the main analysis [5].
- Sources
- [5]
- Caveats
- The oral-only result did not differ from placebo. The overall evidence was rated moderate to low quality [5].
Painful sex and vaginal dryness after menopause
Shown to lower pain during sex and vaginal dryness in postmenopausal women using intravaginal DHEA. This applies to the vaginal form, not oral DHEA.
The numbers and sources
- Effect
- Pooled against placebo, intravaginal DHEA lowered dyspareunia scores by a mean difference of -0.40 (95% CI -0.66 to -0.15) and vaginal dryness by -0.23 (95% CI -0.35 to -0.11) [6]. In the largest single trial, daily intravaginal DHEA for 12 weeks reduced pain at sexual activity by 0.36 severity units over placebo and vaginal dryness by 0.27 units over placebo. Parabasal cells fell 27.7% and vaginal pH 0.66 units over placebo. Serum steroids stayed within normal postmenopausal values [7]. In an open-label trial against vaginal estradiol, 92% on DHEA and 82% on estradiol improved by at least 1 point in dyspareunia at 12 weeks (OR 2.87, 95% CI 1.00 to 8.25, p = 0.051). Vaginal pH, maturity index and clinical signs of atrophy improved more on estradiol [8].
- Population
- 1,611 postmenopausal women with vulvovaginal atrophy in 5 unique RCTs [6]; 482 postmenopausal women (325 on DHEA, 157 on placebo) in one phase 3 RCT [7]; 172 postmenopausal women, mean age 62.4, in the estradiol comparison [8].
- Sources
- [6], [7], [8]
- Caveats
- The phase 3 trial was run by the drug's developer, EndoCeutics. The estradiol comparison was open label. This is a local vaginal treatment and does not describe oral DHEA.
Bone density
Shown to raise hip bone density in older women, with no similar effect in men in pooled trials. No trial counted fractures.
The numbers and sources
- Effect
- In women, hip bone density rose more on DHEA than placebo, reported as an SMD of -0.5 for placebo against DHEA (95% CI -0.95 to -0.04). For the trochanter the SMD was -0.55 (95% CI -1.10 to 0.00, p = .05). No similar effect was seen in men [9]. In a 2-year trial, women on DHEA gained density at the ultradistal radius and men at the femoral neck [3]. In elderly men, no effect on bone health was found [2].
- Population
- Healthy older adults in placebo-controlled RCTs [9]; 144 elderly adults [3]; 1,353 elderly men [2].
- Sources
- [2], [3], [9]
- Caveats
- Results differ by sex and site. No sourced trial counted fractures.
Testosterone and estradiol levels in postmenopausal women
Shown to raise testosterone by about 24 ng/dL and estradiol by about 8 pg/mL in postmenopausal women.
The numbers and sources
- Effect
- DHEA raised serum testosterone by 24.31 ng/dL (95% CI 15.22 to 33.40) and estradiol by 7.86 pg/mL (95% CI 6.33 to 9.40). Trials using 50 mg a day or more showed larger rises in testosterone (29.65 ng/dL) [10].
- Population
- Postmenopausal women in 21 RCTs [10].
- Sources
- [10]
- Caveats
- These are blood levels, not symptoms or outcomes. Subgroup confidence intervals overlapped [10].
IVF and ICSI outcomes
Shown to raise clinical pregnancy rates and eggs retrieved in women having IVF or ICSI, on low-quality evidence. Live birth data were insufficient.
The numbers and sources
- Effect
- In women undergoing IVF or ICSI, DHEA increased endometrial thickness by a mean difference of 0.93 (95% CI 0.27 to 1.60) and clinical pregnancy rate with an OR of 1.34 (95% CI 1.08 to 1.67). Oocytes retrieved rose by 0.73 (95% CI 0.36 to 1.10). Evidence was insufficient to conclude on live birth, ongoing pregnancy or miscarriage [11].
- Population
- 1,973 women in 16 RCTs [11].
- Sources
- [11]
- Caveats
- Quality of evidence was rated low to very low, and heterogeneity was linked to disease type, stimulation protocol and when DHEA was started [11].
Not shown to help2
Strength and physical function in older adults
Not shown to change strength or physical function in most studies of adults aged 50 and older, including a 2-year trial.
The numbers and sources
- Effect
- A systematic review of 8 studies found single improvements in grip, chest press, leg press and knee strength, with similar numbers of studies showing no effect on each. Four of five studies of physical function found no difference from control [4]. Over 2 years, DHEA did not change muscle strength or peak oxygen uptake [3].
- Population
- 661 adults aged 50 and older in 8 studies [4]; 144 elderly men and women [3].
- Sources
- [3], [4]
- Caveats
- The review was not pooled, and its trials differed in population and exercise.
Quality of life and menopause symptoms
Not shown to improve quality of life in menopausal women or in older adults over 2 years.
