Does DHEA help with heart palpitations during perimenopause?

Heart palpitations are one of the most alarming symptoms of perimenopause, and they deserve a clear answer: palpitations should always be evaluated by a healthcare provider before you consider any supplement, including DHEA. DHEA (dehydroepiandrosterone) converts into estrogen and testosterone and has some cardiovascular research behind it, but there is no clinical evidence that DHEA specifically reduces heart palpitations during perimenopause, and adding hormonal supplements without medical clearance when you are experiencing palpitations is not a safe approach.

Some research suggests DHEA may have favorable effects on cardiovascular risk markers. Studies have found associations between higher DHEA-S levels and better endothelial function, lower inflammation, and more favorable lipid profiles in older adults. A 2008 study found that DHEA supplementation improved arterial stiffness in postmenopausal women. These are indirect cardiovascular benefits related to long-term disease risk, not to the palpitation experience itself. The mechanism by which perimenopause causes palpitations is different: falling estrogen affects the cardiac conduction system and the autonomic nervous system's regulation of heart rate, which can produce the fluttering, racing, or irregular heartbeat sensations that many women describe. DHEA's conversion to estrogen might theoretically support this pathway, but no studies have measured this effect on palpitation frequency or severity.

Perimenopause-related palpitations are real and common. Estrogen receptors exist throughout the heart muscle and in the sinoatrial node, which sets heart rhythm. As estrogen fluctuates, autonomic tone becomes less stable, and the heart can respond with benign arrhythmias or heightened awareness of normal beats. Hot flashes often occur alongside palpitations, suggesting a shared autonomic mechanism. Anxiety, which escalates for many women during perimenopause, also increases palpitation awareness significantly. These mechanisms are well-documented. What is not documented is DHEA having a meaningful clinical effect on any of them.

If your healthcare provider supports a DHEA trial for other perimenopause symptoms after evaluation, studies in perimenopausal and postmenopausal women have typically used oral doses of 25 to 50 mg daily. Vaginal DHEA (Intrarosa, 6.5 mg nightly) is FDA-approved for vaginal symptoms with minimal systemic absorption, meaning it is unlikely to affect heart rate in any direction. Always get your baseline DHEA-S blood level tested before starting supplementation. Self-dosing without knowing your levels is risky. Talk to your healthcare provider about dose and timing, and be sure to mention any cardiovascular symptoms you are experiencing.

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 already using hormone therapy, adding DHEA without provider knowledge can produce unpredictable hormonal shifts. Over-the-counter availability does not mean DHEA is safe to self-dose.

If your palpitations have been evaluated and found to be benign, several evidence-supported strategies can reduce their frequency: maintaining consistent sleep, limiting caffeine and alcohol, addressing anxiety with targeted interventions, and staying well hydrated. Magnesium glycinate has some evidence for supporting cardiac conduction stability and is worth discussing with your provider. Reducing stimulant intake often produces noticeable improvement in palpitation frequency within two to four weeks.

See a doctor right away if your palpitations are accompanied by chest pain, shortness of breath, fainting or near-fainting, dizziness, or if they last more than a few seconds and occur frequently. See a provider soon if you have palpitations you have not yet had evaluated, even if they feel mild. An ECG (electrocardiogram) is a simple, non-invasive test that can identify whether any rhythm disturbance is present. Perimenopause palpitations are most often benign, but they should be confirmed as such before any hormonal supplement is added.

Logging your palpitations alongside caffeine intake, sleep quality, stress level, alcohol, and cycle phase often reveals clear triggers within two to three weeks. The PeriPlan app lets you track these variables daily so you and your provider have real data to work with rather than guesses. 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.