This blog is Part 2 of a 4-part series on Bioidentical Hormone Replacement Therapy (BHRT), where we explore the most popular hormone therapy options prescribed for women with hormonal imbalances.
Need to catch up? Read Part I, and stay tuned for the next installment of our BHRT blog series: Testosterone.
Dehydroepiandrosterone (DHEA) is a naturally occurring hormone produced by the adrenal glands, serving as a precursor to sex hormones like estrogen and testosterone. Levels of DHEA naturally decline with age, which has led to increased interest in supplementation — particularly among individuals experiencing hormonal imbalances, fatigue, low libido, or menopausal symptoms.
The mechanism of action of DHEA involves its role as a prohormone — meaning it is converted into active sex hormones like estrogen and testosterone in peripheral tissues through enzymatic pathways.
How DHEA Works
Here’s a breakdown:
- DHEA is synthesized in the adrenal cortex and, to a lesser extent, in the gonads and brain.
- Once secreted, DHEA circulates mostly as DHEA-S (its sulfated form), which acts as a reservoir and can be converted back to active DHEA as needed.
- In target tissues, DHEA is enzymatically converted into androstenedione, which is further converted to either testosterone or estrone/estradiol depending on local enzyme activity (via 5α-reductase, aromatase, and others).
- Beyond hormone conversion, DHEA may act directly on nuclear receptors, such as PPAR (peroxisome proliferator-activated receptors) and potentially the androgen receptor, influencing gene transcription involved in metabolism, inflammation, and immune regulation.
In summary, DHEA works by both serving as a precursor to sex steroids and potentially exerting direct modulatory effects on cellular signaling pathways.
Source: Journal of Molecular Endocrinology
For those seeking personalized solutions, compounded DHEA offers a customized approach not available in standard over-the-counter products.
In this blog, we explore the potential benefits, formats, and clinical considerations of compounded DHEA. At Health Dimensions Clinical Pharmacy (HDRx), a trusted compounding pharmacy in Farmington Hills, MI (serving multiple states), patients and providers can access DHEA in various tailored formulations — including creams, capsules, suppositories, and more — to support individualized BHRT plans.
Why Women May Benefit from Compounded DHEA
Perimenopause and Menopause Support
- DHEA may help support estrogen and testosterone levels, which drop during menopause.
- May also improve libido, mood, energy, and bone density.
Sexual Health & Vaginal Atrophy
- Topical or vaginal DHEA preparations may improve vaginal lubrication, elasticity, and sexual comfort.
- Compounded versions allow for tailored dosages and routes (e.g., vaginal cream, troches, or capsules).
Adrenal Fatigue or Low Cortisol Patterns
- Women under chronic stress or with adrenal dysfunction may have depleted DHEA levels.
- Supplementation may help restore hormonal balance and resilience to stress.
Mood and Cognitive Function
- Some studies suggest that DHEA may play a role in improving mood and cognitive clarity in aging women, particularly those with hormone-related depression.
Understanding Compounded DHEA
Compounded DHEA refers to a customized preparation of the DHEA hormone, made by a licensed compounding pharmacy, like HDRx, in accordance with a healthcare provider’s prescription. Unlike commercial DHEA supplements that come in fixed doses and forms, compounded versions are designed to meet the unique needs of individual patients — taking into account factors such as dosage strength, delivery method, sensitivities to certain excipients, and more.
At HDRx, compounded DHEA is prepared under strict quality standards to ensure precision, consistency, and safety. Healthcare providers often turn to compounded DHEA when standard options fail to meet the therapeutic goals of their patients.
Why Choose Compounded DHEA?
There are several reasons patients and providers may prefer compounded DHEA over commercially available supplements:
1. Personalized Dosage
Traditional pharmacies typically offer DHEA supplements in set doses (e.g., 25 mg or 50 mg), which may not be suitable for all patients. With compounding, the dose can be adjusted precisely to match an individual’s clinical needs and potentially minimize unwanted effects.
2. Alternative Delivery Forms
Some patients may have trouble swallowing capsules or may require transdermal (through-the-skin) delivery due to absorption issues or preferences. HDRx offers a wide range of delivery formats, including:
- Topical creams: Applied to the skin for systemic absorption.
- Capsules: Easy-to-ingest oral options, available in customized strengths.
- Suppositories: For individuals needing rectal or vaginal delivery options.
- Troches: Small, dissolvable lozenges that allow absorption through the mucosal lining of the mouth.
Each form may suit different therapeutic goals or patient lifestyles, allowing for potentially greater compliance and outcomes.
3. No Additives or Allergens
Patients who are sensitive or allergic to preservatives, dyes, gluten, or lactose may benefit from compounded medications. HDRx creates formulations free of unnecessary fillers and allergens.
4. Provider-Guided Monitoring
When prescribed and monitored by a healthcare provider, compounded DHEA can be part of a comprehensive plan that includes regular hormone level testing, symptom tracking, and adjustments as needed.
5. Custom Combinations
Practitioners may also combine multiple hormones into a single compounded medication. For example, DHEA can be combined with Bi-Estrogen (Estriol/Estradiol), Progesterone, Testosterone, Pregnenolone, or Progesterone E4M. This personalized approach helps streamline dosing regimens and may improve adherence while targeting the patient’s unique hormonal balance.
Easily select pharmacist-recommended options on our Female Personalized Medicine Form. Need access? Request it here.
