Does DHEA help with digestive changes during perimenopause?

DHEA (dehydroepiandrosterone) is a precursor hormone produced by the adrenal glands that converts into estrogen and testosterone in body tissues. During perimenopause, DHEA levels decline alongside ovarian hormones, contributing to a wide range of symptoms. Digestive changes including bloating, constipation, looser stools, and increased reflux are common during perimenopause, but DHEA is not primarily a digestive hormone and the evidence for it helping gut symptoms is very limited.

There are no well-designed clinical trials specifically examining DHEA as a treatment for digestive symptoms in perimenopausal women. The theoretical case is indirect: DHEA can convert to estrogen in peripheral tissues, and estrogen receptors do exist in the gut lining and in the enteric nervous system that controls gut motility. In that sense, there is a biological connection between hormonal changes and digestive function. However, studies on DHEA supplementation in menopausal women focus on bone density, libido, vaginal health, mood, and cognition, not on digestive outcomes. A general quality-of-life improvement is sometimes reported, but digestion-specific benefits have not been measured or isolated. DHEA's primary actions are hormonal, not digestive.

Digestive changes during perimenopause have real hormonal roots, but they are driven more directly by progesterone and estrogen than by DHEA. Progesterone normally stimulates gut motility, so as it fluctuates and falls, constipation and sluggish digestion become more common. Estrogen influences the diversity and composition of the gut microbiome; as estrogen becomes erratic, some women notice changes in bowel regularity, increased gassiness, or worsened reflux. Cortisol elevation also plays a role, as the DHEA-to-cortisol ratio shifts with age and stress. Gut symptoms can also be exacerbated by the dietary and lifestyle changes that often accompany perimenopause, including disrupted sleep, increased stress eating, and reduced physical activity.

Studies in perimenopausal and postmenopausal women exploring DHEA for hormonal benefits have generally used oral doses of 25 to 50 mg daily. Vaginal DHEA (Intrarosa, 6.5 mg nightly) is FDA-approved specifically for genitourinary symptoms and has minimal systemic absorption, making it less relevant to gut function. If you are considering oral DHEA for any reason, get your DHEA-S blood level tested first. Self-dosing without knowing your baseline is genuinely risky, because excess androgens and estrogen from DHEA conversion can cause problems. Talk to your healthcare provider about whether your levels support supplementation and at what dose.

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 provider guidance can disrupt your hormone balance. Over-the-counter availability does not mean DHEA is safe to self-dose.

For digestive changes, there are more targeted strategies with actual evidence behind them. Increasing soluble fiber from foods like oats, flaxseed, and cooked vegetables helps with both constipation and loose stools by supporting microbiome balance. Magnesium citrate can help with slow gut motility. Probiotics, particularly strains like Lactobacillus acidophilus and Bifidobacterium, have some evidence for improving general gut symptoms in adults. Reducing alcohol, caffeine, and high-FODMAP foods often produces meaningful improvement within two to three weeks for women who have not tried it systematically.

See a doctor about digestive changes if you have blood in your stool, unexplained weight loss, persistent abdominal pain, or symptoms that came on suddenly and severely. Perimenopause can worsen pre-existing irritable bowel syndrome, and new digestive symptoms always warrant at least a conversation with your healthcare provider to rule out conditions like celiac disease, inflammatory bowel disease, or colorectal changes.

Tracking your digestive symptoms alongside your cycle phase, sleep, stress, and diet in an app like PeriPlan often reveals clear patterns within a few weeks. Knowing whether your gut symptoms cluster around a specific part of your cycle or correlate with poor sleep gives you and your provider much better information to work with. Download PeriPlan 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.