Does DHEA help with brain fog during perimenopause?

DHEA (dehydroepiandrosterone) is a precursor hormone that your body converts into both estrogen and testosterone. It also acts directly in the brain as a neurosteroid, which means it has biological effects on brain function independent of its conversion to other hormones. During perimenopause, DHEA levels decline alongside estrogen, and this dual decline may contribute to cognitive symptoms including the word retrieval problems, poor concentration, and mental fogginess many women describe.

The research on DHEA and cognition is genuinely interesting, though it is more promising than definitive. A number of studies in older adults have found that higher DHEA-S levels correlate with better memory and processing speed. A 2011 trial published in the Journal of Clinical Endocrinology and Metabolism found that DHEA supplementation improved verbal memory in older men and women with low baseline levels. DHEA also influences acetylcholine pathways in the hippocampus, the brain region most central to memory formation, which gives it a biologically plausible connection to the memory lapses common in perimenopause. A smaller set of studies in perimenopausal women specifically suggest improvements in mood and some aspects of cognition with oral DHEA, but the sample sizes are modest and the findings are not consistent across all trials. Research on vaginal DHEA (Intrarosa) has noted improvements in cognitive endpoints in some participants, though this was not the primary focus of those studies.

Why perimenopause is a particularly relevant window: estrogen has direct neuroprotective effects, and as estrogen production from the ovaries becomes erratic, several brain processes are affected simultaneously. DHEA itself is converted to estrogen in brain tissue, meaning it can support local estrogen levels in ways that systemic measurement might underestimate. DHEA-S (the sulfated storage form of DHEA) peaks in your mid-20s and declines steadily with age, so by the time perimenopause arrives, your brain's access to this neurosteroid is already meaningfully reduced. Some researchers believe the DHEA-S decline compounds the cognitive effects of falling ovarian estrogen, though this interaction is still being studied.

Studies examining DHEA for cognitive and mood outcomes in middle-aged and older women have typically used oral doses of 25 to 50 mg daily. Some trials have used lower doses of 10 to 25 mg, particularly in participants with better baseline DHEA-S levels. Vaginal DHEA (Intrarosa, 6.5 mg nightly) is FDA-approved for vaginal symptoms and has also shown some cognitive and libido benefits in trials, with minimal systemic absorption compared to oral forms. Get your baseline DHEA-S blood level tested before starting any form of supplementation. Self-dosing without knowing your baseline is risky. Talk to your healthcare provider about whether your levels support a trial and what dose makes sense for you.

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, androgenic side effects can occur: acne, oily skin, unwanted facial hair, scalp hair loss, and voice changes. If you are currently using hormone therapy, adding DHEA without your provider's knowledge can alter your overall hormone balance unpredictably. Over-the-counter availability does not mean DHEA is safe to self-dose.

If you do try DHEA for brain fog, realistic expectations matter. Some women report noticeably sharper thinking within four to eight weeks; others notice little change. Cognitive symptoms during perimenopause often have multiple drivers including poor sleep, elevated cortisol, thyroid changes, and iron deficiency, so a single supplement rarely resolves them completely. Addressing sleep quality is often the highest-leverage intervention for brain fog, because even mild sleep disruption significantly impairs memory and concentration.

See a doctor about brain fog that is interfering with your work, your ability to manage your household safely, or your sense of self. This is especially important if you are also experiencing depression, significant anxiety, or symptoms that feel more like memory loss than temporary fogginess. Brain fog can also be driven by thyroid dysfunction, anemia, or blood sugar irregularities, all of which are more common during perimenopause and warrant testing.

Tracking your brain fog on a daily basis alongside sleep quality, cycle phase, and stress level often reveals patterns that point to specific drivers. The PeriPlan app makes this easy, letting you log cognitive symptoms alongside hormonal data so you can identify your clearest triggers. 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.