What is DHEA?
This post was written with Consensus AI Academic Search Engine – please read our Disclaimer at the end of this article. Dehydroepiandrosterone (DHEA) is a steroid hormone produced primarily by the adrenal glands, with smaller amounts being secreted by the gonads and brain. It serves as a precursor to male and female sex hormones, including testosterone and estrogen. DHEA levels peak in early adulthood and decline with age, leading to interest in its potential as a supplement to counteract age-related conditions. Other names included: 3b-Hydroxy-Androst-5-Ene-17-One, 3BetaHydroxy-Androst-5-Ene-17-One, Androstenolone, Dehydroepiandrosterone, Déhydroépiandrostérone, DHEA-S, GL701, Prasterone, Prasterone.
Age-Related Decline
The secretion and blood levels of DHEA and DHEAS decrease significantly with age. This decline has been associated with various age-related conditions, including decreased bone density, reduced muscle mass, and impaired immune function1 2 3. The DHEAge Study highlighted that DHEA supplementation could restore youthful levels of DHEAS and potentially counteract some aging effects, such as improved bone turnover and skin hydration in elderly women1.
Effects on Immune Function
DHEA has been shown to activate immune function in elderly men. A study involving age-advanced men demonstrated that DHEA supplementation increased the number of monocytes and B cells, enhanced T cell mitogenic response, and improved natural killer (NK) cell activity. These findings suggest that DHEA could have therapeutic benefits in immunodeficient states2.
Impact on Physical Performance and Body Composition
Research on the effects of DHEA on physical performance and body composition has yielded mixed results. While some studies have shown that DHEA supplementation can enhance muscle mass and strength, particularly when combined with resistance exercise, others have found no significant benefits on body composition or physical performance3 5 6. For instance, a study involving elderly men and women found that DHEA did not significantly alter muscle strength or insulin sensitivity over a two-year period3.
Psychological and Cognitive Effects
DHEA has been reported to improve mood and reduce fatigue, particularly in individuals with adrenal insufficiency, such as those with Addison’s disease. Studies have shown that DHEA supplementation can enhance self-esteem, overall well-being, and reduce evening fatigue without significant adverse effects4 7. Additionally, DHEA has been found to modulate brain activity related to emotion regulation, suggesting potential benefits for mood and anxiety disorders10.
Reproductive Health
DHEA supplementation has also been explored in the context of reproductive health. For example, it has been shown to improve ovarian reserves and pregnancy rates in poor-responder patients undergoing in vitro fertilization (IVF) treatment5. Furthermore, intravaginal DHEA has been effective in alleviating symptoms of vulvovaginal atrophy and dyspareunia in postmenopausal women9.
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Biological Role and Mechanism of DHEA
DHEA and its sulfate ester, DHEA sulfate (DHEAS), are involved in a variety of physiological processes. They act as precursors for the synthesis of androgens and estrogens, which are crucial for maintaining various bodily functions. DHEA is also known to have neurosteroidal properties, influencing brain function and mood regulation1 7 10.
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Uses of DHEA
Reproductive Health and Fertility
DHEA supplementation can improve ovarian reserves and live birth rates in women undergoing in vitro fertilization (IVF) and frozen embryo transfer (FET) cycles, particularly in those with diminished ovarian reserves or poor ovarian response1 4.
Mood and Emotional Regulation
DHEA has anxiolytic and antidepressant properties. It reduces activity in brain regions associated with negative emotions and enhances connectivity in regions linked to emotional regulation, potentially making it useful for mood and anxiety disorders2.
Bone Health and Body Composition
In patients with Addison’s disease, DHEA supplementation can improve bone mineral density at the femoral neck and increase lean body mass without affecting fat mass. It also improves psychological well-being3.
DHEA enhances the effects of weight training on muscle mass and strength in elderly individuals, suggesting benefits for age-related muscle decline7.
Sexual Function
DHEA improves sexual function in women with Sheehan syndrome and those experiencing vulvovaginal atrophy due to menopause. It alleviates symptoms like dyspareunia (pain during sex) and vaginal dryness5 8.
