DHEA

What it is

DHEA (dehydroepiandrosterone) is a steroid hormone made mainly by the adrenal glands. The body converts it into testosterone and oestrogens. Levels peak in early adulthood and fall steadily with age, which is why it has been marketed as an anti-ageing supplement.

Its legal status differs by country. In the US it is sold over the counter as a supplement. In many other countries it is regulated as a medicine. In the UK the position is complicated: it is not licensed as a general-use medicine and supplement sales have been restricted, so check current MHRA guidance and be cautious about online sellers.

It is used for low libido, menopause symptoms, adrenal insufficiency, ageing, and by athletes and bodybuilders. It is a real hormone, not a gentle herbal.

How it works

DHEA and its sulphate form (DHEA-S) are converted in tissues into androgens and oestrogens, depending on the person and the tissue. Effects therefore vary by sex, age and existing hormone levels, and can raise testosterone or oestrogen unpredictably.

What the evidence says

• Moderate Adrenal insufficiency (replacement, medical use)
  Some benefit in selected women with adrenal insufficiency under specialist care; not a self-treatment.
• Moderate Vaginal dryness after menopause (prescription vaginal prasterone)
  Licensed vaginal DHEA (prasterone) improves symptoms; it is a different product from oral supplements.
• Limited Libido and sexual function
  Mixed results; small benefits in some women with low levels, little in healthy men.
• Weak Muscle, bone and anti-ageing effects
  Trials in older adults generally show little or no meaningful benefit, and long-term safety is unknown.
• Weak Mood and wellbeing
  Mixed and small effects, with many people reporting no change.

Evidence ratings are our plain-English summary of how much good human research exists, not a promise of results. How we rate evidence.

Dosage and timing

• Doses in trials are usually around 25 to 50 mg a day, but needs are individual and should be guided by blood tests (DHEA-S), a clinician and a medical reason.
• Women generally need lower doses than men because of androgenic effects.
• Do not self-treat on the basis of age alone; lower levels are a normal finding in older adults.
• Where it is a prescription medicine, only use what is prescribed to you.

Forms and what to look for

• Oral capsules and tablets are the common unlicensed form.
• Vaginal prasterone is a licensed prescription product in the UK and EU for menopausal vaginal symptoms.
• Micronised forms are marketed for absorption; be wary of brand claims.
• 7-keto DHEA is a related compound sold as a "non-hormonal" version, but it is not the same and has little evidence.

What to expect, and when

• Blood levels rise within days of dosing.
• Subjective effects, if any, take weeks to months.
• Many people feel nothing; others notice acne, mood swings or hair changes first.

Side effects

• Acne, oily skin, hair loss or unwanted hair growth, particularly in women.
• Voice deepening and menstrual irregularity in women at higher doses.
• Mood changes, irritability, sleep disturbance or palpitations.
• In men, breast tenderness and suppression of natural testosterone production.

Interactions

• Hormone therapies (oestrogen, testosterone, contraceptives, anti-oestrogens): can add to or interfere with their effects.
• Antipsychotics, antidepressants and lithium: possible mood effects; check with a prescriber.
• Blood thinners such as warfarin, where hormone changes could alter control.
• Other steroid hormones or prohormones: effects stack and are unpredictable.

Who should avoid it

• Anyone with a hormone-sensitive cancer (breast, prostate, ovarian, uterine) or a history of one: DHEA can be converted into hormones that may fuel such cancers.
• Pregnant or breastfeeding women.
• People with liver disease, PCOS, or conditions affected by androgens or oestrogens.
• Competitive athletes under anti-doping rules.

Risks and safety

• DHEA is prohibited by WADA at all times, in and out of competition, as an anabolic agent, and many sports bodies test for it.
• Legal status differs by country: over the counter in the US, restricted or prescription-only elsewhere, and complicated in the UK. Importing or buying online can be unlawful or risky; check current MHRA and local rules.
• Products sold online as DHEA may contain a different dose or other hormones.
• Long-term use risks are not well characterised, including effects on the heart and on cancers.

Buying well: quality and testing

• Only consider pharmacy-supplied or prescription products if a clinician has advised use.
• Avoid unverified online sellers; tests of hormone supplements sometimes find wrong doses.
• Third-party testing (such as Informed Sport) does not make it permitted in sport; DHEA is banned regardless.
• Be wary of "anti-ageing" or "hormone restoring" marketing.

Bottom line

DHEA is a hormone, and treating it like a vitamin is the main mistake. It has a few real medical uses, but for healthy people the benefits are weak and the downsides unpredictable. If you are thinking about it, ask a doctor to check your hormone levels first, especially if you have any hormone-sensitive condition, and do not use it if you are subject to drug testing in sport.