DHEA and Perimenopause: What It Is and Why It Matters
Understand what DHEA is, how it declines during perimenopause, what low DHEA feels like, and what your options are.
What Is DHEA?
DHEA stands for dehydroepiandrosterone. It is a hormone produced mainly by the adrenal glands and, to a lesser extent, the ovaries. DHEA is a precursor hormone, meaning your body converts it into oestrogen and testosterone depending on what is needed. It is produced in larger quantities during your 20s and 30s, then declines naturally with age. By the time most women reach perimenopause, DHEA levels are already meaningfully lower than they were a decade earlier.
Why DHEA Matters in Perimenopause
As ovarian hormone production falls during perimenopause, the adrenal-derived DHEA pathway becomes more significant. DHEA contributes to libido, energy, mood, skin quality, and vaginal tissue health. Low DHEA is associated with fatigue that sleep does not fix, reduced sex drive, dry or thinning skin, and a general loss of vitality. Because these symptoms overlap heavily with other perimenopause complaints, DHEA is often overlooked as a contributing factor.
How DHEA Levels Change During Perimenopause
DHEA-S (the sulphate form, which is more stable and easier to measure in blood) declines at roughly one to two percent per year from around age 30. By the time a woman is 50, her DHEA-S may be 50 to 60 percent lower than it was at peak. Perimenopause does not itself cause a sharp DHEA drop, but it amplifies the impact of already declining levels because oestrogen and testosterone are also falling. The combined effect is felt across energy, mood, and sexual function.
Testing Your DHEA Levels
A serum DHEA-S test is available through your GP or a private hormone clinic. It is a single blood test, and unlike other reproductive hormones, timing in the menstrual cycle matters less because DHEA-S is relatively stable. Your doctor may include it as part of a broader adrenal or hormonal panel. It is worth requesting if you have persistent low energy, flat mood, or low libido that has not responded to other treatments.
What the Results Mean
Normal DHEA-S ranges vary by age. For women in their 40s, a typical reference range might be 1.0 to 7.0 umol/L, but this varies by laboratory. A result in the lower quartile of the normal range for your age may still be clinically significant if you have corresponding symptoms. Interpreting DHEA-S is best done alongside oestrogen, testosterone, and cortisol levels for a full picture of adrenal and ovarian hormone status.
What to Do if DHEA Is Low
DHEA supplementation is available over the counter in some countries and by prescription in others. In the UK, DHEA is a prescription-only medicine. Topical DHEA (prasterone) is available for vaginal symptoms and is licensed for that use. If you are considering DHEA, it is worth discussing with a doctor experienced in hormonal health rather than self-prescribing. Sleep, stress management, and adequate protein intake also support adrenal function and can help your body make better use of the DHEA it does produce.
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