High and Low DHEA Levels in Women (All You Need to Know)
DHEA is one of dozens of hormones in your body.
We have a few general ideas about how high levels of DHEA are correlated with certain diseases or disorders, and we also have some ideas about how low DHEA levels may contribute to a variety of symptoms.
However, DHEA is something of a mystery — science still fails to grasp clearly what it does.
What We Know About DHEA in Women
There are a handful of things we do know about this poorly understood hormone:
- DHEA is the most common hormone in the body
- DHEA is produced in the ovaries and the adrenal gland in females
- DHEA ranges between 13–380 ug/dL for women between the ages of 20–69
- DHEA is involved in sexual function for females, and supplementation of DHEA may help improve sexual function
- Low DHEA is associated with panic attacks
- High DHEA levels are associated with PTSD in women
- DHEA may help with both obesity and insulin resistance
Because DHEA seems to be involved in these bodily functions, and, because a few studies show that DHEA supplementation may help alleviate certain symptoms in women (see symptoms of low DHEA below), it’s reasonable to assume that having either low or high DHEA levels could cause some symptoms.
On the other hand, some studies indicate DHEA supplementation doesn’t necessarily do much.
That means we’re still uncertain whether DHEA alone could be the source of the problem — other hormones may be causing your symptoms.
Low or High DHEA: Possible Symptoms
The following symptoms that are possibly linked to low DHEA:
- Depression
- Sexual dysfunction (including erectile dysfunction in men and low libido in women)
- Heart disease
- Obesity
- Low bone density
Many of these same symptoms occur from low testosterone or low estrogen — one reason the issue of low DHEA is so clouded.
Many of the symptoms of high levels of DHEA look very similar to high levels of testosterone in females, or even high levels of estrogen.
Here are some of the symptoms of high DHEA levels:
- Hirsutism (excess hair growth and male hair growth patterns)
- Hair loss
- Aggressive behavior
- Irritability
- Trouble sleeping
- Acne and/or oily skin
High DHEA levels can be a very serious indicator of deeper problems:
- High DHEA levels in females are often associated with PCOS
- High levels of DHEA are also associated with a higher risk for breast cancer (here’s a second article on DHEA and breast cancer)
- High DHEA levels in females also may indicate an adrenal gland tumor or overactive adrenal glands
- High DHEA levels in females also seem to be associated with Cushing’s syndrome
The question of whether DHEA levels are causing your symptoms is complicated because DHEA is a precursor hormone (or prohormone).
That means DHEA generally doesn’t stay as DHEA in your body, but rather transforms into other hormones — testosterone and estrogen.
In actuality, DHEA may be converting into imbalanced amounts of one of these sex hormones — too much or too little estrogen or testosterone could result in imbalances and symptoms.
In other words, the actual source of the problem likely is not too much or too little of the root hormone DHEA.
Increasing DHEA — Probably Not the Answer
Since testosterone and estrogen come from DHEA, it would seem logical on the surface that increasing DHEA might help restore hormone levels to those suffering from the symptoms of either low estrogen or low testosterone.
However, that solution is overly simplistic because of the way your body processes hormones.
Since DHEA can transform into both testosterone and estrogen, there’s no way to know or control what hormones your body will produce from it.
Therefore, adding DHEA into your body with unpredictable results could worsen the imbalance you currently have or throw your other hormones off balance, creating additional problems — we just don’t have enough conclusive information to know what this hormone does and does not do.
Many people seem to focus on these lesser-known hormones like DHEA, leaving the major sex hormones to take a backseat.
Instead, testosterone and estrogen should both be considered first.
Treating Hormone Imbalances (Including Low DHEA) by Restoring Balance
There’s really no need to rely on DHEA to treat your symptoms.
Testosterone or estrogen can be supplemented directly, producing better and faster relief from the symptoms that you’re feeling.
In some cases, this can be done by treating a medical cause of the hormone imbalance.
In other cases, there is no cure, and hormones need to be introduced from outside the body through Hormone Replacement Therapy (HRT) to bring hormone levels back to normal.
Generally, it’s not a single hormone that’s problematic — DHEA is no exception to this pattern.
If any of your hormone levels are too high or too low in relation to the others, you will likely experience symptoms.
The goal of any hormone replacement therapy should be to restore balance among all your hormones.
That’s why we want to look carefully at what your body is doing.
It’s important to determine as definitively as possible whether you’re experiencing low or high DHEA symptoms, or if your symptoms are caused by another hormone being out of balance.
Then, we can make suggestions for treatment based off of those initial tests.
Finally, we want to see how your body reacts, to monitor any changes in your health, and then to decide if more of one hormone or less of another is the direction to move.
A Word of Caution About Over-the-Counter DHEA Supplements
There are a lot of DHEA supplements out there being sold over the counter.
Supplements designed to increase your hormone levels, including DHEA, generally don’t work.
In fact, such supplements can actually be very bad for you, so even if you think that your DHEA levels are low, taking a DHEA supplement is probably not the best idea.
So start by looking at testosterone and estrogen levels. Have a complete test done of all your hormones, and let your medical provider determine what the appropriate treatment should be.
Finding the Source of Your Hormone Imbalance
DHEA is an interesting but poorly understood hormone, which is why information on the symptoms of high DHEA levels in females (or the effects of adding DHEA to, or subtracting DHEA from, your body) is hard to find.
The most important step is finding out conclusively what the source of your trouble is before beginning HRT of any kind.