The numbers and sources
- Effect
- In menopausal women, DHEA did not improve quality of life (SMD 0.16, 95% CI -0.03 to 0.34, 8 studies, 287 women). Effects on menopausal symptoms were unclear because trials measured them in ways that could not be pooled [5]. In older men and women over 2 years, quality of life did not change [3].
- Population
- Peri- and postmenopausal women in 28 trials (1,273 women) [5]; 144 elderly adults [3].
- Sources
- [3], [5]
- Caveats
- Quality of life evidence was rated moderate quality [5].
Doses studied
The intravaginal trial used 6.5 mg (0.50%) DHEA daily for 12 weeks [7]. The estradiol comparison used 6.5 mg pessaries daily for 4 weeks, then twice weekly up to 12 weeks [8]. The Cochrane review included any dose, form and route given for at least 7 days [5]. The testosterone meta-analysis compared trials using less than 50 mg a day with those using 50 mg a day or more [10]. The other abstracts sourced here do not state doses.
Risks
Reported risks2
Vaginal discharge with intravaginal DHEA
One trial found about 6% of postmenopausal women using intravaginal DHEA reported vaginal discharge.
Acne and other androgenic effects in women
Shown to raise androgenic side effects, mainly acne, about 3.8 times the odds on placebo in menopausal women.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- DHEA raised the odds of androgenic side effects, mainly acne, with an OR of 3.77 (95% CI 1.36 to 10.4). No associations were found with other adverse effects [5].
- Population
- 376 menopausal women in 5 trials [5].
- Sources
- [5]
- Caveats
- Evidence was rated moderate quality [5].
Checked, no increase found1
Adverse effects in older adults
One small 2-year trial found no major adverse effects in older men or women.
Claims tested and not found
- That DHEA builds strength or physical performance in older adults. A 2-year trial found no change in strength or peak oxygen uptake [3], and most studies in a systematic review found no difference in physical function [4].
- That DHEA improves quality of life. It did not differ from placebo in menopausal women [5] or in older adults over 2 years [3].
- That DHEA improves sexual function, lipids or glucose in older men. No effect was found on these in 25 placebo-controlled trials [2].
Sources
- Wang F, He Y, Santos HO, et al. The effects of dehydroepiandrosterone (DHEA) supplementation on body composition and blood pressure: A meta-analysis of randomized clinical trials. Steroids. 2020. https://doi.org/10.1016/j.steroids.2020.108710
- Corona G, Rastrelli G, Giagulli VA, et al. Dehydroepiandrosterone Supplementation in Elderly Men: A Meta-Analysis Study of Placebo-Controlled Trials. The Journal of Clinical Endocrinology & Metabolism. 2013. https://doi.org/10.1210/jc.2013-1358
- Nair KS, Rizza RA, O'Brien P, et al. DHEA in Elderly Women and DHEA or Testosterone in Elderly Men. New England Journal of Medicine. 2006. https://doi.org/10.1056/NEJMoa054629
- Baker WL, Karan S, Kenny AM. Effect of Dehydroepiandrosterone on Muscle Strength and Physical Function in Older Adults: A Systematic Review. Journal of the American Geriatrics Society. 2011. https://doi.org/10.1111/j.1532-5415.2011.03410.x
- Scheffers CS, Armstrong S, Cantineau AE, et al. Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database of Systematic Reviews. 2015. https://doi.org/10.1002/14651858.CD011066.pub2
- Lemos MJ, Queiroz LF, Diniz AF, et al. Intravaginal dehydroepiandrosterone for the treatment of vulvovaginal atrophy: a systematic review and meta-analysis. Menopause. 2026. https://doi.org/10.1097/gme.0000000000002736
- Labrie F, Archer DF, Koltun W, et al. Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause. 2016. https://doi.org/10.1097/GME.0000000000000571
- Strandberg M, Cockin A, Hirschberg AL. Effects of vaginal dehydroepiandrosterone and estradiol on dyspareunia, a symptom of vulvovaginal atrophy in postmenopausal women - a randomized controlled trial. Maturitas. 2026. https://doi.org/10.1016/j.maturitas.2026.108924
- Lin H, Li L, Wang Q, et al. A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA supplementation of bone mineral density in healthy adults. Gynecological Endocrinology. 2019. https://doi.org/10.1080/09513590.2019.1616175
- He S, Lu K, Zhang L, et al. Impact of DHEA supplementation on testosterone and estradiol levels in postmenopausal women: a meta-analysis of randomized controlled trials assessing dose and duration effects. Diabetology & Metabolic Syndrome. 2025. https://doi.org/10.1186/s13098-025-01770-0
- Huang L, Gao Y, Liang S, et al. Administration of dehydroepiandrosterone improves endometrial thickness in women undergoing IVF/ICSI: a systematic review and meta-analysis. Journal of Ovarian Research. 2025. https://doi.org/10.1186/s13048-024-01581-3