Compounded DHEA Delivery Formats Explained
Topical Cream
DHEA cream is applied to the skin, often on areas with good blood flow, such as the inner arms or thighs. (see diagram)
Transdermal delivery may provide consistent absorption and is commonly used for hormone therapy. Providers may favor this option for patients who experience gastrointestinal sensitivity or prefer not to take oral medications.
Capsules
Capsules remain one of the most convenient and widely used formats. They are easy to take and allow for fine-tuned dosage adjustments. HDRx compounds capsules in precise strengths not typically available from retail supplements.
Vaginal Administration
DHEA can be compounded into vaginal creams or suppositories (often prasterone is used as the active ingredient) to address:
- Vaginal dryness
- Atrophy
- Pain with intercourse (dyspareunia)
- Thinning of the vaginal epithelium post-menopause
Related Article
Vaginal DHEA to treat menopause related atrophy: a review of the evidence.
Panjari M, Davis SR. Vaginal DHEA to treat menopause related atrophy: a review of the evidence. Maturitas. 2011 Sep 1;70(1):22-5.
Other DHEA Forms
Depending on the needs of the patient, HDRx may also prepare sublingual troches or tablets, liquid suspensions, or other forms, each serving a specific clinical purpose and offering alternatives for patients who need them.
What Providers Prescribe Compounded DHEA?
- Hormone specialists, OB-GYNs, endocrinologists, functional medicine specialists, and primary care physicians looking to tailor hormone therapy.
- Providers interested in a more controlled and monitored approach to hormonal balance.
- Practitioners who prefer working with a trusted compounding pharmacy that offers clinical support and quality assurance.
The Role of Health Dimensions Clinical Pharmacy (HDRx)
At Health Dimensions Clinical Pharmacy, we formulate compounded DHEA with a strong emphasis on:
- Patient safety and quality control
Every prescription at HDRx is compounded in our PCAB-accredited laboratory using USP-grade ingredients and rigorous quality assurance protocols. From sourcing raw materials to final packaging, each step is carefully monitored to ensure purity, consistency, and safety. Our pharmacists prioritize accuracy and sterile technique—especially important for hormone therapies like DHEA.
- Provider collaboration
Beyond compounding, HDRx offers comprehensive support for both patients and healthcare professionals. This includes access to clinical pharmacist consultations to assist with dosing strategies and patient education, as well as a secure Online Prescriber Portal that streamlines communication and ordering for providers.
- Education and clinical transparency
We believe informed decisions lead to better health outcomes. HDRx supports both patients and prescribers with ongoing education about DHEA and other compounded therapies. This includes detailed product information, clinical references, and open dialogue with our pharmacy team to ensure transparency in what’s being prescribed and why.
HDRx works closely with healthcare providers to deliver consistent formulations and supports ongoing patient monitoring. The pharmacy uses high-quality ingredients and follows industry best practices for sterile and non-sterile compounding. Providers and patients alike appreciate HDRx’s commitment to personalized care and precision.
Health Dimensions Clinical Pharmacy (HDRx) is located in Farmington Hills, Michigan, and is licensed to ship compounded prescription medications — including compounded DHEA formulations — to several states, provided a valid prescription is issued by a licensed healthcare provider.
Patients and providers can receive customized hormone therapies directly from HDRx in these states:
- Florida
- Illinois
- Indiana
- Michigan
- Minnesota
- Ohio
- Wisconsin
HDRx: Your Partner in Compounded DHEA and Hormone Therapy
Compounded DHEA provides a flexible and personalized approach to hormone support for patients whose needs aren’t met by over-the-counter products. Whether it’s delivered as a cream, capsule, vaginal suppository, or another format, individualized therapy may allow for better alignment with patient preferences and clinical goals.
For patients and providers looking for a reliable partner in hormone therapy, Health Dimensions Clinical Pharmacy (HDRx) delivers not only high-quality compounded medications, but also a commitment to patient safety and collaborative care.
With a range of delivery options and the ability to customize strengths and excipients, HDRx helps make hormone support accessible, consistent, and clinically guided.
References:
Labrie, F., Archer, D. F., Koltun, W., Vachon, A., Young, D., Frenette, L., … & Moyneur, É. (2018). Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause, 25(11), 1339-1353. Link
Panjari M, Davis SR. Vaginal DHEA to treat menopause related atrophy: a review of the evidence. Maturitas. 2011 Sep 1;70(1):22-5. Link
Pluchino, N., Drakopoulos, P., Bianchi-Demicheli, F., Wenger, J. M., Petignat, P., & Genazzani, A. R. (2015). Neurobiology of DHEA and effects on sexuality, mood and cognition. The Journal of steroid biochemistry and molecular biology, 145, 273-280. Link
Prough, R. A., Clark, B. J., & Klinge, C. M. (2016). Novel mechanisms for DHEA action. Journal of molecular endocrinology, 56(3), R139-R155. Link
Rutkowski, K., Sowa, P., Rutkowska-Talipska, J., et al. (2014). Dehydroepiandrosterone (DHEA): Hypes and Hopes. Drugs 74, 1195–1207. Link
Maggio, M., Fisichella, A., Colizzi, E., et al. (2015). DHEA and cognitive function in the elderly. J. Steroid Biochem. Mol. Biol. 145 281–292. Link
