DHEA (dehydroepiandrosterone) is a naturally occurring steroid hormone produced primarily by the adrenal glands, but also in the brain and gonads.
It is a precursor hormone, meaning the body converts it into male and female sex hormones, including testosterone and estrogen.
The most abundant steroid hormone in the circulation.
Levels decline from the third decade onward.
Longevity in healthy adults associated with relatively high levels of DHEA.
Adrenal DHEA is a precursor two more potent androgens such as dihydroxytestosterone , which binds to the androgen receptors and normally cancer cells.
Modestly increases testosterone levels in women.
In the absence of hypogonadism replacement therapy with DHEA has minimal effect on testosterone levels in men.
Administration to elderly men and women with low androgen levels for about 23 months resulted in increased sulfated DHEA that would be considered high normal range for young adults, and it resulted in slightly increased levels of testosterone and estradiol in women and levels of estradiol in men.
SLCO2B1 is ian organic anionic transporter enables anticancer compounds in hormones to enter cells.
DHEA production typically peaks in the mid-20s and gradually declines with age.
By age 70, levels may be only 20% of their peak.
DHEA is sold over-the-counter as a dietary supplement.
It is widely sold as a dietary supplement and has been studied for diverse indications, but evidence of clinical benefit is mixed and safety concerns limit routine use.
However, a prescription version (Prasterone) is used for specific medical conditions.
Because it can increase testosterone levels, DHEA is banned by the World Anti-Doping Agency (WADA), NCAA, and the International Olympic Committee for use in competitive sports.
Prescription DHEA (such as Intrarosa) is FDA-approved to treat vaginal atrophy and painful intercourse in postmenopausal women.
Some research suggests DHEA may help reduce symptoms of depression, particularly in individuals with naturally low levels.
Adrenal insufficiency: It may improve quality of life and mood for individuals whose adrenal glands do not produce enough hormones.
Fertility: It is sometimes used as an add-on treatment in IVF to help women with a diminished ovarian reserve improve egg quality.
There is no strong evidence that DHEA improves muscle mass, prevents cognitive decline (Alzheimer’s), or significantly aids in weight loss for healthy adults.
Side Effects and Risks DHEA can significantly alter hormone balance.
Common Effects: Acne, upset stomach, hair loss on the head, or increased facial/body hair in women.
DHEA may stimulate the growth of hormone-sensitive cancers (such as
DHEA may interact with antidepressants, blood thinners, insulin, and medications like Tamoxifen.
Contraindications:use by pregnant or breastfeeding women, or individuals with liver disease or PCOS.
DHEA levels decline significantly after trauma and critical illness, with the resulting increased cortisol:DHEA ratio associated with higher infection rates.
In animal models of trauma, hemorrhage, and sepsis, DHEA supplementation improved survival rates and clinical outcomes through immunomodulatory effects, including restoration of cellular immunity, reduced apoptosis of immune cells, enhanced splenocyte proliferation, and modulation of TNF-alpha expression.
These effects were accompanied by improved organ function and augmented heat shock protein production.
DHEA is synthesized in the adrenal zona reticularis, gonads, and brain.
It is converted peripherally into testosterone, dihydrotestosterone, and estrogens depending on tissue-specific enzymes.
Circulating DHEA is largely present as its sulfated form, DHEA‑S, which has a much longer half-life and is often measured as a marker of adrenal androgen production.
Levels of DHEA peak in the 20s and then fall progressively, reaching roughly 10–20% of peak by older age.
It is marketed as an anti‑aging hormone.
Its promotion includes anti‑aging, improved physical performance, mood, libido, and menopausal symptom relief, but for most of these the data are inconsistent or show little to no clinically meaningful benefit.
Sronger but still limited evidence for use in: Adrenal insufficiency-quality of life, mood, sexual well‑being.
Mild benefit in some postmenopausal women for vaginal atrophy and sexual function with low‑dose intravaginal DHEA.
Selected autoimmune conditions (e.g., SLE) where DHEA may modestly improve symptoms such as fatigue and pain, but it is not standard of care.
DHEA is an androgen/estrogen precursor: adverse effects are largely androgenic: acne, hirsutism, seborrhea, hair loss, voice changes, and menstrual irregularities in women; in men, potential for gynecomastia and changes in prostate parameters, alterations in lipid profile (e.g., reduced HDL), potential effects on insulin sensitivity, liver enzyme changes, and theoretical increased risk of hormone‑sensitive cancers (breast, prostate, endometrium).
Long‑term safety is not established.
It is sold as a supplement, so product quality and dosing can be highly variable.
Oral doses in trials are often 25–50 mg/day in adults, with lower local doses (e.g., 6.5 mg intravaginal) for vulvovaginal atrophy, but optimal dosing is not well defined and should be individualized.
Monitoring typically includes: symptom tracking; exam for androgenic effects; lipids, liver enzymes, glucose parameters; and for at‑risk populations, appropriate cancer screening (breast, prostate, endometrium) and consideration of baseline and follow‑up DHEA‑S levels.
In eugonadal individuals or those without clear adrenal androgen deficiency, routine DHEA supplementation has limited evidence of benefit and nontrivial potential risk.
DHEA tends to be reserved for:
Documented adrenal insufficiency with persistent fatigue/low libido despite standard replacement.
Patients with peri‑/postmenopausal genitourinary syndrome of menopause when standard local estrogen is contraindicated or declined, using prescription intravaginal formulations rather than OTC oral products.