DHEA (dehydroepiandrosterone) is a hormone made mainly by your adrenal glands, two small glands that sit on top of your kidneys. The same signal from your brain that tells these glands to make cortisol, your stress hormone, also tells them to make DHEA.¹

Your body uses DHEA mostly as raw material. Each tissue turns it into the sex hormone it needs, testosterone or estrogen, inside its own cells. In women who still have periods, hormones from the adrenal glands such as DHEA supply about two-thirds of their testosterone before ovulation. In women, DHEA is turned mostly toward testosterone-like hormones, and in men mostly toward estrogen.¹

Because this happens inside the cells, the testosterone or estrogen in your blood does not show how much DHEA is doing. That is why we follow DHEA itself.

• DHEA rises in your teens, peaks between the ages of 20 and 30, then falls by about 2–5% a year. By the ages of 70 to 89, it is 80–90% lower than at its peak, in both men and women.¹
• People differ a lot, partly because of their genes, and some people still make plenty as they get older.¹ That is why we always test before we treat.

Apart from age, medical sources list these reasons for a low level:¹

• You take steroid tablets (corticosteroids) for a long time. Steroid tablets switch off the signal that makes DHEA.
• You have a serious long-term illness
• You have rheumatoid arthritis

In standard medicine, low sex drive, low mood and low energy are the signs doctors look at when the adrenal glands do not work well.² Physicians who focus on optimal hormone levels look for a wider range of signs:

• Energy and mood: moderate tiredness, low mood, or mild anxiety
• Stress: finding it hard to cope with stress or loud noise
• Sex life: low sex drive; in men, weaker erections; in women, less satisfaction
• Eyes and skin: dry eyes and dry skin
• Body hair: thinner hair under the arms and in the pubic area

These signs have many other causes. Only a blood test tells you whether DHEA is part of the reason.

We want you to know what the evidence shows, including its limits. Most benefits found so far are small, and some studies disagree. Large medical guidelines do not recommend DHEA for everyone, because the benefits are modest and there is little long-term data.³ This is why we offer it only after a blood test shows your level is low and you have signs that fit.

• Skin. In a 1-year trial of 280 people aged 60 to 79, skin became more hydrated and thicker, with fewer pigment spots, most clearly in women.⁴
• Sex drive. In the same trial, sex drive rose in women over 70.⁴
• Bone. In older people who took DHEA for 2 years, bone density rose a little: in women at the forearm, in men at the hip.⁵ The effect is smaller than with osteoporosis medicines, and there is no data on fractures.¹
• Blood sugar. In people aged 65 to 75 whose insulin resistance was already abnormal, it improved.⁶
• Body shape. A review of trials found a small gain in lean mass and a small loss of body fat, with no change in weight.⁷
• Immune cells. In a small study of 9 men in their 60s with a low DHEA level, 20 weeks of DHEA raised the number and activity of natural killer cells, the immune cells that clear virus-infected cells.⁸ This was measured in the blood only. We do not yet know whether it means fewer infections.

Trials have not shown a benefit for quality of life in women after menopause,⁹ for memory in healthy older people,¹ or for muscle strength.⁵ We tell you this plainly, so you can decide with the full picture.

Most people start to feel a difference at 3 to 4 months, and the full effect may take about 6 months. About 3 to 5 in 10 people do not notice much change. We tell you this on day one, so you do not stop too early.

We aim for a DHEA level in the middle of the range of healthy young adults, not higher.^1,2

• Why not lower. Below this level, there is less raw material for your tissues to work with.
• Why not higher. More is not better. Too much DHEA shows itself early and in a fairly set order. In women, oily hair and oily skin come first, in the first weeks, then acne at about one month. Extra body hair, or thinning hair on top of the head, is uncommon and comes later. In men, acne is uncommon. In a review of trials in women around menopause, acne-type side effects were more common than with a dummy pill, and no other side effects increased.⁹

Because the early signs come first, they work as a warning. If you tell us at the first sign, we can lower your dose before anything harder to fix appears.

We measure two things together, in the morning:

• DHEA-S. This is the stored form of DHEA in your blood. It stays steady through the day, unlike DHEA itself, so it gives a reliable picture of your level.¹
• Morning cortisol. Studies show DHEA can lower cortisol slightly.¹⁰ In someone whose cortisol is already low, this could tip it lower, so we check it before you start. We test in the morning because cortisol changes through the day, and the morning result is the one we can compare.

If you already take DHEA, have your blood taken first and take your capsule after. Your level rises for a few hours after each capsule, so a test soon after it would look higher than it really is. Testing before the capsule, at the same time each visit, lets us compare one result with the next.²

DHEA is sold as a food supplement. Quality varies between products, and there is little data on how well they are absorbed.^11,1 A poor product may not raise your level at all, or not enough. This is one reason we check your blood level rather than rely on the label.

