Dehydroepiandrosterone, or DHEA for short, is a steroid hormone that is a precursor to androgens and estrogens (i.e., DHEA is an intermediate step in the production of testosterone and estrogens in the body). The adrenal glands naturally produce a vast majority of DHEA from cholesterol, while ovaries, testicles and brain contribute a small amount.
DHEA itself is a weak androgen. As we age, the body’s natural DHEA production slows down, which leads to a gradual decline in the levels of other hormones, like DHEA-s and testosterone. Read on to learn how your body produces and distributes DHEA to various tissues to meet the body's hormonal needs.
What is DHEA sulfate (DHEA-S)?
DHEA transforms into DHEA-S in both the adrenal glands and the liver. The main difference between DHEA and DHEA-S is that DHEA-S has an additional sulfate molecule attached.
Like DHEA, DHEA-S comes mainly from the adrenal gland. When you take DHEA supplements, DHEA is converted to DHEA-S in the liver. The blood then transports DHEA-S to various parts of your body. This is the “storage” form of DHEA in the body that doctors use to measure your DHEA levels. (More on that later.)
How does DHEA (dehydroepiandrosterone) work?
DHEA is a step in the biochemical process we call steroidogenesis - how the body synthesizes male and female sex hormones.
The adrenal cortex synthesizes DHEA from cholesterol. After this androgen is produced, your body carries it to the brain, liver, kidney, and gonads (ovaries and testicles). Depending on the tissue, the body metabolizes DHEA to be converted to 5-androstene-3β,17β-diol, 4-androstene-3,17-dione, testosterone, estrogen, and other steroids that fulfill various key functions throughout the body.
What are “normal” levels of DHEA?
Typical levels of DHEA vary by age. DHEA levels are generally low at birth but increase as you approach your early 20s, and peaks at around ages 20-24. After this peak of DHEA production, your body starts experiencing a gradual decline in DHEA levels.
The decline in DHEA levels is typically steeper for women than men. As men start to age, their levels decrease at a lower rate. For women, the decline is faster at first but then starts to level out as they get older.
DHEA is converted into DHEA-S soon after you take a DHEA supplement. As a result, DHEA levels are usually measured via DHEA-S in a blood test.
According to Rebecca Fett of “It Starts with the Egg,” the expected levels of DHEA-S for women are as follows:
- 30-39 years of age 31-228 µg/dL
- 40-49 years of age 18-244 µg/dL
Note, though, that the “normal range” can vary, depending on the laboratory that performs the blood test. That's partly why the "normal" range is quite wide. Your result should come with a reference range for the particular lab to compare against.
Doctors often look at more than just your DHEA and DHEA-S levels in your test results. Female fertility specialists may look at your testosterone levels, as well as sex hormone binding globulin (SHBG). By evaluating these other hormones, along with DHEA and DHEA-S, doctors can better assess whether DHEA can support your reproductive health through ovarian health.
How is DHEA typically used?
You can’t get DHEA from food sources, so the only way to get extra DHEA is to take a supplement. As a hormone, it’s a controlled substance in much of the world. However, DHEA is considered a dietary supplement in the United States, and can be purchased without a prescription. DHEA can be found as a supplement by itself, or in preconception multivitamins for women.
Your body uses both the natural DHEA and DHEA from supplements to maintain healthy hormone levels, which can support many biological functions of the body, including ovarian health.
Studies have suggested that DHEA may help:
- Maintain normal hormone levels
- Support female reproductive health
- Support ovarian health
- Maintain a healthy sex drive in women
A recent study suggested that DHEA may help support ovarian function and support female reproductive health. Study authors hypothesized that supplementing with DHEA may restore DHEA - and testosterone - levels that are typically seen in women in their 20s.
Remember, before you start taking over-the-counter supplements, it is always good to talk to your healthcare provider to ensure the supplements are safe and supportive for your specific needs.
How much DHEA should you take?
The daily amount of DHEA should be no more than 50-100 mg. Although it’s a weak hormone, taking too much DHEA can lead to an imbalance in your hormones, which can interfere with the normal functioning of your endocrine system.
For female reproductive health, the typical dose is 75 mg/day, usually 25 mg spread across 3 meals. However, before starting on DHEA, make sure to discuss it with your healthcare provider and follow their instructions - it is a hormone, after all.
What are the risks of taking DHEA?
Some people should not take DHEA. Even if you are without contraindications, taking DHEA inappropriately carries risks, just like other supplements. DHEA is not recommended for:
- Women under the age of 18: This is due to the paucity of safety studies.
- Women who are pregnant or nursing: This is because the body naturally produces more DHEA during pregnancy, and an extra dose isn’t likely beneficial.
- Women with polycystic ovary syndrome (PCOS): As we saw above, the body converts DHEA into testosterone, which is often already elevated in women with PCOS.
- Women with estrogen-sensitive conditions, including breast or ovarian cancer: The extra estrogen generated from DHEA can trigger estrogen-sensitive conditions.
It is also important to work with your healthcare provider about possible interactions and side effects when taking any supplements. Let's discuss a few.
Possible interactions when taking DHEA
Like most medications and supplements, DHEA supplements may have interactions with other medications - one more reason it’s important to talk to your doctor before starting on DHEA supplements.
Medications that may have interactions when taken with DHEA include:
- Antipsychotics, carbamazepine, lithium and valproic acid: DHEA can reduce the effectiveness of these medications.
- Selective serotonin reuptake inhibitors: DHEA can change how these medications work and lead to manic symptoms.
- Estrogen and testosterone: Because DHEA is converted into these sex hormones, taking DHEA together with estrogen or testosterone can be excessive.
- Triazolam: Taking DHEA can increase the effects of this sedative.
- Insulin: DHEA may change a diabetic patient’s insulin requirements.
The list above is not comprehensive. Refer to MedlinePlus, which has a full list of drug interactions here, and definitely talk to your doctor if you are taking any medications.
Possible side effects of DHEA in men and women
Some people experience side effects when taking a DHEA supplement. Most side effects are mild - like headache and fatigue. Women and men may experience DHEA’s side effects differently:
DHEA side effects for women
- Higher testosterone levels and associated effects, such as deepening of the voice, increased hair growth (hirsutism) or hair loss, oily skin and acne
- Changes in menstrual cycles
- Changes in emotional well-being, like increased irritability
- Changes in sexual well-being, including increased libido and enjoyment
DHEA side effects for men
- Skin blemishes
- Increase in breast tissue
- High blood pressure
- Higher levels of estrogen
DHEA can also lower the “good cholesterol” (high-density lipoprotein, or HDL) and worsen liver problems.
Stop taking DHEA if you start experiencing negative side effects. Usually, the side effects subside relatively quickly once you are off DHEA. If they persist, talk to your doctor to rule out any other health problems.
Can you get DHEA naturally from foods?
You cannot get DHEA naturally from foods. A species of wild yams has a similar substance that is used to produce DHEA supplements, but our bodies cannot synthesize DHEA from wild yams (or soybeans, which also contain a similar chemical). The only way to get extra DHEA is through DHEA supplements.
The bottom line on DHEA
DHEA is a precursor to female and male sex hormones that plays important roles in women’s reproductive health, particularly in the ovaries. As women (and men) age, the natural levels of DHEA decline, and some reproductive health specialists recommend DHEA supplements to women on the TTC journey.
Since it’s a hormone with some contraindications and side effects, make sure to consult your doctor before starting on DHEA. They can test your hormone levels to determine if DHEA is right for your journey, monitor you while you take DHEA and adjust your doses, depending on your progress.
Please reach out if you have any questions about DHEA. We are with you.
