Dehydroepiandrosterone
DHEA
What it isAdrenal androgen precursor and neurosteroid; supplement use and adrenal insufficiency in women.
Why this onePeripheral substrate for both androgens and estrogens, producing broad but weak effects.
What limits itAndrogenic effects in women. Evidence for most marketed uses is weak; it is banned in sport.
Principal riskAndrogenic effects in women; banned in sport
Classes and tags
Clinical profile
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Moderate-to-severe dyspareunia (symptom of vulvovaginal atrophy due to menopause) | Postmenopausal women | 1 insert (6.5 mg) vaginally QHS | 1 insert QHS | 1 insert/day |
Renal Undefined
Hepatic Undefined
Instructions
- Insert vaginally once daily at bedtime using the provided applicator
Available strengths
- insert 6.5 mg
Contraindications
- Undiagnosed abnormal genital bleeding (evaluate cause before treatment)
Cautions
- Current or past history of breast cancer — estrogen is a metabolite of prasterone; exogenous estrogen is contraindicated in known/suspected breast cancer history and Intrarosa was not studied in these women
Adverse reactions
- Vaginal discharge (≥2%, 12-wk trials; 14.2% at 52 wk)
- Abnormal Pap smear (≥2% at 52 wk; mostly ASCUS)
Pregnancy Indicated only in postmenopausal women; no human data; animal reproduction studies not conducted.
Lactation Indicated only in postmenopausal women; no information on milk presence, infant effects, or milk production.
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 6.5 mg | insert | per unit | — | $10.98/ea | not offered |
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Self-check
- Which two hormone groups can form peripherally from DHEA?
Androgens and estrogens. - How strong is evidence for most marketed DHEA uses?
Weak.