During the perimenopausal period, there are large reductions in estrogens and progesterones. By the time menopause begins, DHEA and testosterone levels have also reduced by 55%–60%.[1] DHEA has been studied as a potential therapeutic for postmenopausal women. A systematic review found that in postmenopausal women, supplementation with vaginal DHEA, testosterone, and estrogen were all associated, in a dose-response manner, with improvements in genitourinary complaints such as vaginal atrophy and sexual function.[2] Like other androgens, DHEA supplementation increases testosterone in postmenopausal women, but it is unique among supplemental androgens in also increasing estrogens.[1]
In addition, another systematic review found that in older women without health conditions, DHEA supplementation may have small benefits for bone mineral density; however, the benefits did not extend to men.[3] Although that meta-analysis did not evaluate fracture risk, one Mendelian randomization study found that women with genes predicting higher DHEA-S serum levels had higher bone mineral density and less risk of lower back and forearm fractures (but not hip or femoral fractures).[4]