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Dehydroepiandrosterone (DHEA) – Hormone & Effects

Dehydroepiandrosterone (DHEA) is a natural steroid hormone produced by the adrenal glands, acting as a precursor to sex hormones and playing a key role in metabolism and aging.

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Things worth knowing about "Dehydroepiandrosterone"

Dehydroepiandrosterone (DHEA) is a natural steroid hormone produced by the adrenal glands, acting as a precursor to sex hormones and playing a key role in metabolism and aging.

What is Dehydroepiandrosterone (DHEA)?

Dehydroepiandrosterone (DHEA) is a steroid hormone primarily produced by the adrenal cortex, with smaller amounts synthesized in the gonads and brain. It is the most abundant circulating steroid hormone in the human body and serves as a critical precursor (prohormone) for the biosynthesis of androgens such as testosterone and estrogens. In the bloodstream, DHEA is predominantly found in its sulfated form, DHEA-sulfate (DHEAS), which acts as a storage reservoir and can be converted to the active form as needed.

Biological Functions

DHEA plays several important roles in the human body:

Precursor to sex hormones: DHEA is converted in peripheral tissues into androgens and estrogens, which is particularly important in postmenopausal women whose ovarian hormone production has declined.
Immune modulation: DHEA influences immune function and exhibits anti-inflammatory properties.
Metabolism: The hormone contributes to regulating body fat composition, insulin sensitivity, and energy metabolism.
Bone and muscle health: DHEA supports the maintenance of bone density and muscle mass.
Neuroprotection: Acting as a neurosteroid in the brain, DHEA may positively influence cognitive function and mood.

DHEA Levels Throughout Life

DHEA production follows a characteristic age-dependent pattern. Levels peak in early adulthood (between the ages of 20 and 30) and then gradually decline. By the age of 70 to 80, DHEA levels may be only 10 to 20 percent of their youthful peak. This age-related decline is referred to as the adrenopause and is associated with various aspects of aging, including changes in body composition, immune function, and well-being.

Medical Applications

Approved Indications

In the European Union, DHEA is approved as a prescription medication under the trade name Prasterone (Intrarosa) for the treatment of vulvovaginal atrophy in postmenopausal women. It is administered as a vaginal insert and helps relieve symptoms such as vaginal dryness, irritation, and pain during intercourse.

Other Clinical Uses

Adrenal insufficiency: In patients with Addison disease or secondary adrenal insufficiency, DHEA supplementation may improve well-being, libido, and quality of life.
Systemic lupus erythematosus (SLE): Some clinical studies have demonstrated beneficial effects of DHEA on disease activity in SLE.
Anti-aging and sports: DHEA supplements are widely marketed for anti-aging and performance enhancement; however, the scientific evidence supporting these claims remains limited.

Dosage and Usage Notes

Therapeutic dosing of DHEA depends on the indication. For adrenal insufficiency, typical oral doses range from 25 to 50 mg per day. Vaginal administration for vulvovaginal atrophy uses 6.5 mg daily. Self-medication with over-the-counter DHEA supplements should be avoided without medical supervision, as uncontrolled use may lead to unwanted hormonal side effects.

Side Effects and Risks

The use of DHEA may be associated with the following side effects:

Androgenic effects in women (acne, hair loss, increased body or facial hair)
Estrogenic effects (breast tenderness, fluid retention)
Mood changes and irritability
Potential stimulation of hormone-sensitive conditions (e.g., hormone-dependent tumors)
Interactions with other hormones and medications

Individuals with hormone-sensitive conditions such as breast or prostate cancer should not use DHEA.

Diagnostics: Measuring DHEA Levels

DHEA and DHEAS levels can be measured with a routine blood test. DHEAS is preferred for measurement due to its longer half-life and greater stability. Clinical indications for testing include:

Suspected adrenal insufficiency or hyperfunction
Evaluation of androgen excess (e.g., polycystic ovary syndrome)
Diagnosis of adrenal tumors
Assessment of pubertal development (adrenarche)

References

Arlt W. - Dehydroepiandrosterone and ageing. Best Practice & Research Clinical Endocrinology & Metabolism, 2004; 18(3): 363-380.
European Medicines Agency (EMA) - Assessment report for Intrarosa (Prasterone), 2016. URL: https://www.ema.europa.eu
Labrie F. et al. - DHEA and the formation of sex steroids in peripheral intracrine tissues. Journal of Steroid Biochemistry and Molecular Biology, 2015; 145: 174-180.

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