DHEA – a forgotten hormone

DHEA, or dihydroepiandosterone, is an often-overlooked hormone when it comes to aging. Its secretion begins to decrease after the age of 30, and has diminished by 60% by age 55. Most of the body’s DHEA comes from the adrenal glands, with the remainder coming from either the ovaries in women or testicles in men. There is wide variety in the circulating levels of DHEA in the patients I see: some folks have barely detectable levels while others maintain normal values. Why is this important?

It turns out that DHEA is mostly a neurohormone, supporting various brain functions including mood, memory, and concentration. It also has a role in metabolism, assisting with fat-burning. In women, DHEA becomes the exclusive source of sex steroids after menopause, as it is directly converted into both estrogen and testosterone. The women who breeze through menopause are the ones with great levels of DHEA, meaning they have strong adrenal function. Women with low DHEA will suffer a marked deficit of sex steroids leading to osteoporosis, muscle loss, vaginal atrophy, and memory loss, together with the hot flashes and night sweats typical of menopause. A recent randomized, placebo-controlled study has shown that all the signs and symptoms of vaginal atrophy, a classical problem recognized to be due to the hormone deficiency of menopause, can be rapidly improved or corrected by local administration of DHEA without systemic exposure to estrogens.1

For men, the contribution of adrenal DHEA is not quite as big a deal, as the testicles continue to manufacture some testosterone for our whole lifetime. DHEA replacement can still be helpful for mood and memory, but supplementation does have more easily measurable benefits in women. In men, DHEA does not convert directly to testosterone.

No serious adverse events related to DHEA supplementation has ever been reported in the medical literature. Mild side effects can include oily skin, acne, and unwanted hair growth. Some people may feel a bit angry or irritable, but otherwise DHEA certainly has an excellent safety profile. It is readily available over-the-counter in the USA in a wide variety of doses from 5 to 100 mg, but in Canada it is only available through a compounding pharmacy where the raw powder can be made either into a cream or a capsule. I generally start with 5-10 mg daily for women, and 50-100 mg daily for men. If you’re not sure whether DHEA supplementation might be helpful for you, ask your physician to test your blood level. The test is covered by MSP. It is clear that DHEA can be a safe and effective replacement therapy for multiple problems related to hormone deficiency associated with aging.

Your partner in Living Longer Better,

Dr. Grant Pagdin, MD

1. Labrie F. DHEA, important source of sex steroids in men and even more in women.
Prog Brain Res. 2010;182:97-148. doi: 10.1016/S0079-6123(10)82004-7.