Last checked September 2026 against 9 sources · Editorial policy
DHEA for menopause
Oral DHEA supplements aren't a proven menopause treatment. A Cochrane review of 28 trials in 1,273 women found no improvement in quality of life, unclear effects on hot flashes and other symptoms, a slight improvement in sexual function, and more acne and other androgenic side effects. DHEA does raise estradiol and testosterone a little. Prescription vaginal DHEA, prasterone (Intrarosa), is FDA-approved for painful sex caused by menopause.
Oral DHEA raises estradiol slightly but didn't improve quality of life in 28 trials and causes acne. Vaginal prasterone (Intrarosa) is approved for painful sex after menopause.
DHEA for menopause: expectation vs reality
What people often expect
“DHEA is a natural way to restore my estrogen and testosterone”
What the evidence shows
DHEA is converted in the body into testosterone and estrogen, and supplements do raise both modestly. But higher blood levels haven't translated into better quality of life or clear relief of menopause symptoms. NCCIH says long-term safety is unknown and even short-term use may cause harm, including liver damage.
DHEA and menopause: what studies show
What DHEA is
Dehydroepiandrosterone (DHEA) is made naturally in the body and converted into testosterone and estrogen. Production falls with age, but NCCIH says it's unclear whether that affects aging or menopause symptoms. In the US, DHEA is sold over the counter as a dietary supplement, so it isn't FDA-approved before sale.
Does DHEA increase estrogen?
Yes, modestly. A 2025 meta-analysis of 21 studies in postmenopausal women found DHEA raised estradiol by 7.86 pg/mL and testosterone by 24.31 ng/dL on average. Increases were larger at doses of 50 mg a day or more, and the estradiol rise was clearest in women aged 60 or older.
Learn more →DHEA for menopause symptoms
The Cochrane review found it unclear whether DHEA affects hot flashes and other menopause symptoms because trial results were inconsistent and couldn't be pooled. Compared with placebo, DHEA didn't improve quality of life in 8 studies of 287 women. NCCIH says it's uncertain whether DHEA helps menopause symptoms.
DHEA for libido and sexual function
Results are mixed. The Cochrane review found DHEA slightly improved sexual function over placebo. A second meta-analysis of 23 trials of systemic DHEA in 1,188 postmenopausal women found no significant improvement in libido or sexual function, with low confidence in the evidence. Oral DHEA alone showed no clear effect in the Cochrane subgroup.
Learn more →Vaginal DHEA: prasterone (Intrarosa)
Intrarosa is a prescription vaginal insert containing 6.5 mg of prasterone, which is DHEA. It's FDA-approved for moderate to severe pain during sex caused by menopausal vaginal atrophy. You use one insert every night at bedtime. Its most common side effects are vaginal discharge and abnormal Pap smear results.
Learn more →DHEA side effects
DHEA was linked to androgenic side effects, mainly acne, with odds 3.77 times higher than placebo in the Cochrane review. No links were found with other adverse effects in those trials. NCCIH warns that long-term safety is unknown and that even short-term use may be harmful, including liver damage.
Learn more →What guidelines say
A task force from several professional societies recommends against routine use of DHEA, according to NCCIH. For hot flashes, the North American Menopause Society recommends HRT as most effective, with CBT, hypnosis, SSRIs or SNRIs, gabapentin and fezolinetant as non-hormonal options.
Learn more →DHEA by the numbers
28
3.77
7.86 pg/mL
6.5 mg
Most DHEA trials were small, and the quality of evidence was moderate to low.
DHEA supplements vs prescription DHEA compared
Oral DHEA supplements
Good for
Modestly raise estradiol and testosterone.Watch
No proven benefit for quality of life or symptoms; acne; possible liver harm.Prasterone vaginal insert (Intrarosa)
Learn more →Good for
FDA-approved for painful sex due to menopause.Watch
Prescription only; vaginal discharge; not studied after breast cancer.Vaginal estrogen
Learn more →Good for
Standard treatment for vaginal dryness and painful sex.Watch
Prescription needed.Testosterone for women
Learn more →Good for
Evidence for low sexual desire after menopause.Watch
Prescription; acne and hair growth possible.
Before you take DHEA
- Don't take DHEA if you've had breast cancer or another hormone-sensitive cancer; it's converted into estrogen.
- Watch for acne or other androgenic effects.
- Stop and see a doctor if you notice signs of liver trouble.
- For painful sex, ask about prescription vaginal DHEA or vaginal estrogen instead of pills.
When to talk to a doctor about DHEA
DHEA and menopause: questions women ask
Does DHEA help menopause symptoms?
It's uncertain. The Cochrane review found trial results on menopause symptoms inconsistent and no improvement in quality of life compared with placebo.
Does DHEA increase estrogen in postmenopausal women?
Modestly. A meta-analysis found estradiol rose by 7.86 pg/mL on average, more at doses of 50 mg a day or more and in women aged 60 or older.
Does DHEA help libido in menopause?
Maybe slightly. One review found a small improvement in sexual function; another found no significant effect on libido. Testosterone has better evidence for low desire.
What is prasterone?
Prasterone is DHEA. As Intrarosa, a 6.5 mg vaginal insert used nightly, it's FDA-approved for moderate to severe painful sex due to menopause.
What are the side effects of DHEA?
Acne and other androgenic effects were more common than with placebo. NCCIH says long-term safety is unknown and short-term use may cause liver damage.
Is DHEA safe for women over 50?
Long-term safety is unknown, and professional societies recommend against routine use. Women who've had breast cancer shouldn't use it without their oncology team's advice.
Is vaginal DHEA the same as a DHEA supplement?
No. Intrarosa is a prescription vaginal insert approved for painful sex; oral supplements aren't FDA-approved and act on the whole body.
Sources
- Scheffers CS, Armstrong S, Cantineau AE, et al. Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database Syst Rev. 2015;1(1):CD011066.
- 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. Diabetol Metab Syndr. 2025;17(1):258.
- Prescribing information: Intrarosa (prasterone vaginal inserts). Millicent, 2026. DailyMed, US National Library of Medicine.
- National Center for Complementary and Integrative Health. Menopausal symptoms: in depth.
- US Food and Drug Administration. Dietary supplements.
- Elraiyah T, Sonbol MB, Wang Z, et al. Clinical review: The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2014;99(10):3536-42.
- The North American Menopause Society. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause. 2023;30(6):573-590.
- NHS. Vaginal dryness.
- Islam RM, Bell RJ, Green S, et al. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. Lancet Diabetes Endocrinol. 2019;7(10):754-766.
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