DHEA supplement
DHEA (dehydroepiandrosterone) is an OTC adrenal hormone supplement used for energy and libido in menopause, though clinical evidence is limited.
How it works
DHEA is a precursor hormone produced by the adrenal glands that the body can convert into estrogens and androgens. Levels peak in the mid-20s and decline with age — a process called adrenopause. Some postmenopausal women use OTC DHEA supplements hoping to restore some of that hormone availability. However, the evidence base for systemic OTC DHEA in menopause is modest: a 2015 Cochrane review found little to no significant benefit for general wellbeing or sexual function from oral DHEA supplements, though individual responses vary.
OTC DHEA supplements are not FDA-regulated for potency or safety the way prescription hormone products are. The conversion of oral DHEA into estrogens and androgens is unpredictable and varies by individual. This makes blood level monitoring relevant if DHEA is used regularly. Note that Intrarosa (prescription vaginal prasterone/DHEA insert) is a distinct FDA-approved product — it works locally in vaginal tissue and has specific clinical trial evidence for dyspareunia. OTC oral DHEA is a different product with a different evidence profile.
How to track DHEA supplement
- Energy and sense of wellbeing — commonly cited reasons for using OTC DHEA; track with a consistent scale from before starting.
- Libido and sexual desire — another common rationale; rate consistently and separately from energy.
- Androgenic side effects: acne, oily skin, or body hair changes — oral DHEA converts to androgens and these are dose-related.
- Sleep quality — some people report effects on sleep with DHEA.
- Blood DHEA-S and testosterone levels if monitored — track test dates and results to ensure levels remain within appropriate ranges.
- Establish a baseline for energy, libido, and wellbeing before starting — OTC DHEA's effects are subtle and individualized; without a baseline, it is impossible to attribute any changes to the supplement.
- Track androgenic side effects (acne, hair changes) from the first week — they are the most reliable indicator of whether you are converting enough DHEA to androgens.
- Log blood test dates and results if your physician is monitoring DHEA-S or testosterone levels — this data belongs in the same record as your symptom log.
- Note the specific product, dose, and any changes — OTC supplements vary in quality and actual DHEA content.
- After six to eight weeks of consistent use and logging, assess the data honestly — if there is no measurable signal in your tracked outcomes, discuss with your physician whether continuation is justified.
Questions to ask your physician
- I've been using OTC DHEA at [dose] for [N] weeks. My energy and libido log shows [pattern] — does that suggest a real effect, or could it be attributable to other factors?
- My androgenic side effect log shows [pattern] — does that suggest I'm converting a significant amount of DHEA to androgens at my current dose?
- My DHEA-S and testosterone levels were [X] on [date]. Are those within appropriate ranges, and should I continue monitoring?
- I'm using OTC DHEA alongside [other HRT medications]. Is there any interaction or risk I should be aware of?