Hormone

DHEA

Dehydroepiandrosterone

Evidence TierBWADA PROHIBITED

tuneTypical Dose

25-50 mg per day

watchEffect Window

4-12 weeks for mood and libido. 6+ months for bone density.

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WADA PROHIBITED

Overview

Clinical Summary

DHEA is an adrenal steroid hormone precursor that can convert to androgens and estrogens. It is used to address low DHEA status and related well-being and libido symptoms.

Evidence supports benefits in adrenal insufficiency and in some individuals with low baseline DHEA, improving well-being and libido measures. Trials show modest improvements in bone density and skin hydration in older adults. Minority findings include mood and fatigue improvements, with variable results. Responses vary widely and hormone-sensitive risks depend on dose and individual context.

Circulating prohormone serving as precursor to both androgens and estrogens. Also acts as neurosteroid at NMDA and GABA-A receptors.

Outcomes

What This Is Expected To Influence

Primary Outcomes

  • Restore DHEA-S levels in older adults
  • Improve bone mineral density in postmenopausal women

Secondary Outcomes

  • Mood improvement in deficient populations
  • Modest libido enhancement

Safety

Contraindications and Interactions

Contraindications

  • Hormone-sensitive cancers
  • PCOS
  • Pregnancy
  • Lactation

Side effects

  • Acne
  • Oily skin
  • Hair loss
  • Facial hair growth (hirsutism), especially in women
  • Deepening of the voice
  • Irregular menstruation
  • Mania
  • Sweating
  • Skin spots
  • Hormonal disruption

Interactions

  • Drugs that are CYP3A4 substrates (Possible/Unknown) - DHEA might affect the metabolism of CYP3A4 substrates, but the evidence is conflicting.
  • Supplements that are CYP3A4 substrates (Possible/Unknown) - DHEA might affect the metabolism of CYP3A4 substrates, but the evidence is conflicting.
  • Blood-thinning drugs (Theoretical/Unknown) - Theoretically, taking DHEA with blood-thinning drugs may have additive effects.
  • Fulvestrant (Theoretical/Unknown) - In vitro research has found that DHEA blocks the effects of fulvestrant, which can result in treatment failure and the proliferation of breast cancer cells.
  • Estrogens (Theoretical/Unknown) - Theoretically, taking DHEA with estrogen-containing drugs can have additive effects.
  • Testosterone (Theoretical/Unknown) - Theoretically, taking DHEA with testosterone-containing drugs can have additive effects.
  • Aromatase inhibitors (Theoretical/Unknown) - DHEA may reduce treatment efficacy by increasing downstream androgen/estrogen signaling.
  • Tamoxifen (Theoretical/Unknown) - DHEA may reduce treatment efficacy in hormone-sensitive contexts.
  • Insulin sensitizers (Theoretical/Unknown) - DHEA may have additive glucose-lowering effects.
  • Drugs that are CYP2C9 substrates (Theoretical/Unknown) - DHEA may increase the metabolism of CYP2C9 substrates.
  • Drugs that are CYP2C19 substrates (Theoretical/Unknown) - DHEA may increase the metabolism of CYP2C19 substrates.

Avoid if

  • Hormone-sensitive cancers
  • PCOS
  • Pregnancy
  • Lactation
  • Young healthy adults with normal DHEA-S levels

Evidence

Study-level References

dhea-SRC-001RCT
Sourceopen_in_new

Weiss EP, et al. "Dehydroepiandrosterone replacement therapy in older adults improves indices of bone mineral density." J Bone Miner Res. 2009.

Population: Older men and women (65-75 years)

Dose protocol: Source-listed

Key findings: DHEA replacement therapy for 1 to 2 years improved BMD in older women and older men.

Paper content

DHEA replacement therapy for 1 to 2 years improved BMD in older women and older men.

dhea-SRC-002Systematic review and meta-analysis of 38 randomized controlled trials.
Sourceopen_in_new

Conforti A, Carbone L, Di Girolamo R, et al. Therapeutic management in women with a diminished ovarian reserve: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2025;123(3). doi:10.1016/j.fertnstert.2024.09.038. PMID:39332623.

Population: Women with diminished ovarian reserve undergoing IVF/ICSI across 38 RCTs.

Dose protocol: Systematic review and meta-analysis of 38 RCTs. DHEA evaluated in 4 studies (418 patients) for diminished ovarian reserve.

Key findings: DHEA significantly improved oocyte retrieval (WMD 0.60, 95% CI 0.07 to 1.13) but did not demonstrate improved live birth rates compared to testosterone or growth hormone.

Notes: Places DHEA in context for fertility support. Modest oocyte yield benefit but no clear advantage for the most important outcome (live births).

Paper content

This systematic review and meta-analysis of 38 RCTs evaluated therapeutic strategies for women with diminished ovarian reserve. DHEA was evaluated in 4 studies (418 patients) and significantly improved the total number of oocytes collected (WMD 0.60, 95% CI 0.07 to 1.13). However, DHEA did not demonstrate improved live birth rates compared to testosterone supplementation. Growth hormone showed the strongest evidence for improving oocyte yield and live births in this population. This places DHEA as a modestly effective but not clearly superior option for ovarian reserve support in the fertility context.

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