DHEA is also not one size fits all. Some people need special consideration before they start, because DHEA turns into sex hormones, affects cortisol, or does not mix well with some medicines. Before you start, our doctor checks for:

• Age under 40. Levels usually have not fallen much yet, and younger women are more prone to acne and extra hair.
• Pregnancy or breastfeeding¹¹
• Breast, womb, ovarian or prostate cancer, now or in the past. DHEA can turn into sex hormones, and there is no long-term safety data in these cancers.^11,1
• Low morning cortisol
• Steroid tablets taken long term
• Bipolar disorder, or a past episode of mania (an unusually high or excited mood). DHEA can trigger mania in some people.^11,12
• Antidepressant medicines. Some antidepressants taken with DHEA can trigger mania.¹¹
• Active liver disease
• A high DHEA level without taking any DHEA. This can be a sign that the body is making too much for another reason, which a hospital specialist should look into.
• Testosterone or estrogen treatment, acne or extra body hair already, or heart disease

For some of these, we adjust your plan, for example by starting low or by giving one hormone at a time. For others, the specialist who already looks after you knows your results and medicines best, so we refer you back to them rather than start treatment ourselves.

• You take DHEA once every morning. Your doctor sets your dose from your blood test.
• We start low for everyone. The target is narrow, and starting low makes side effects less likely.
• We check your level 3 months after you start, and 3 months after any change in dose, until you are on target. Then a check every 6 months is enough.
• At 6 months, if your level is on target but you do not feel better, your doctor will talk with you about stopping. The choice is yours.²

Your level settles within about a week of daily use and does not build up over time.¹³ The effects on how you feel take longer, which is why we judge your dose at 3 months.

• One capsule a day is enough. The stored form lasts about a day in your blood.¹³
• Missing a day is not a worry. Your level dips, but it does not fall back to where it was before treatment.

The longest trials lasted 2 years. Trials of 1 to 2 years in people aged 60 and over found no serious side effects.^5,6,4 There is no data beyond that yet,¹ so we use doses close to what the body makes naturally, and we keep your level within the range of young adults.

• Prostate. A large analysis of 18 studies found no link between DHEA levels and prostate cancer.¹⁴ A 2-year trial in men found no harmful effect on the prostate.⁵
• Breast. In women before menopause, a naturally higher DHEA level was linked with a slightly higher risk of breast cancer.¹⁵ This is about the body’s own level, not supplements, and supplements have not been fully studied for this. This is one reason we do not give DHEA to people who have had breast cancer.
• Womb lining. In a 1-year trial in women after menopause, DHEA did not thicken the womb lining.¹⁶
• Cholesterol and liver. DHEA slightly lowered HDL, the “good” cholesterol, in women but not in men.¹⁷ Liver tests did not change.¹⁰ Blood pressure did not change.⁷

1. Papadopoulou-Marketou N, Kassi E, Chrousos GP. Adrenal Androgens and Aging. In: Feingold KR, et al., editors. Endotext. MDText.com; updated 2023.

2. Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(2):364–389.

3. Wierman ME, Arlt W, Basson R, et al. Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2014.

4. Baulieu EE, Thomas G, Legrain S, et al. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci USA. 2000;97(8):4279–4284.

5. Nair KS, Rizza RA, O’Brien P, et al. DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med. 2006;355:1647–1659.

6. Weiss EP, Villareal DT, Fontana L, Han DH, Holloszy JO. Dehydroepiandrosterone (DHEA) replacement decreases insulin resistance and lowers inflammatory cytokines in aging humans. Aging. 2011;3(5).

7. Wang F, He Y, Santos HO, et al. The effects of dehydroepiandrosterone (DHEA) supplementation on body composition and blood pressure: a meta-analysis of randomized clinical trials. Steroids. 2020;163:108710.

8. Khorram O, Vu L, Yen SS. Activation of immune function by dehydroepiandrosterone (DHEA) in age-advanced men. J Gerontol A Biol Sci Med Sci. 1997;52(1):M1–M7.

9. Scheffers CS, Armstrong S, Cantineau AEP, Farquhar C, Jordan V. Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database Syst Rev. 2015;(1):CD011066.

10. Chen H, Jin Z, Sun C, Santos HO, Kord Varkaneh H. Effects of dehydroepiandrosterone (DHEA) supplementation on cortisol, leptin, adiponectin, and liver enzyme levels: a systematic review and meta-analysis of randomised clinical trials. Int J Clin Pract. 2021;75(11):e14698.

11. Mayo Clinic Staff. DHEA. Mayo Clinic, Drugs and Supplements; 2026.

12. Kline MD, Jaggers ED. Mania onset while using dehydroepiandrosterone. Am J Psychiatry. 1999;156(6):971.

13. Legrain S, Massien C, Lahlou N, et al. Dehydroepiandrosterone replacement administration: pharmacokinetic and pharmacodynamic studies in healthy elderly subjects. J Clin Endocrinol Metab. 2000;85(9):3208–3217.

14. Endogenous Hormones and Prostate Cancer Collaborative Group. Endogenous sex hormones and prostate cancer: a collaborative analysis of 18 prospective studies. J Natl Cancer Inst. 2008;100(3):170–183.

15. Endogenous Hormones and Breast Cancer Collaborative Group. Sex hormones and breast cancer risk in premenopausal women: collaborative reanalysis of seven prospective studies. Lancet Oncol. 2013;14(10):1009–1019.

16. Panjari M, Bell RJ, Jane F, et al. The safety of 52 weeks of oral DHEA therapy for postmenopausal women. Maturitas. 2009;63(3):240–245.

17. Qin Y, Santos HO, Khani V, Tan SC, Zhi Y. Effects of dehydroepiandrosterone (DHEA) supplementation on the lipid profile: a systematic review and dose-response meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2020;30(9):1465–1475.