When talking about cyclical hormones, estrogen is the star of the show, but did you know you need DHEA to make estrogen? DHEA is the most abundant steroid hormone in the body and is required for both estrogen and testosterone production.
If DHEA levels are low, you might notice low libido, fatigue, and other symptoms of low sex hormones. Low levels may contribute to infertility, osteoporosis, and depression.
DHEA is critical and understanding it may help you improve hormone function and balance in your body. Today’s article will cover:
- What does DHEA do in the body?
- Normal DHEA levels in women
- Supplementation – DHEA benefits and risks
- DHEA and fertility
Plus, I’ll cover ways to support DHEA production, naturally. Let’s jump into this important topic!
What Does DHEA Do in the Body?
Dehydroepiandrosterone, or DHEA, is a steroid hormone made primarily by the adrenal glands and in lesser amounts by the ovaries (testes in men). The adrenals make DHEA-S, which is DHEA with a sulfur molecule called sulfate attached. DHEA and DHEA-S convert back and forth. (Hint: the sulfur comes from the food you eat, like broccoli, garlic, artichokes, and animal protein).
What does DHEA do? DHEA turns into testosterone and then into estrogen. So, having enough DHEA is critical to producing both sex hormones.
Low DHEA impacts estrogen and testosterone production, bone health, heart health, immunity, fertility, and virtually all body systems.
What Causes Low DHEA Levels?
Low DHEA can be caused by several conditions, including adrenal disease, pituitary dysfunction (hypopituitarism), and certain medications, like glucocorticoids. Your doctor can evaluate you for each of these to help you determine which is causing low DHEA.
Adrenal Insufficiency
Adrenal insufficiency results in low hormone production (including cortisol) in the adrenal glands due to an autoimmune condition known as Addison's Disease. In adrenal insufficiency, the immune system destroys the adrenal gland, leaving it unable to produce sufficient hormones.
HPA Dysregulation
Also commonly referred to as “adrenal fatigue” or HPA axis dysfunction, this is a condition in which pituitary and adrenal communication, enzyme activation, or cortisol receptors can be temporarily impacted.
Aging
DHEA levels decline as we age, however, it is not uncommon to see too low of levels of DHEA during perimenopause and menopause. DHEA levels peak in our mid-twenties and decline as we age.
Medications
Low levels of DHEA, along with testosterone, may result from oral contraceptive pill use, as I talk about in my book Beyond the Pill. Interestingly, recent research has suggested taking 50 mg of DHEA restores levels of both total and free testosterone in women on the pill.
Glucocorticoids, which are often used to manage inflammation or autoimmune disease, can lead to lower levels of DHEA.
Normal DHEA Levels in Women
DHEA levels peak in your 20s, then decline with age. In animal studies, low DHEA correlates with reduced lifespan. Slowing the DHEA decline with nutrition and lifestyle interventions or using DHEA replacement is increasingly used for “anti-aging” support.
Because of the natural decline, optimal levels of DHEA depend on your age. DHEA-S is tested using a simple blood, urine, or saliva test. It’s also part of the DUTCH hormone panel (urine collection) that can also provide information about cortisol, cortisone, melatonin, and ovarian hormones.
Normal DHEA-S varies according to age and biological sex. And while there are established normal ranges, the results should be interpreted in the context of the patient's symptoms.
| DHEA-S by Age (decades) | Normal Range (serum) |
| Twenties | 65 to 380 µg/dL |
| Thirties | 45 to 270 µg/dL |
| Forties | 32 to 240 µg/dL |
| Fifties | 26 to 200 µg/dL |
| Sixties | 13 to 130 µg/dL |
| Over 69 | 17 to 90 µg/dL |
You can get a DHEA blood test at any point in the monthly cycle, and it’s a good idea to check cortisol levels simultaneously. Please check out this article for more information about the best time to test various hormones.
Low DHEA has been associated with:
- Diabetes
- Dementia
- Osteoporsis
- Low sexual desire or libido
- Thinning or dry vaginal tissue
- Chronic fatigue syndrome
- Lupus
- Autoimmune disease
DHEA Supplements: Benefits and Risks
Before we dive into DHEA benefits for women, it’s important to understand that DHEA is a hormone. In some places, DHEA is available over the counter as a supplement instead of a prescription, but its use still requires care, guidance, and monitoring from your healthcare provider.
Self-supplementing with DHEA without understanding your unique hormonal landscape could have undesired consequences, such as hair loss and other side effects I will discuss below.
Benefits of DHEA for Women
A DHEA supplement can have some incredible benefits when it’s a good fit for you. When you support healthy DHEA levels, there are many downstream effects on estrogen, testosterone, and different body systems.
Increase Libido
Low libido and low sexual desire is the most common sexual health complaint among women. Uncovering the root cause of low libido is important – is it physical or psychological?
If it’s physical, low DHEA may be a root cause leading to low testosterone and low estrogen, and both affect libido. But it’s important to differentiate because there could be other root causes, such as low thyroid hormone, nutrient deficiencies, stress, medication use, and others.
If low DHEA contributes to low libido, supplementation may help support optimal levels, increasing desire, arousal, lubrication, orgasm, and overall satisfaction with sex.
For more tips about improving your libido, check out my new book, Is This Normal.
Bone and Heart Health
Low DHEA, and subsequent low estrogen and testosterone, can be detrimental to the heart and bones.
