Does DHEA help with bloating during perimenopause?

DHEA (dehydroepiandrosterone) is a hormone produced by your adrenal glands that the body converts into estrogen and testosterone. During perimenopause, both DHEA and ovarian hormones decline, which affects many body systems. Bloating is one of the most common perimenopause complaints, but the honest answer here is that there is very little evidence DHEA meaningfully helps with it.

Researchers have not conducted clinical trials specifically examining DHEA for bloating in perimenopausal women. The theoretical connection exists because estrogen receptors are found throughout the gastrointestinal tract, and since DHEA can convert to estrogen, some have speculated that raising DHEA levels might ease gut symptoms indirectly. However, this has not been tested in well-designed human studies. A few trials on DHEA supplementation in perimenopausal women report general quality-of-life improvements, but these studies do not measure bloating as a specific outcome. Using DHEA primarily to target bloating would be getting ahead of the available evidence.

Bloating during perimenopause is real and has identifiable hormonal drivers, though DHEA's role in any of them is indirect at best. Declining progesterone is one of the biggest culprits: progesterone normally helps stimulate gut motility, so as levels drop, food and gas can move through the intestines more slowly. Estrogen fluctuations affect both the gut microbiome and intestinal permeability, which can increase gassiness and discomfort. Cortisol tends to rise when the DHEA-to-cortisol ratio shifts with age, and elevated cortisol further disrupts gut function. DHEA supplementation might theoretically influence some of these pathways through its conversion products, but this chain of events has not been measured in bloating-focused research.

If you and your healthcare provider decide to trial oral DHEA for other perimenopause symptoms, studies in perimenopausal and postmenopausal women have generally used doses of 25 to 50 mg daily. Some researchers have used lower doses of 10 to 25 mg in women with higher baseline DHEA-S levels. Vaginal DHEA (Intrarosa, 6.5 mg nightly insert) is the best-studied form and is FDA-approved specifically for vaginal symptoms related to genitourinary syndrome of menopause. Oral DHEA is available over the counter in the US but is not approved for any specific indication. Get your baseline DHEA-S blood level tested before starting supplementation. Self-dosing without knowing your starting level is genuinely risky because more is not better with hormones. Talk to your healthcare provider about the right dose for your situation.

If you have or have had breast cancer, ovarian cancer, uterine cancer, endometriosis, PCOS, or uterine fibroids, do not use DHEA without discussing it with your healthcare provider first. At higher doses, DHEA can cause androgenic side effects including acne, oily skin, unwanted facial hair, scalp hair loss, and voice changes. If you are already using hormone therapy, adding DHEA without your provider's knowledge can shift your hormone balance in ways that are difficult to predict. Over-the-counter availability does not mean DHEA is safe to self-dose.

Do not expect DHEA to resolve bloating, even if you take it for other reasons. Better-studied approaches for perimenopause bloating include eating smaller and more frequent meals, reducing carbonated drinks and high-FODMAP foods, supporting your gut microbiome with prebiotic fiber and fermented foods, and staying well hydrated. Magnesium citrate can help with gut motility when constipation is driving the discomfort. Probiotics have some evidence for reducing general bloating in adults, though research specifically in perimenopausal women is limited. Most people notice meaningful change from dietary adjustments within two to four weeks.

See a doctor about your bloating if it is persistent and does not respond to dietary changes, if it is accompanied by abdominal pain, blood in your stool, unintentional weight loss, or significant nausea, or if it has worsened noticeably and quickly. Bloating can occasionally signal conditions like ovarian cysts, irritable bowel syndrome, small intestinal bacterial overgrowth, or in rare cases, something more serious. These deserve a proper evaluation, not a supplement trial.

The most useful thing you can do right now is track your bloating alongside what you eat, your cycle phase, your stress levels, and your sleep quality. Patterns often emerge that point to a specific trigger you can address. The PeriPlan app lets you log symptoms daily alongside cycle data and lifestyle factors, making it much easier to connect bloating spikes to specific inputs. Download it at https://apps.apple.com/app/periplan/id6740066498.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.