Cognitive Function
DHEA does not significantly improve cognitive performance in HIV-positive patients with non-major depression6.
Preliminary evidence suggests DHEA may improve memory and reduce negative symptoms in schizophrenia patients, although more research is needed9.
Vaginal Health
Intravaginal DHEA is effective in treating vaginal symptoms in postmenopausal women, including those with a history of cancer. It improves vaginal cytology and pH without significantly altering systemic hormone levels10.
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💁♀️Does DHEA improve sexual function in postmenopausal women? 💪🏼Can DHEA enhance muscle mass and strength in elderly individuals during weight training?Adverse Effects of DHEA
Reproductive Toxicity in Pregnant Rats
DHEA caused miscarriages, slowed weight increase in mothers and fetuses, slowed sternum growth, increased visceral abnormalities in fetuses, and decreased the number of living fetuses in pregnant rats1.
Androgenic Effects
DHEA treatment in postmenopausal women led to androgenic side effects such as acne and increased hair growth8.
Vaginal Discharge
Intravaginal DHEA treatment caused vaginal discharge due to the melting of the vehicle at body temperature in about 6% of participants5.
Lack of Significant Adverse Effects in Some Studies
Some studies reported no significant adverse effects on lipid profiles, insulin sensitivity, or endometrial health in postmenopausal women7.
Short-term DHEA treatment in young women with anorexia nervosa was well-tolerated with no adverse clinical side effects noted4.
Long-term DHEA treatment in elderly men and women showed no major adverse effects3.
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How has DHEA Improved Patient Outcomes?
Improvement in IVF Outcomes for Poor Responders and Older Women
DHEA supplementation has been shown to improve live birth rates, embryo quality, and reduce cycle cancellation rates in poor-responder patients undergoing IVF treatment1 4 5 9.
In women with advanced reproductive age and normal ovarian reserve, DHEA significantly increased live birth rates and reduced miscarriage rates2.
DHEA also improved ovarian response markers, such as the number of retrieved oocytes and top-quality embryos, in patients with diminished ovarian reserve4 5 8.
Psychological Well-being
DHEA supplementation led to modest improvements in psychological well-being, including better mood and self-esteem, in hypopituitary patients on growth hormone replacement3.
In HIV/AIDS patients with subsyndromal depression, DHEA was superior to placebo in reducing depressive symptoms7.
Effect on Schizophrenia Symptoms
DHEA showed potential in improving negative symptoms and certain extrapyramidal side effects in schizophrenia patients treated with olanzapine, although no significant change in psychosis was noted10.
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Common Complaints Associated with DHEA Use
Lack of Superior Effect Over Placebo
DHEA did not show a superior effect over placebo in improving fatigue, well-being, or depressive mood in women with primary Sjögren syndrome1.
DHEA supplementation did not significantly improve perimenopausal symptoms, mood, dysphoria, libido, cognition, memory, or well-being compared to placebo in perimenopausal women4 5.
No significant effects of DHEA were observed on cognition or well-being in older men in the short term6.
Side Effects and Adverse Events
The only side effect reasonably related to intravaginal DHEA treatment was vaginal discharge due to the melting of the vehicle at body temperature, reported in about 6% of participants2.
Few adverse events were reported in HIV/AIDS patients treated with DHEA, and no significant changes in CD4 cell count or HIV RNA viral load were observed7.
Endocrine and Lipid Profile Changes
DHEA supplementation significantly affected the endocrine profile, including increases in DHEAS and testosterone levels, and a decline in cortisol levels4 5.
There were declines in high-density lipoprotein and Lp(a) levels, but these changes did not significantly differ from those in the placebo group4 5.
Improvement in Specific Symptoms
Intravaginal DHEA showed significant improvement in dyspareunia, vaginal dryness, and other symptoms of vulvovaginal atrophy in menopausal women2.
DHEA appeared to improve negative symptoms and certain features of extrapyramidal side effects in schizophrenia patients treated with olanzapine3.
DHEA was superior to placebo in reducing depressive symptoms in HIV/AIDS patients with subsyndromal depression or dysthymia7.
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Disclaimer
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