DHEA is critical for cardiovascular health. It’s anti-inflammatory and involved in heart signaling pathways. Low DHEA levels correlate with increased heart disease and could be one reason that heart disease rates increase in women after menopause.
As women age, the loss of estrogen and testosterone from low DHEA production also affects bone health. One of the benefits of DHEA for women is improved bone density and muscle mass. Supplemental DHEA helps prevent bone loss and improve bone mineral density.
Improve Body Composition
When you supplement DHEA in cases of low levels, you may improve metabolic health. When DHEA converts to estrogen, it improves insulin sensitivity. Research suggests DHEA supplementation may help improve lean body mass while reducing fat mass.
DHEA and testosterone are essential for muscle strength and preserving and improving lean body mass. DHEA supplementation may enhance the effects of strength training.
DHEA and Fertility
DHEA for fertility is an exciting topic! Women with fertility challenges may have a declining ovarian reserve and poor egg quality due to age, oxidative stress, and other factors, including low DHEA/DHEA-S. Supplementing with DHEA offers a non-invasive solution for activating egg development.
Many studies of women with low ovarian reserve undergoing fertility treatments, including IVF, show increased pregnancy success. Supplementation may improve reproductive hormone levels, and improve egg quality. Typical dosages for fertility range from 25-75 mg. The most common dose of DHEA for women undergoing fertility treatments is 75 mg, although this should be monitored by a licensed clinician in order to avoid side effects.
Recommended Dosage for Women
The recommended dosage of DHEA varies based on the situation. It is best to speak with your physician about the best dose for your situation. The most common dosage is 25-50 mg daily. Studies have shown supplementation with DHEA for two years to be a safe range. More longterm data is needed.
Many studies aimed at improving egg quality and fertility use doses of 25 mg up to three times per day, but this level may be too high for some women. It is regarded as best practice in most cases to start at a lower dose, of 25 mg per day and then increase over time.
Best Time to Take DHEA Supplements
DHEA follows a similar diurnal pattern to cortisol, where levels are high in the morning and low in the evening. The best time to take DHEA is in the morning when supplementing once daily. If your provider recommends multiple doses, you can spread the dose throughout the early part of the day. Work with your health care provider to determine the best timing to optimize your hormone patterns.
How to Increase DHEA Naturally
Taking oral DHEA hormone supplements isn’t the only option for optimizing DHEA and DHEA-S levels in the body. A foundational aspect is to support the adrenals. Adrenal health becomes particularly important as we age, and the ovaries stop producing DHEA, along with testosterone and estrogen as we enter menopause. In menopause, women get all their DHEA from the adrenals. Poor adrenal function may be the underlying piece contributing to hormonal symptoms.
The Dr. Brighten Optimal Adrenal Kit provides comprehensive adrenal support from targeted nutrients and adaptogenic herbs. It’s perfect for women wanting to support their adrenal health, those who want to support their body when they're experiencing low DHEA, estrogen, or testosterone levels, and anyone going through a stressful phase.
The Optimal Adrenal Kit includes:
- Adrenal Support – A blend of adrenal-supportive herbs, including vitamin C, vitamin B2, vitamin B5, and vitamin B6, along with an effective blend of adaptogenic herbs to help the body adapt to stress and optimize adrenal hormone production. The adaptogenic herbs include eleuthero, Ashwagandha, Rhodiola, and holy basil.
- B-Active Plus – A powerful B vitamin complex to support the body during times of stress and greater metabolic need. B vitamins support adrenal health, hormone production, metabolism, bone health, libido, and more. This supplement contains B vitamins in their active forms so cells can utilize them immediately.
- Adrenal Calm – An herbal formula with added vitamins, minerals, and amino acids to relax and calm the nervous system while promoting balanced adrenal health and quality sleep. The formula contains lemon balm, passionflower, valerian, phosphatidylserine, l-theanine, and other supportive ingredients.
DHEA Supplement Potential Risks and Side Effects
All hormones work together in concert and adjusting one will influence others. This adjustment may be beneficial or have side effects if DHEA isn’t the right choice for hormone replacement or downstream pathways don’t convert DHEA as intended. Side effects of DHEA may include elevated androgens, medication interactions, and health risks, including cancer.
High Androgens
Androgens are considered “male” hormones. They include DHEA, testosterone, and dihydrotestosterone. As you know, androgens are also essential for women’s health, but we want just the right amount. Because DHEA converts to testosterone, supplemental DHEA may sometimes create too much testosterone.
Symptoms of high testosterone in women may include:
- Anger and aggression
- Changes in body odor
- Increased male pattern hair growth – on chest and chin
- Increased hair loss – especially on the top of the head
- Acne
- Irregular menstrual cycles
In addition, high testosterone can be a possible root cause of anxiety.
Drug Interactions
As with any supplement or hormone, it’s critical to make sure it won’t interact with medications you take, including SSRIs, antipsychotic drugs, sedatives, and others. Please discuss DHEA use with your doctor or pharmacist for guidance.
Hormone-Sensitive Cancers
DHEA is a hormone that can raise estrogen and testosterone levels. If you have a risk of hormone-sensitive cancers including breast, prostate, and ovarian cancer, DHEA may be contraindicated. Work with your doctor to make the best choice, given your risks and medical history.
The Takeaway
When working for overall hormone support and improving DHEA and sex hormone balance, adrenal health is foundational. Whether you and your doctor decide DHEA supplementation is a good fit for you or not, you’ll benefit from sending your adrenals some extra love and nourishment!
References
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