DHEA Boosts Sexual Function in Postmenopausal Women

observational-study PMID: 26725467

DHEA Boosts Sexual Function in Postmenopausal Women

Quick Summary: This 52-week study looked at how a vaginal cream made from DHEA—a natural hormone precursor—helps postmenopausal women with symptoms like dryness and discomfort. Women who used it daily saw big improvements in desire, arousal, lubrication, orgasm, satisfaction, and less pain during sex, with overall sexual function scores jumping 60%. The benefits came from local effects in the vagina without changing hormone levels in the blood.

What The Research Found

Researchers tested a vaginal DHEA cream on women past menopause who had vulvovaginal atrophy (VVA), which means thinning and drying of the vaginal tissues that can make sex painful or less enjoyable. The cream worked by turning into local hormones right where needed, boosting nerve endings in the vagina for better sensation.

Key improvements after one year (52 weeks) included:
- Desire: Up 28%—women felt more interested in sex.
- Arousal: Up 49%—easier to get excited.
- Lubrication: Up 115%—much better natural wetness to reduce dryness.
- Orgasm: Up 51%—stronger and more achievable climaxes.
- Satisfaction: Up 41%—higher overall enjoyment from sex.
- Pain: Down by 108%—way less discomfort during intercourse.

The total sexual function score rose from 13.4 to 21.5, a 60% gain. All changes were highly significant, meaning they're unlikely due to chance. Blood tests showed no big shifts in hormones like estrogen or testosterone, proving the effects stayed local.

Study Details

Who was studied: 154 postmenopausal women with at least one mild to severe VVA symptom, like vaginal dryness or pain during sex. They filled out a standard questionnaire on sexual function at the start and follow-ups.
How long: One full year (52 weeks), with check-ins at 6 months and one year.
What they took: A 0.50% DHEA cream (6.5 mg dose) applied inside the vagina every day. This open-label study meant everyone knew what they were getting, and there was no placebo group for comparison.

What This Means For You

If you're a postmenopausal woman dealing with low libido, dryness, or painful sex due to VVA, this DHEA cream could be a game-changer. It offers targeted relief without the whole-body hormone risks of pills or patches, like those linked to breast cancer concerns. Talk to your doctor about trying prasterone (the DHEA form approved by the FDA for VVA)—it might help you feel more comfortable and connected in your intimate life. Results suggest steady use over months brings the best gains, so patience pays off.

Study Limitations

This study wasn't perfect, so keep these in mind:
- No blind testing or placebo: Everyone knew they were using the cream, which might make results seem better due to expectations (placebo effect).
- Self-reported info: Scores came from questionnaires, which can vary based on personal feelings rather than objective measures.
- Specific group only: It focused on postmenopausal women with VVA, so it may not apply to younger women, those without VVA, or men.
- Long-term safety unknown: While one year showed no blood hormone changes, effects beyond that or rare side effects weren't checked.
- Not the strongest proof: As an open-label study, it can't fully prove cause-and-effect—bigger, controlled trials are ideal for confirmation.

For more details, see the original study on PubMed (2016). Always consult a healthcare pro before starting any treatment.

Key Findings

The study found that daily intravaginal administration of 0.50% DHEA (6.5 mg) significantly improved all domains of female sexual function in postmenopausal women with vulvovaginal atrophy (VVA). After 52 weeks, the Female Sexual Function Index (FSFI) total score increased by 60% (from 13.4±0.62 to 21.5±0.82, p<0.0001). Domain-specific improvements included desire (+28%), arousal (+49%), lubrication (+115%), orgasm (+51%), satisfaction (+41%), and pain reduction (+108%), all statistically significant (p<0.0001). These effects were attributed to localized conversion of DHEA into androgens and estrogens within vaginal tissue, with no systemic hormonal changes observed.

Study Design

This was an open-label observational study conducted over 52 weeks. It included 154 postmenopausal women experiencing mild to severe VVA symptoms who completed the FSFI questionnaire at baseline and at least one post-baseline timepoint (Week 26 and Week 52). The lack of a control group and blinding introduces potential bias, though the longitudinal design allowed assessment of long-term effects.

Dosage & Administration

Participants received 0.50% DHEA (prasterone) cream, delivering 6.5 mg of DHEA daily via intravaginal application. The regimen was continuous for 52 weeks.

Results & Efficacy

FSFI Total Score: Increased from 13.4±0.62 (baseline) to 21.5±0.82 at 52 weeks (+60%, p<0.0001).
Domain Improvements:
Desire: +28%
Arousal: +49%
Lubrication: +115%
Orgasm: +51%
Satisfaction: +41%
Pain Reduction: +108%
All outcomes showed p<0.0001 significance. Serum DHEA and metabolite levels (estradiol, testosterone) remained stable, confirming localized action.

Limitations

Open-label design: Lack of blinding and control group increases risk of bias and placebo effects.
Self-reported data: Reliance on FSFI questionnaires may introduce subjectivity.
Sample specificity: Results apply only to postmenopausal women with VVA symptoms, limiting generalizability.
Short-term hormonal assessment: Long-term safety and systemic effects beyond 52 weeks were not evaluated.
Observational nature: Cannot establish causality; randomized controlled trials (RCTs) are needed for stronger evidence.

Clinical Relevance

The findings suggest that intravaginal DHEA may serve as a non-systemic option for improving sexual function in postmenopausal women with VVA. The localized mechanism avoids systemic hormone exposure, addressing safety concerns linked to traditional hormone therapy. However, the open-label design limits conclusive interpretation, and users should consider these results in the context of higher-quality RCTs (e.g., the WHIMES trials) that supported DHEA’s FDA approval for VVA. Practical use requires medical supervision, particularly for women with hormone-sensitive conditions.

Source: PubMed (2016)