Using DHEA vaginally has been in the research since about 2005, but only recently has it been getting more press with 2 studies this year alone. Studies have found that DHEA supplementation had both an estrogen and androgenic effect on vaginal tissue, perhaps creating a best of both world situations. Research showed that the mucus layer of the epithelial tissues the collagen layer, and muscle layer all improved with DHEA vaginal treatment. Interestingly though, more has not been found to be better; lower dosages perform just as well as the higher dosage.

How could this be working?

DHEA is the precursor to androstenedione which is a precursor to both testosterone as well as estradiol. Oral DHEA supplementation appears to have different effects in women as compared to me. Men appear to take any excessive DHEA and convert it to estradiol while women appear to take excessive DHEA and convert it to testosterone in their tissues. It appears that vaginal tissue has the ability to use both pathways depending on what the woman's tissue needs.

Prasterone™/Prestara™ /Aslera™ /GL701 / DHEA) was originally given a NDA for the treatment of Systemic Lupus. Since the drug form of DHEA is likely reaching the end of its patent, there is renewed interest in creating new indications. There are currently about 45 studies that have been initiated, active, or already discontinued looking at DHEA treatments. Perhaps we can expect a new vaginal medication in a couple of years? Some studies are already in phase III clinical trials.

Until then, what can you do if you want to try it out? DHEA is an OTC supplement and any compounding pharmacy should be able to create a vaginal suppository or vaginal cream similar to those used in the studies. The studies have used dosages of 3.25mg to 13mg. Since the 3.25 mg dosage worked as well as the 13 mg I would not see any reason for using the higher dosage. In fact, since you are going for a localized effect, my educated guess is that even ½ that dosage – 1.5 would work well for many women. Using DHEA may also have a higher safety rating than using vaginal testosterone since you are unlikely to trigger irreversible clitoral hypertrophy which maybe caused rarely by testosterone especially at higher dosages.

Since DHEA plays an important role in adrenal function, energy and immunity, and as it turns out aids vaginal health, measuring your DHEA levels is recommended. ZRT Laboratory offers simple saliva and blood spot DHEA testing. If the levels are low, oral supplementation  is suggested.

By Dr. Alison McAllister

Labrie F et al. 2010.High internal consistency and efficacy of intravaginal DHEA for vaginal atrophy.Gynecol Endocrinol. May 12. (Epub ahead of print).

Berger, L et al. 2005.Effects of dehydroepiandrosterone, Premarin and Acolbifene on histomorphology and sex steroids receptors in the rat vagina.J Steroid Biochem Ml Biol. Jul;96(2): 201-215.