From the Hopkins Health Watch Q&A
(Questions and Answers)

DHEA Should be Used with Care

Q: I read with great interest the study on DHEA. My saliva test revealed a lack of it and yet the practitioner didn't suggest I supplement!? I plan to add at least 5 mg daily ASAP. I'm 44 years old.

Anyway, on to my real question. My 17-year-old daughter has an irregular menstrual cycle ranging anywhere from 30 days to in excess of 50 days. She started menstruating when she was 12. She has no pimples, but does infrequently experience debilitating mood swings. Would DHEA benefit her? Is it fair to “read between the lines” of this study that it might raise her hormones to levels that would regulate her period without having to resort to the birth control pill for regularity?

A: I take my cues on these kinds of questions from Dr. John Lee, who was the old-fashioned, down-to-earth, commonsense kind of family doctor. He was reluctant to recommend hormones of any kind to teens, and before even considering supplemental hormones nearly always suggested first addressing issues such as diet, exercise and stress management (see What Your Dr. May Not Tell You about Premenopause for details). One of the most common prescriptions he wrote for teenage girls was for daily outdoor exercise, which seems even wiser advice now that we know so much more about the importance of sunshine and vitamin D!

An irregular menstrual cycle and fluctuating hormones is a common occurrence among teens and always has been. The tendency to declare it abnormal and regulate it with birth control pills is a phenomenon of modern medicine. In adolescence the body is gearing up for a whole new way of being. Every single aspect of your daughter’s body, from her brain down, is undergoing profound changes. You might want to consider giving her body every opportunity to find its own balance before stepping in with supplemental hormones.

Having said that, one of my favorite tools for increasing body awareness in teens is the Fertile-Focus, a lipstick-sized microscope that will show a ferning pattern in saliva which can indicate fertility/ovulation. If your daughter finds that she doesn’t ovulate during a cycle, then a small amount of progesterone cream (e.g. 10 mg daily for a week or so) may help with the mood swings.

DHEA is a much trickier hormone than progesterone, as there is a wide variation in how individuals process it. Some women will get whiskers from just a small dose, others will find themselves estrogen dominant, while others find that their energy is increased and their achy joints feel better. There’s no telling how it might affect a teen whose hormones are already fluctuating.

Women using DHEA should not take it lightly, since it can easily spill over into estrogen, even with just a 5 mg dose. It’s a good idea for women who take DHEA to track their symptoms and get their hormone levels tested, and/or work with a health professional. Here’s where you’ll find a handy chart for tracking symptoms that you can download and print out. Comparing your symptoms on the Hormone Balance Test for Women can help you figure out which hormones may be out of balance.