What Happens If You Take Too Much DHEA for Libido?

Taking 50 mg or more of oral DHEA a day raises testosterone and estradiol in postmenopausal women, and acne and extra hair growth become more likely than on placebo. In trials, the higher oral dose did not reliably improve sex drive, so taking more brings the side effects without the libido boost. Lower doses did not significantly change either hormone.

What does too much DHEA do to your testosterone and estrogen?

At 50 mg a day or more, both hormones go up by an amount that shows on a blood test. Below 50 mg, the average changes were small enough that they could be chance.

These are average changes from a meta-analysis of 21 trials in postmenopausal women. "Statistically significant" means the change was bigger than chance would explain.

In a year-long study of women aged 60 to 79 taking 50 mg a day, testosterone and estradiol rose by 6 months, and 21% of the hormone values landed outside the normal range for premenopausal women. The two hormones did not move together. Testosterone came back down by 12 months, but estradiol stayed raised the whole year.

Women still in perimenopause see the same rise. In a 3-month study of 60 perimenopausal women, 50 mg a day raised testosterone and doubled estradiol.

How much counts as too much depends on who you ask. Endocrinologists who reviewed the research on DHEA in women put the dose that matches what a woman's body makes at around 25 mg a day, not 50. Harvard Health says DHEA is generally considered safe for up to two years at doses up to 50 mg a day, and that higher doses or longer use may raise the risk of serious side effects. Between 25 and 50 mg, you are inside Harvard's safety range but taking more than your body would make on its own. Past 50 mg, you are outside both.

What androgenic side effects does too much DHEA cause?

Acne is the main one, along with unwanted hair. These are androgenic side effects, meaning they come from male-type hormones such as testosterone. In a Cochrane review, women taking DHEA had 3.77 times the odds of androgenic side effects, mainly acne, compared with women on placebo.

In a year-long trial of postmenopausal women with low desire taking 50 mg a day, more women on DHEA got acne and increased hair growth than women on placebo.

Mayo Clinic lists oily skin, acne and male-pattern hair growth as possible DHEA side effects in women. That hair growth, called hirsutism, means thicker hair on the face, chest or belly.

The endocrinology review found these effects were more common with DHEA than placebo, and how common depended on the dose. The higher the dose, the more likely the breakouts and the hair.

Does taking more DHEA help your libido?

Not reliably. The trial built to test it enrolled 93 postmenopausal women with low desire. Over 26 weeks, 50 mg a day did not significantly change how many satisfying sexual experiences they had or how they rated their own sexuality, compared with placebo.

The Cochrane review, which included 28 trials, found DHEA may slightly improve sexual function compared with placebo. When the reviewers looked only at the studies of DHEA taken by mouth, the change was small and not statistically significant.

The clear libido results came from DHEA used inside the vagina, called prasterone. In a trial of 216 postmenopausal women with vaginal atrophy (thinning, drier vaginal tissue), 12 weeks of daily 1.0% vaginal DHEA improved desire scores by 49% and 23% on two questionnaires compared with placebo. Arousal and sensation improved by 68%, lubrication by 39%, orgasm by 75% and dryness during sex by 57%. Blood hormone levels stayed within normal postmenopausal values.

If you have been raising your pill dose because desire hasn't come back, the trials suggest the dose is not what's missing. The extra milligrams raise your hormone levels without reliably raising your sex drive.

Is high-dose DHEA safe with estrogen, HRT or other health conditions?

For some women, no. These are the situations where the higher dose becomes a problem:

• Estrogen or HRT. Mayo Clinic says not to use DHEA with estrogen, because together they might cause symptoms of too much estrogen, such as nausea, headache and insomnia. Mayo also says not to combine DHEA with testosterone.
• Your uterus. Estradiol that stays high can stimulate the lining of the uterus, and high levels over a long time may raise the risk of endometrial cancer. The meta-analysis authors advise caution with long-term use and regular monitoring for hormone receptor-positive cancers.
• A history of breast cancer. Because DHEA turns into testosterone and estradiol, endocrinologists say it should not be used by women with a history of breast cancer.
• Pregnancy, liver problems or PCOS. Harvard Health says DHEA should not be used during pregnancy or breastfeeding, or by women with liver problems or PCOS. It also says DHEA might lower HDL, the protective cholesterol, and can cause excitability, impulsiveness and irritability in people with mood disorders.
• The label. DHEA supplements are not regulated by the FDA, and their quality and content can vary. The dose on the bottle is not a guarantee of the dose in the capsule.

What can help low libido if DHEA isn't working?

Start with what you are trying to fix, because low desire is not always about hormone levels. One woman on Reddit, in a new and healthy relationship, put it this way: "So WHY WHY WHYYYYY am I not horny for this wonderful man WHYYYYY". Whether the problem is desire itself, arousal or comfort during sex shapes which treatment makes sense.

Our clinical team can prescribe PT-141, kisspeptin or bioidentical estrogen if one fits your goal and your health history.

Before you start any of them, tell your clinical team if you take DHEA or plan to, including your dose and brand. Harvard Health gives the same advice. This matters most if estrogen is part of your plan, because Mayo Clinic advises against combining DHEA and estrogen.

You want your sex drive back without breakouts and new chin hair. Take the quiz so your clinical team can see whether PT-141, kisspeptin or estrogen fits your goal.