Does DHEA help with mood swings during perimenopause?

DHEA may offer some benefit for mood instability during perimenopause, though the evidence is stronger for depression than for the rapid mood shifts most women describe as swings. DHEA acts as a neurosteroid, meaning it crosses the blood-brain barrier and influences neurotransmitter activity directly. It can affect serotonin and dopamine pathways, and it converts to allopregnanolone, a calming neurosteroid that acts on GABA receptors in the brain. Given how much of perimenopausal mood disruption is tied to neurochemistry rather than just hormone levels, DHEA's effects in the brain are worth understanding.

The clearest human evidence comes from depression research. A 2005 randomized controlled trial published in Archives of General Psychiatry found that DHEA at 90 mg per day for 6 weeks significantly improved midlife-onset depression compared to placebo. Another study in postmenopausal women found that lower DHEAS levels correlated with higher rates of depressive symptoms. For mood swings specifically (rapid shifts rather than sustained low mood), the direct evidence is thinner. However, allopregnanolone, one of DHEA's downstream metabolites, is closely studied in perinatal mood disorders and GABA-related mood instability, suggesting a plausible biological pathway for broader mood regulation.

Perimenopause disrupts mood through several overlapping mechanisms. Fluctuating estrogen destabilizes serotonin receptor sensitivity and reduces progesterone, a natural anxiolytic. Sleep disruption compounds emotional reactivity. DHEA's potential value here is partly through estrogen conversion and partly through its direct neurosteroid activity. Women in perimenopause often have falling DHEAS levels alongside falling ovarian hormones, compounding the neurochemical disruption. The mood swings many women experience may reflect not just estrogen fluctuation but also a broader decline in protective neurosteroid activity, of which DHEAS is one component.

Studies on DHEA for mood have used a range of doses from 25 mg to 100 mg per day orally. The depression trial referenced above used 90 mg, but that was a clinical research setting. Studies have used 25 to 50 mg as a typical starting dose in general supplementation research. Talk to your healthcare provider about the right dose for your situation, especially given that higher doses carry more androgenic risk. Getting a baseline DHEAS blood level before starting helps determine whether you are actually deficient, which is the group most likely to see a mood benefit.

For mood support, DHEA may work best alongside magnesium (which supports GABA function), regular exercise (which raises endorphins and improves serotonin sensitivity), and consistent sleep hygiene. Do not add DHEA to an existing hormone therapy regimen without your prescribing provider's knowledge. 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 including acne, oily skin, facial hair growth, scalp hair thinning, and voice changes can occur. OTC availability does not mean DHEA is safe to self-dose.

Mood-related benefits from DHEA, if they occur, tend to emerge over 4 to 8 weeks of consistent use. The effect is unlikely to be dramatic for most women, but some report a reduction in emotional volatility and a steadier baseline mood. Keep in mind that mood swings in perimenopause are multi-factorial, and DHEA is not a replacement for therapy, stress management, or sleep improvement, all of which have stronger behavioral evidence than any supplement.

You should see a doctor for mood swings if they are severe enough to damage relationships or your ability to function at work, if you are experiencing thoughts of self-harm, if the swings are cycling rapidly over hours or days in a pattern that does not align with your menstrual cycle, or if you have a personal or family history of bipolar disorder (which can be unmasked or worsened during perimenopause). A mental health provider can help distinguish perimenopause-related mood changes from other conditions that need different treatment.

Logging your mood day by day alongside your cycle and sleep quality reveals patterns you cannot see in the moment. The PeriPlan app (https://apps.apple.com/app/periplan/id6740066498) is designed for exactly this kind of daily symptom tracking during perimenopause, helping you see whether your mood shifts follow hormonal timing or other triggers you can address.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.