Impact of DHEA supplementation on testosterone and estradiol levels in postmenopausal women: a meta-analysis of randomized controlled trials assessing dose and duration effects.

Abstract

Background and aim: The effects of dehydroepiandrosterone (DHEA) supplementation on testosterone and estradiol concentrations in postmenopausal women have produced conflicting results. This meta-analysis of randomized controlled trials aimed to evaluate the impact of DHEA supplementation on serum testosterone and estradiol levels and to provide evidence regarding the optimal dosage and duration of supplementation.

Methods: A comprehensive literature search was conducted across PubMed/Medline, Embase, Web of Science, and Scopus to identify relevant studies published before June 11, 2024. Data were analyzed using a random-effects model and presented as weighted mean differences (WMDs) with 95% confidence intervals (CIs).

Results: The analysis included 21 studies, comprising 17 trial arms assessing estradiol and 20 assessing testosterone. DHEA supplementation significantly increased estradiol (WMD: 7.86 pg/mL; 95% CI 6.33-9.40; P ≤ 0.001) and testosterone levels (WMD: 24.31 ng/dL; 95% CI 15.22-33.40; P ≤ 0.001). Subgroup analyses showed greater increases in estradiol levels among studies using DHEA dosages ≥ 50 mg/day (WMD: 8.65 pg/mL) and those with participants aged ≥ 60 years (WMD: 8.92 pg/mL), although the differences were modest and 95% CIs overlapped. For testosterone, higher levels were observed with DHEA dosages ≥ 50 mg/day (WMD: 29.65 ng/dL).

Conclusion: DHEA supplementation at doses ≥ 50 mg/day significantly increases testosterone levels in postmenopausal women. Moreover, in women aged ≥ 60 years, supplementation at the same dosage significantly elevates estradiol levels.