Does DHEA help with irregular periods during perimenopause?

DHEA (dehydroepiandrosterone) is a precursor hormone that converts into estrogen and testosterone in body tissues. Irregular periods are the hallmark of perimenopause, driven by fluctuating and declining ovarian hormone production. The direct answer is no: there is no clinical evidence that DHEA regularizes periods during perimenopause, and because DHEA has hormonal activity, it could actually worsen cycle irregularity in some women. Any new or worsening irregular bleeding also requires medical evaluation to rule out conditions unrelated to perimenopause.

No published randomized controlled trials have specifically examined DHEA for the purpose of regulating the menstrual cycle in perimenopausal women. DHEA can influence the hormonal milieu of the cycle by contributing to both estrogen and androgen levels, but this influence is unpredictable and not targeted to cycle regularity. In women with PCOS, where excess androgens are part of the underlying problem, DHEA could theoretically worsen cycle disruption. Some case reports and observational data suggest that DHEA supplementation can alter cycle length and bleeding patterns, though not in a consistently beneficial direction. Research on DHEA in perimenopausal women focuses on bone density, libido, vaginal health, mood, and cognition, not menstrual regulation.

Irregular periods during perimenopause occur because follicular recruitment becomes erratic, leading to cycles that skip ovulation, produce variable amounts of estrogen, and generate unpredictable luteal progesterone. This is a normal part of the ovarian aging process, not a deficiency that DHEA supplementation is designed to address. DHEA can contribute additional estrogen and androgen to an already fluctuating hormonal environment, which in some women may shorten or lengthen cycles or change bleeding volume in ways that are hard to predict. Adding more hormonal input to an already irregular system without medical oversight is not straightforward.

Studies in perimenopausal and postmenopausal women examining DHEA for other symptoms 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 and is much less likely to affect menstrual patterns. For oral forms, get your baseline DHEA-S blood level tested before starting. Self-dosing without knowing your levels risks overshooting into androgen excess or adding excessive estrogen. Talk to your healthcare provider before starting DHEA, especially given that you are experiencing irregular periods.

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. The hormone-sensitive cancer warning is especially critical in the context of irregular bleeding, because unexplained bleeding can be a symptom of uterine pathology that requires investigation. 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 your provider's knowledge can produce unpredictable bleeding changes. Over-the-counter availability does not mean DHEA is safe to self-dose.

Realistic expectations: DHEA is not going to regularize your cycle. The irregular periods of perimenopause are a natural consequence of ovarian aging, and no supplement is going to override this process. What tends to help most with managing the disruption of irregular cycles is tracking carefully so you are not caught off guard, maintaining consistent sleep to reduce hormonal volatility, and speaking with your provider about whether low-dose hormonal support makes sense for your specific symptom burden.

See a doctor about irregular periods if you are bleeding for more than seven days, soaking more than one pad or tampon per hour for two or more hours in a row, experiencing bleeding after sex, spotting between periods when that is new for you, or having periods more frequently than every 21 days. Also see a provider if you have not had a pelvic ultrasound or endometrial assessment in the context of irregular bleeding that began recently. Irregular bleeding during perimenopause is usually benign, but uterine fibroids, polyps, and in rare cases endometrial hyperplasia or cancer need to be ruled out. Do not delay evaluation while trying supplements.

Logging your periods, including start date, duration, flow volume, spotting, and any pain, in the PeriPlan app gives you a clear picture of your patterns over time and gives your provider useful clinical information at your appointment. 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.