Patient complaints regarding sexual functioning, either lowered levels of desire, or difficulty becoming aroused, are common. Currently, there are drugs, such as testosterone, that are being used ‘off label’ for this purpose. A patient may request a trial of a ‘more natural’ alternative, available over the counter (OTC) such as Dehydroepiandrosterone (DHEA). In this setting, consider discussing the following
Data support the positive role of androgens in female sexual function and ovarian physiology. However, the availability of approved testosterone formulations remains limited, particularly in the US. Therefore, patients may opt to obtain DHEA, the precursor hormone, in its stead. There is no positive guidance regarding the use of DHEA in women for sexual dysfunction because currently there remains a lack of well-designed studies demonstrating consistent clinical improvement.
Systemic DHEA has been tested but has not shown efficacy in postmenopausal women for treatment of sexual interest and arousal disorders and, therefore, is not recommended for use
Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction
ACOG Practice Bulletin 213: Female Sexual Dysfunction
DHEA therapy for women: effect on sexual function and wellbeing
Effects of a 3-week dehydroepiandrosterone administration on sleep, sex steroids and multiple 24-h hormonal profiles in postmenopausal women: a pilot study
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