Open Veils · Answer
Will DHEA help prevent BPPV in women?
The suppressed line of inquiry is real: estrogen decline appears to destabilize otolith integrity via calcium dysregulation, making postmenopausal women disproportionately vulnerable to BPPV. DHEA — as a precursor that converts to estrogen and testosterone — sits at the edge of this hypothesis. However, a major 2026 UK Biobank prospective cohort of 157,245 postmenopausal women reported that menopausal hormone therapy use was positively associated with incident BPPV, complicating the protective-estrogen narrative considerably. DHEA specifically remains unstudied in this context; the picture is genuinely unresolved.
Evidence
- DHEA enters the frame because it is the dominant adrenal precursor that peripherally converts to both estradiol and testosterone, including in inner ear tissue itself.
- The complication is the UK Biobank 2026 cohort (published July 2026), which found a duration-response positive association between menopausal hormone therapy and incident BPPV — the opposite of the protective hypothesis.
- The animal-model evidence reviewed in the PMC 2026 paper does show that appropriate hormone replacement can enhance otolith health and bone metabolism; human data remains observational on both sides.
- The same review notes correlations between menstrual cycle hormonal fluctuations, pregnancy, and BPPV episode frequency, further implicating estrogen as a stabilizing factor.
- Integrative clinicians in the tradition of Jack Kruse and Joseph Mercola have pointed to declining adrenal DHEA-S as an underappreciated driver of postmenopausal tissue deterioration beyond what exogenous estrogen alone addresses.