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Vaginal DHEA—who might consider it for sexual comfort?
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The Dual Action and Mechanism of Vaginal DHEA
DHEA (dehydroepiandrosterone) is a naturally occurring hormone produced by the adrenal glands, and its levels drop sharply after menopause. Vaginal DHEA is inserted as a small pessary (typically 6.5mg nightly) and works directly within the vaginal tissue.
Vaginal DHEA is a unique "Pro-Hormone" because it is converted locally into both oestrogen and testosterone. This process is known as Intracrinology, where the vaginal cells ingest the inactive DHEA (Prasterone) and convert it into the exact amount of estrogen and testosterone they require strictly inside the cell.
Estrogen: Helps restore tissue thickness and moisture ("wetness").
Testosterone/Androgens: Helps maintain nerve density, which is required for sensation.
Who Might Benefit from Vaginal DHEA?
Vaginal DHEA is specifically designed for postmenopausal women experiencing Genitourinary Syndrome of Menopause (GSM).
1. Women Experiencing Specific GSM Symptoms:
Vaginal dryness and atrophy: Thinning of the vaginal walls, reduced elasticity, and loss of natural moisture.
Dyspareunia (painful sex): Burning, tearing, or discomfort during or after penetration.
Loss of libido or sensation: This includes reduced sexual desire or difficulty achieving arousal, which may be linked to low androgens.
2. Women Who Need the Dual Hormone Action:
Vaginal DHEA may be preferred for women who find they are "lubricated but numb" or struggle to reach orgasm, as this may be caused by a lack of local testosterone.
It is suitable for women who have seen improvements in dryness but have not fully responded to standard vaginal oestrogen treatment.
3. Women with Clinical Restrictions or Preferences:
Vaginal DHEA is particularly suited to women who cannot or prefer not to use oestrogen-based treatments.
This includes women with a history of oestrogen-sensitive conditions like breast cancer or endometrial cancer who may be advised to avoid localized oestrogen.
It is an alternative for women who simply prefer a non-oestrogen therapy for personal, medical, or psychological reasons.
Women already taking oral or transdermal systemic Hormone Replacement Therapy (HRT) may still experience vaginal symptoms and can benefit from adding local DHEA (combination therapy).
The Specialist Who Reviewed the Content
The content concerning Vaginal DHEA was authored and medically reviewed by Dr. Farzana Khan.
Dr. Khan qualified as an MD from the University of Copenhagen in 2003 and holds over 20 years of medical experience, having worked in dermatology and obstetrics & gynaecology.
She obtained her Diploma of the Faculty of Sexual & Reproductive Health and her MRCGP (CCT) in 2013.
Her clinical focus includes vaginal health, specifically dryness/GSM, sexual function concerns, and lichen sclerosus.
She offers careful assessment, discusses medical and conservative options, and considers selected regenerative or aesthetic treatments.
Dr. Khan also works as a Key Opinion Leader (KOL)/Trainer for Neauvia, Asclepion Laser, and RegenLab.
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