DHEA cream is a topical product containing dehydroepiandrosterone, or DHEA, a steroid hormone precursor produced mainly by the adrenal glands. The body can convert DHEA into androgens, including testosterone, and estrogens. Depending on the product, DHEA cream may be marketed for skin use, hormone-related symptoms, or vaginal dryness and discomfort.
"DHEA cream" does not describe one standardized medicine. Products can differ in dose, formulation, route of administration, quality and intended use. A cream is also a different product from the oral capsules sold in pharmacies and online, and if you want to see what the oral form looks like before raising either option with a clinician, this is an oral DHEA supplement sold online, with the Supplement Facts panel shown on the listing.
DHEA Cream at a Glance
| Question | Answer |
|---|---|
| What is the active ingredient? | Dehydroepiandrosterone, also called DHEA or prasterone |
| How is it used? | Applied to the skin or used vaginally, depending on the product |
| Common claims | Menopausal vaginal symptoms, libido, energy, skin aging and hormone support |
| Is every DHEA cream FDA-approved? | No |
| FDA-approved U.S. vaginal product | Intrarosa, a 6.5 mg vaginal insert, not a general-purpose cream |
| Main concern | DHEA is hormone-active, and absorption and product quality can vary |
What Is DHEA?
DHEA is a hormone precursor produced by the adrenal glands in both men and women. The body can convert it into testosterone and estrogen. DHEA levels generally decline with age, although the importance of that decline is not fully understood.
The effects of a DHEA product depend on its concentration, formulation, application site and absorption. A product used on the skin may not have the same effects or evidence as a product intended for vaginal use.
What Is DHEA Cream Used For?
DHEA cream is marketed for several uses, but the evidence differs by product and purpose.
Vaginal Dryness and Painful Sex After Menopause
Vaginal DHEA, also called vaginal prasterone, is used for symptoms associated with genitourinary syndrome of menopause. These symptoms can include vaginal dryness and pain during sexual activity.
Research suggests that vaginal DHEA may improve vaginal dryness and dyspareunia in the short term. The overall certainty of the evidence remains low, and long-term safety data are limited.
In the United States, the FDA-approved prasterone product is Intrarosa, a 6.5 mg vaginal insert used once daily at bedtime. It is approved for moderate to severe pain during sex caused by menopausal vulvar and vaginal atrophy. Intrarosa is an insert, not a conventional DHEA cream.
Skin, Energy and Libido
Some over-the-counter DHEA creams are marketed for anti-aging, energy, mood, muscle, libido or general hormone support. These claims are not established medical benefits. Reliable evidence does not support DHEA as a proven anti-aging treatment, and the long-term safety of DHEA supplementation is unknown.
Is DHEA Cream FDA-Approved?
Most DHEA creams are not FDA-approved to treat a medical condition.
The FDA-approved U.S. vaginal prasterone product is Intrarosa, which comes as a vaginal insert. A cream made by a compounding pharmacy is not FDA-approved. The FDA has not reviewed that specific product in advance for safety, effectiveness or manufacturing quality.
An over-the-counter product being available for purchase does not mean the FDA has confirmed that it works for menopause, aging, low libido or another advertised use. Dietary supplements are not FDA-approved to treat or prevent disease.
DHEA Cream Versus Vaginal Estrogen Cream
DHEA and vaginal estrogen are different treatments.
| Feature | DHEA or prasterone | Vaginal estrogen |
|---|---|---|
| What it is | A hormone precursor converted into active hormones in tissue | Estrogen supplied directly |
| U.S. FDA-approved vaginal form | Intrarosa 6.5 mg vaginal insert | Creams, tablets, inserts and rings are available |
| Typical use | Menopausal vaginal dryness and painful sex | Vaginal and urinary symptoms related to low estrogen |
| Product variability | Greater with over-the-counter and compounded creams | More consistent with an approved prescription product |
Both vaginal DHEA and vaginal estrogen may help some symptoms of genitourinary syndrome of menopause. The better option depends on medical history, symptom severity, treatment preferences and advice from a healthcare professional.
What Are the Risks and Side Effects?
DHEA can be converted into sex hormones, so it may cause hormone-related effects. Possible problems include acne, oily skin, unwanted hair growth, hair changes and mood changes. The risk depends on the dose, formulation, absorption and route of use.
For FDA-approved vaginal prasterone, vaginal discharge is the most commonly reported adverse reaction. The prescribing information also includes warnings for people with a current or past history of breast cancer. It says not to use the product with unexplained abnormal genital bleeding.
Compounded creams add uncertainty because the FDA does not pre-review their strength, effectiveness or quality. A compounded product may meet a particular medical need, but it should not automatically be treated as equivalent to Intrarosa or another FDA-approved medicine.
What Should You Check Before Using DHEA Cream?
Before buying or using a DHEA product:
- Check the route: Confirm whether the product is intended for skin application or vaginal use. Do not use a skin cream internally unless a qualified clinician prescribed it for that purpose.
- Check the dose: DHEA creams may contain different concentrations, so products are not interchangeable.
- Identify the product type: Determine whether it is an FDA-approved prescription, a compounded medication or an over-the-counter supplement.
- Discuss hormone-sensitive conditions: Speak with a healthcare professional before use if you have a history of breast cancer, unexplained vaginal bleeding or another hormone-related condition.
- Review medications: Tell your clinician about all medications and supplements because DHEA may interact with hormone treatments and other medicines.
Bottom Line
The word "cream" does not tell you enough about a DHEA product. Check the route, dose, formulation and regulatory status before comparing its benefits with those of vaginal prasterone or vaginal estrogen. If part of that comparison is the oral route, a DHEA supplement product listing shows the strength and ingredient list an over-the-counter capsule carries, which is a different product from any cream.