DHEA (Dehydroepiandrosterone) is a naturally occurring hormone in our bodies which depletes as we get older. Here’s some info quoted from a UK site (<– click the link for more detailed info):
Description: DHEA, also known as “the mother hormone”, is produced by the adrenal glands and is the most dominant hormone in the body. The body converts DHEA into whatever hormone it needs (i.e. estrogen, testosterone, progesterone, and coriconsterone) In both sexes, blood levels of DHEA peak at 20. Thereafter, the levels steadily decline throughout aging, more dramatically with child bearing and with menopause. By eighty years old, the body only has 5% of the DHEA levels it had at 20! Many age-related conditions appear associated with lower than average levels of DHEA.
OK, so what’s all this got to do with infertility?
Dr Norbert Gleicher and colleagues at the Center for Human Reproduction in the States stumbled across the idea when a poor responder over 40 patient of theirs started having better and better responses to IVF – she had been secretly taking DHEA. Since then they (and others) have conducted some randomised trials and have seen some promising results in poor responders.
Want more info? Here are a few useful links to some of the research (you can find more through Google Scholar):
- CHR’s web page explaining their DHEA research programme
- A summary of answers from Gleicher to a poor responder patient asking about DHEA
- Dehydroepiandrosterone supplementation augments ovarian stimulation in poor responders: a case series Human Reproduction, Vol. 15, No. 10, 2129-2132, October 2000
- Update on the use of dehydroepiandrosterone supplementation among women with diminished ovarian function Journal of Assisted Reproduction and Genetics, Volume 24, Number 12 / December, 2007
OK, sounds like a miracle cure – should I take it?
It does sound amazing, but the reality is that it doesn’t help all poor responders. In fact, the poor responders I have spoken to over the years have seldom had such obvious beneficial effects. Also, it does have some downsides for some people. Here are the ones I’ve become aware of:
- Anyone who has higher than normal androgen or DHEA-S levels should definitely NOT take it because it can exacerbate these issues. Be especially cautious if you have PCOS or PCO, or any facial hair issues. Make sure you get DHEA-S and androgen levels measured first by your doctor and discuss the idea with him/her thoroughly to decide together whether it’s right for you. You have to do this anyway because it is only available on prescription in New Zealand. And even then, you can expect it to cost about $75/month.
- If you’re under 40 then your DHEA levels may already be normal, so you wouldn’t benefit from it. It’s really only useful for those whose levels are seriously depleted.
- Anyone who has a history or risk of ovarian cancer should not take it.
- Some women have experienced hair loss and wacky cycles after taking DHEA.
- Some women get too high levels of testosterone after taking it, and can end up with facial hair and deeper voices.
- It can cause sleeplessness, especially if you launch straight into a high dose. If your doctor does agree and prescribes it, ask to start on a lowish dose (like, 25mg), take this in the morning (not the evening), and let yourself get used to it for a week or two before increasing the dose.
- If you are taking Dexamethasone during your stim cycle to enhance response or help with implantation, the general advice is to stop DHEA before you start Dex because they apparently work in opposite ways.
So, are there any upsides? I took it myself for a couple of years, and had some upsides (also reported by others). The flipside of the sleeplessness thing is that it can make you feel like you have more energy. I also found it seemed to increase my metabolic rate, so I lost a couple of kilos while on it. But did it help my response to IVF? Well, not obviously, but it certainly didn’t hurt.
To sum up, the jury’s still out on this one. Do your research, talk to your doctor, get your DHEA-S levels tested first before agreeing to try it. Dr. Gleicher says that he sees many spontaneous natural pgs among women taking it while waiting to start IVF, so don’t wait until you start cycling. Many say it takes about 4 months before the effects really kick in. If you notice any adverse effects, talk to your dr straight away about whether you should stop it or reduce the dose. Make sure your DHEA-S and androgen levels are retested regularly to make sure they aren’t going too high.