Does DHEA help with hair thinning during perimenopause?

DHEA and hair thinning have a more complicated relationship than most supplement-symptom pairings. DHEA converts into testosterone and then into dihydrotestosterone (DHT) in body tissues, and DHT is the main driver of androgenic alopecia, the pattern of hair thinning at the crown and temples that affects many women during and after perimenopause. Whether DHEA helps or worsens your hair thinning depends largely on what type of thinning you have, and getting this distinction wrong can make the problem significantly worse.

For hair thinning driven by low androgen levels, very low DHEA-S levels, or adrenal insufficiency, some research suggests DHEA supplementation could provide modest benefit by restoring androgen-driven stimulation of hair follicles. A study in older women with low DHEA-S found that oral DHEA improved some skin and hair quality measures. However, the much more common picture in perimenopausal women is androgenic alopecia, where the follicles are sensitive to DHT and more androgens makes the problem worse. If you have this type of thinning, taking oral DHEA is likely to accelerate shedding, not slow it. DHEA's conversion to DHT in the scalp has been directly implicated in follicle miniaturization. This is a genuine risk that should not be minimized.

Perimenopause creates a specific androgenic vulnerability. During the transition, estrogen declines but androgens often remain relatively stable for longer, or decline more slowly. This shifts the estrogen-to-androgen ratio in a direction that makes hair follicles more susceptible to DHT-driven miniaturization. Women who were never sensitive to androgens before may notice thinning for the first time. This is why perimenopause is a common onset point for androgenic alopecia in women who had no hair concerns in their 20s and 30s. Adding more androgen precursor via oral DHEA in this context carries a real risk of worsening the very thinning you are trying to address.

Studies on DHEA for general hormonal benefits in perimenopausal women have used oral doses of 25 to 50 mg daily. Vaginal DHEA (Intrarosa, 6.5 mg nightly) is FDA-approved for vaginal symptoms and has minimal systemic conversion, making it less of a hair-loss concern than oral forms. If you have confirmed low DHEA-S levels and a type of diffuse thinning not related to androgens (such as telogen effluvium from stress or nutritional deficiency), your provider might consider whether oral DHEA is worth a cautious trial. But this decision requires knowing your androgen sensitivity and your specific type of hair loss first. Get your DHEA-S level tested before starting. Talk to your healthcare provider before initiating any form of DHEA.

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. Androgenic side effects at higher doses include acne, oily skin, unwanted facial hair, scalp hair loss, and voice changes. Scalp hair loss is listed explicitly here because it is a known, dose-dependent risk of DHEA in women with androgen-sensitive follicles. If you are already using hormone therapy, adding DHEA without your provider's knowledge creates unpredictable hormonal effects. Over-the-counter availability does not mean DHEA is safe to self-dose.

If you trial DHEA and notice increased shedding, stop immediately and speak with your provider. Hair follicle miniaturization from androgen exposure can become permanent if it continues long enough, so this is not a side effect to wait out. If DHEA is appropriate for you and your provider supports a trial, monitor your hair every four weeks by photographing the part width and crown area under consistent lighting.

See a dermatologist or your primary care provider about hair thinning that is progressing noticeably, that affects your part width or hairline, or that is accompanied by scalp itching, scaling, or inflammation. Blood work for thyroid function, iron stores (ferritin), zinc, and vitamin D is a reasonable starting point because these deficiencies are common contributors to perimenopausal hair thinning and are far more straightforward to address safely.

Tracking your hair shedding, scalp condition, and any new supplements in the PeriPlan app makes it easier to identify correlations. If shedding spikes after starting a new supplement or in a particular cycle phase, you will have the data to act on. 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.