Benefits
Bone density in older women
In a pooled analysis of four one-year trials in adults aged 55 and older, women taking DHEA gained about 1% lumbar spine bone density versus placebo, while men had no bone benefit. A review of trials in postmenopausal women found no significant bone density effect, so any benefit is small.
Sexual function in postmenopausal women
Two pooled analyses of trials in postmenopausal women found no clear improvement in sexual function or libido from oral or systemic DHEA. In the larger of the two, oral DHEA alone did not differ from placebo, and the small overall benefit included a vaginal DHEA trial, a different product. A one-year trial in older adults found no change, while one small trial in midlife depression reported better sexual function scores.
Body composition and muscle strength
A two-year trial in older men and women with low DHEA levels (75 mg a day for men, 50 mg for women) found no effect on body composition, muscle strength or aerobic capacity. A pooled analysis of four one-year trials found only a small fat loss in men, about 0.4 kg, and no significant change in lean mass in women.
Mood in adults aged 45 to 65
In a crossover trial of 46 men and women aged 45 to 65 with midlife-onset major or minor depression, six weeks of DHEA improved depression rating scores more than placebo; 23 people had at least a 50% improvement on DHEA versus 13 on placebo. A one-year trial in healthy older adults found no mood benefit.
Memory and thinking in older adults
A one-year trial of 50 mg a day in 225 adults aged 55 to 85 found no cognitive benefit. A review of four trials in postmenopausal women found a benefit in only one 4-week study of 24 women, and the authors concluded the evidence does not support DHEA for cognition.
Quality of life and insulin sensitivity
In a two-year placebo-controlled trial in older adults, DHEA did not improve quality of life or insulin sensitivity. A review of trials in peri- and postmenopausal women also found no quality of life benefit, and another found no effect on blood glucose, lipids or weight.
Mechanism of action
Precursor to sex hormones
DHEA is converted in body tissues into androgens such as testosterone and into estrogens. In one-year trials of older adults, oral DHEA raised DHEA-S, estradiol and IGF-1 in both sexes and testosterone in women.
Estradiol increase in women
A pooled analysis of randomized trials found that DHEA raised blood estradiol in women by about 7 pg/mL on average, more so in women aged 60 and over and at 50 mg a day. This is why DHEA needs caution in anyone with a hormone-sensitive condition.
Clinical trials
Randomized, double-blind, placebo-controlled 2-year trial of oral DHEA (75 mg a day for men, 50 mg a day for women), with a testosterone arm for men (Nair et al. 2006, New England Journal of Medicine).
87 men with low DHEA-S and bioavailable testosterone and 57 women with low DHEA-S, all older adults.
DHEA raised DHEA-S but did not improve body composition, muscle strength, aerobic capacity, insulin sensitivity or quality of life. Women on DHEA had a small bone density gain at the wrist and men at the hip. No major adverse effects were seen.
Randomized, double-blind, placebo-controlled crossover trial: 6 weeks of DHEA (90 mg a day for 3 weeks, then 450 mg a day for 3 weeks) and 6 weeks of placebo (Schmidt et al. 2005, Archives of General Psychiatry).
46 adults aged 45 to 65 (23 men, 23 women) with midlife-onset major or minor depression, not taking antidepressants.
Depression scores improved more on DHEA than on placebo; 23 people improved by at least 50% on DHEA versus 13 on placebo. Sexual function scores also improved versus placebo.
Randomized, double-blind, placebo-controlled trial of oral DHEA 50 mg a day for 1 year (Kritz-Silverstein et al. 2008, Journal of the American Geriatrics Society).
225 healthy adults aged 55 to 85 (110 men, 115 women).
No difference from placebo in cognitive function, depression scores, quality of life, life satisfaction or sexual function.
Pooled analysis of four double-blind, randomized, placebo-controlled 12-month trials of daily DHEA (Jankowski et al. 2019, Clinical Endocrinology).
295 women and 290 men aged 55 and older.
Women on DHEA gained about 1.0% lumbar spine and 0.5% trochanter bone density and kept total hip density stable versus placebo; men had no bone benefit but a small fat mass decrease. DHEA raised DHEA-S, estradiol and IGF-1 in both sexes and testosterone in women.
Systematic review and meta-analysis of 28 randomized trials of DHEA by any route (Scheffers et al. 2015, Cochrane Database of Systematic Reviews).
1,273 peri- and postmenopausal women.
DHEA did not improve quality of life and raised the odds of androgenic side effects, mainly acne. Overall sexual function improved slightly, but oral DHEA alone did not differ from placebo, while one vaginal DHEA trial did. Effects on menopausal symptoms were unclear.
Systematic review and meta-analysis of 23 randomized trials of systemic DHEA (Elraiyah et al. 2014, Journal of Clinical Endocrinology and Metabolism).
1,188 postmenopausal women with normal adrenal function.
DHEA was not linked to a significant improvement in libido or sexual function and had no significant effect on lipids, glucose, weight or bone density. Confidence in the evidence was low.
Dose-response meta-analysis of randomized trials reporting estradiol after DHEA (Zhu et al. 2021, Steroids).
1,223 women across 21 trial arms.
DHEA raised estradiol by about 7 pg/mL on average, with larger rises in women aged 60 and over, with 26 weeks or more of use, at 50 mg a day and in postmenopausal women.
Systematic review of randomized trials of oral DHEA 50 mg a day (Sultana et al. 2023, Menopause).
Postmenopausal women in four trials.
Only one 4-week crossover study of 24 women found better visual-spatial test scores; no other trial found a cognitive benefit, and the authors concluded the evidence does not support DHEA for cognition.