Getting More out of DHEA

Q I live in Australia. Menopause is my problem. Would DHEA or Pregnenolone help me? My symptoms include hot flashes, fatigue, unfocused state of mind, etc.

GAYE, Glen Innes, Australia

A In a recent paper, Italian researchers, following up on a prior study, gave DHEA (25 mg/day) for 12 months to 20 healthy, early-postmenopausal (50–55) and late-postmenopausal (60–65) women.1 They evaluated the effects of the supplemental DHEA on 17 hormones (mostly steroids, and a few neuropeptides and proteins)—including, of course, DHEA itself. (See “DHEA Helps Restore Hormonal Balance” in the March 2004 issue.)

The results showed that the 25-mg/day DHEA treatment had similarly positive (though not as strong) hormonal effects as did the 50-mg/day dose used in the previous study (and in a number of other studies as well). There were 3- to 4-fold increases in the plasma levels of estrogen and testosterone, and progesterone levels more than doubled. The levels of beta-endorphin (the principal “feel-good” hormone) tripled, and the levels of cortisol (the principal stress hormone) fell by about 35%, suggesting, in the authors’ words, “a sort of neuroprotective (antistress) role for exogenous [from the outside] DHEA administration.”

They noted that DHEA supplementation brought about “progressive and significant improvement” in subjective symptoms of menopause, notably hot flashes and psychological effects. Also of great importance, the authors reported that throughout the study there were no significant changes in body weight, occurrence of uterine bleeding, abnormal events, or side effects. Measurements of the women’s endometrial thickness showed no significant changes either. The authors summarized by saying,

In conclusion, our data show that a daily dosage of 25 mg of DHEA restored the steroid milieu, both in early and late postmenopausal women … reducing postmenopausal and aging symptoms. In addition, according to our data, DHEA seems not to stimulate the endometrium. … these data support and confirm that DHEA must be considered a valid compound and drug for HT [hormone therapy] in postmenopausal women and not just a “dietary supplement.”

On a cautionary note, I have seen some women convert DHEA excessively to testosterone, leading to increased secondary sexual characteristics (facial hair, acne, male-pattern hair loss, etc.), so I advise them to reduce their dose. Some conversion to testosterone is useful, since menopausal women generally have lower levels of this male hormone, which is needed for libido, building muscle mass, and even for having a positive mental attitude. Other women tend to convert DHEA to estrogen. I recommend testing hormone levels before and after taking DHEA to monitor levels both of DHEA and of downstream hormone metabolites, such as testosterone and estrogen, and thus to maintain hormonal balance.

Regarding pregnenolone, it is often called the “mother hormone,” because it’s a precursor to DHEA and many other hormones, including progesterone, testosterone, estrogen, and cortisol, all of which decline with age. In my own practice, I have found that pregnenolone can enhance memory, mood, and energy and reduce symptoms of PMS and menopause, all without significant side effects.

Reference

  1. Genazzani AD, Stomati M, Bernardi F, Pieri M, Rovati L, Genazzani AR. Long-term low-dose dehydroepiandrosterone oral supplementation in early and late postmenopausal women modulates endocrine parameters and synthesis of neuroactive steroids. Fertil Steril 2003;80(6):1495-1501.

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