When you reach menopause, hormone shifts can affect your body, mood, and life. Dehydroepiandrosterone (DHEA) levels decline as part of that shift, and supplementing it can help with symptoms like hot flashes and low mood. 

But DHEA isn’t as widely known as estrogen and progesterone. So how does it work? And how can DHEA products for menopause ease your symptoms? Read on to learn more. 

‍

What DHEA is and what it does in the body

DHEA is a hormone that mostly comes from the adrenal glands. The ovaries produce it in small amounts, too. It’s a precursor hormone, which means the body converts it into other hormones, such as testosterone and estrogen.

Does menopause affect DHEA?

DHEA gradually declines over time. It typically peaks in your 20s, then falls by 2–5% each year. In most cases, as menopause starts, DHEA has already declined. 

Here’s why that matters: The ovaries produce less estrogen in menopause. The body relies on hormone precursors, like DHEA, for part of its estrogen production. Low DHEA may further contribute to the already-diminished pool of available estrogen. 

This can affect your mind and body in multiple ways, including: 

• Bone density: Higher DHEA-S* levels may promote bone density. 
• Sexual function: Lower DHEA-S levels may impair sexual function. 
• Mood: Low DHEA may promote depression (mixed outcomes). 

These findings are observational. Further research is required to confirm these associations. 

*DHEA-S (dehydroepiandrosterone-sulfate) is the stored form of DHEA. 

Understanding DHEA products

DHEA dietary supplements are widely available in the United States, sold over the counter (OTC). Prescription medications are also available. But only one product is FDA-approved in the U.S. for menopause care: Intrarosa®. 

Intrarosa® is approved to treat moderate-to-severe dyspareunia (painful sex) due to menopause. All DHEA products contain prasterone—the pharmaceutical name for DHEA—as their active ingredient. 

What’s the difference between DHEA supplements and FDA-approved prescription medications, exactly? Approved products are standardized and subject to regulatory oversight (premarket and ongoing). Supplements face comparatively limited oversight, but that doesn’t mean they’re unsafe. It just means these products aren’t subject to the FDA’s specific premarket approval process. 

DHEA products fall into three main camps:

• Transdermal: You apply this medication to the skin, where it absorbs into the bloodstream and produces body-wide effects. 
• Oral: This is a pill (capsule or tablet) you swallow, which enters your bloodstream and carries body-wide effects. 
• Local vaginal: Local vaginal medication gets delivered directly to vaginal tissue, with effects largely contained to this area. 

Intrarosa® is a local vaginal insert that you typically use once daily around bedtime. Other DHEA products vary in their administration methods and dosages. 

‍

Can DHEA supplementation help in menopause?

DHEA supplementation might help ease some menopause symptoms. One meta-analysis looked at DHEA products’ menopause benefits. It pooled 28 randomized controlled trials, involving over 1,200 menopausal women.

Here’s what the analysis found:

• Quality of life: DHEA didn’t improve quality of life compared with placebo. 
• Hot flashes: Outcomes were unclear because across trials were inconsistent. 
• Sexual function: DHEA might modestly improve sexual function compared with placebo. The study’s authors note that while DHEA may modestly support sexual function, its benefits may not outweigh its side effect risk.

‍

DHEA safety, side effects, and dosing

The same analysis as above tracked side effects across its trials:

• Androgenic side effects: DHEA was associated with side effects stemming from excess androgen production, mainly acne. Around 15% of participants using a DHEA product experienced these effects, versus 3% on placebo. 
• Long-term risks: These are unknown because none of the trials ran for over a year. Other researchers indicate that DHEA products might raise the risk of hormone-sensitive cancers, though more research is required. 

These findings primarily involve DHEA supplements. They don’t apply directly to Intrarosa®, whose safety profile has been separately and individually reviewed by the FDA. 

In one study about Intrarosa®, researchers identified vaginal discharge as its most common side effect. It affected 5.71% of women versus 3.66% on placebo. In another study, 2.1% of patients had an abnormal Pap smear. This is a screening test that finds any changes in cervical cells. An abnormal result might indicate a precancerous change that warrants further testing. Of the participants in this study who had abnormal results, one had a low-grade squamous intraepithelial lesion, and 10 had atypical cells of undetermined significance.

Contraindications

Approved products must list contraindications if any apply. Contraindications are conditions or circumstances that make the product unsafe to use. DHEA supplements typically carry warnings that function similarly to contraindications. 

Intrarosa® has one contraindication: undiagnosed abnormal genital bleeding. This may indicate a serious underlying condition that must be ruled out first. If your doctor is considering this treatment for perimenopause or menopause, they’ll screen for this contraindication before prescribing. 

Dosing schedules

Intrarosa® is a 6.5 mg once-daily vaginal insert. Other DHEA products vary in both dosage and frequency. But due to their targeted and confined delivery, local vaginal products tend to have lower dosages than transdermal and oral forms. 

Intrarosa® doesn’t involve gradual dose adjustments (titration) to ease into the treatment. Patients can start with the standard dose of 6.5 mg, unless advised otherwise. 

OTC DHEA supplements typically don’t involve titration, either. Other DHEA products, particularly high-dose regimens, may warrant it under medical supervision. 

Is DHEA better than HRT for menopause?

Hormone replacement therapy (HRT) is an established, first-line menopause intervention. The Menopause Society, a leading U.S. authority on menopause, states that HRT is the most effective intervention for vasomotor symptoms (VMS) and genitourinary syndrome of menopause (GSM). These are among the most common—and taxing—menopause symptoms.

Compared to DHEA, HRT has a more extensive body of research backing its safety and efficacy in menopause care. A 2025 review in the International Journal of Molecular Sciences indicates that HRT can:

• Reduce hot flash frequency by up to 80%
• Improve sleep quality
• Reduce depressive symptoms
• Modestly improve sexual function
• Reduce bone resorption (the breakdown of bone tissue)

That said, DHEA products do have their place. A 2025 guideline from the American Urological Association and two partner societies lists local vaginal DHEA products alongside local vaginal HRT as an effective GSM treatment. 

Navigating menopause with Maven Clinic

Menopause can be stressful and isolating. With Maven Clinic, you can get the support and treatment you need to treat symptoms from weight gain to brain fog.

As one patient, Debbie, put it: "I started using Maven because I was looking for answers and support during perimenopause. What stood out immediately was how understood I felt. The providers didn't dismiss my symptoms. They helped me make sense of the changes happening in my body and gave me practical, personalized support.”

This is why millions of women trust Maven Clinic with their care. Discover our approach to hormone treatment to find out more.