Testosterone Centers of Texas (TCT) offers a free consult to help you understand the root causes of your symptoms and develop a treatment plan.
We strive for significant improvement of your quality of life through relief of your symptoms and careful maintenance of safety and overall health, all while making treatment as convenient as possible. Our commitment is to improve your level of health across the board.
Click to schedule your free initial consultation today.
Can someone from Europe have a free consultation online, discussing bloodresults of high dhea, high testosterine and high androgens in woman?
Thank you for your time.
Nathalie,
If discussing patient specific labs with one of our providers, you would need to schedule a telemedicine visit. There would be a charge for that, but you can contact us via email to arrange an appointment.
Best regards,
Augie Galindo, MPAS, PA-C
Testosterone Centers of Texas | Founding Partner
Menopause almost killed me. I had testing and had sky high dheas but undetectable levels of Testosterone and progesterone and very low estrogen…after going on bhrt including Testosterone AND natural dessicated thyroid i now feel better at age 60 than i have in 30 years! I no longer need Testosterone replacement. I lift heavy weights and lost 106 lbs over the last 2 years (maintaining 155 lbs and wear size 6 thanks to my musculature) my Testosterone levels are higher than my husband who is age 37 ! I also reversed diabetes. I ride my bike 3 or 4x a week 2 to 4 hours on trails. Hormones saved my life. So why does my GP want me off them when i look 20 years younger and feel great? I get my hormones from a hormone specialist. But my GP says i have to stop as im 60 and have been on them more than the recommended 5 years…id rather die than stop my regime…i take estradot patch .75 2x a week and 200 mgs prometrium nightly. and 180 mgs erfa thyroid every morning.
Its wonderful.
Anita,
That is great to hear, thank you for commenting! I am sorry that you are receiving dissenting opinions, but it is very common among mainstream medicine. Realizing that estrogen, progesterone, testosterone, and thyroid hormones have a huge impact, beyond the perimenopausal window, is ignored by many. The 5 year recommendation is short-sighted in my opinion, but certainly, opinions vary. I never advocate “doctor shopping” for the mere sake of finding someone who is agreeable to anything and everything; but being on the same page as your PCP, or at least being able to work through minor differences of opinion is important. It looks like you have assessed the risk for yourself, and have deemed the benefits of therapy to outweigh the concerns. Best of luck for continued success!
Best regards,
Augie Galindo MPAS, PA-C
Testosterone Centers of Texas | Managing Partner
Hi, You are an inspiration! I am 43 and will be menopausal very soon. My DHEA is very high too. I am going to go on bhrt. Were you able to lower your dhea? Should I worry about that? Thank you! Sommer
Very simple and well written article
Thank you
My DHEA and Testosterone level was extremely low and I read about DHEA and Ashwagandha Root combination so I purchased supplements and after carefully studying the effect of these supplements I started taking DHEA and Ashwagandha Root . Within a Month and a half I was retested for low Testosterone and DHEA levels and my DHEA level has increased quite a bit and my Testosterone level went up from 14 to 55 . These supplements certainly worked for me and my OBGYN saw it too when the second test was performed . I try to keep these levels the way they are now by staying on moderate amount of DHEA and Testosterone . I feel better and more energetic , not as tired as I did before taking the supplements . I am a 55 yr old female , not in peri menopause nor in menopause at all , get my period still every month and am quite active .
I think especially women with symptoms of low DHEA and low Testosterone should consult with their PC or OBGYN or Endo about introducing these supplements .
Hi Anya,
How was your estrogen level before and after your supplementation? And have your levels been tested since July?
DHEA IS 795 Can you please help me with where to start? I am looking for a 2nd opinion . I have been working on my PCOS and have lost 20pd in the last 3 months. Discovered the issue while trying to get pregnant. Please help THANKS
Destenie Burgess
Destinie,
I would strongly recommend seeking direct help with experience in hormonal treatment in conjunction with DHEA. Your calculated free testosterone may often not be nearly as high as your total testosterone levels may suggest. Some studies show the valuable role testosterone levels play in the maintenance of ovarian follicle/egg health. Metformin is a staple of treatment, but you are likely to have progesterone deficiency and other hormonal issues.
Best regards,
Augie Galindo MPAS, PA-C
Testosterone Centers of Texas | Managing Partner
Hi I am a 58 yr old Australian women who’s test reveal I’m low in DHEA 2.5 should be up to 8.4 and Testosterone 0.5 (used to be on the higher end pre menopaus
I’m on a very low dose of oestrogen and progesterone they have helped a lot but not everything
Recently my doctor prescribed 0.02 testosterone cream but that doesn’t seem to have made any difference. Its such a low dose (is that effective at all )
No labido and tired sore muscles all the time generally not 100% myself
(I do train quite a bit) and I eat very well weight 68k 167 cm height BMI 20 -21
I will consult my doctor again but can I suggest DHEA supplements to him
Your Opinion Please
Hello Philippa!
Thank you for your inquiry! The problem with topical medication like testosterone creams is that up to 40% of people don’t absorb the medicine in that way. For those that do, absorption can be limited by sweating, bathing, loss by contact with clothing…
DHEA supplementation can help natural production when DHEA deficiency is the cause, but it won’t do a great deal in the setting of current testosterone therapy. I prefer testosterone to be replaced via injections rather than topical applications. You may want to explore that modality.
Best regards,
Augie Galindo MPAS, PA-C
Testosterone Centers of Texas
I have been in menopause hell since May 2020. I progressively became a different person. After seeing every doctor under the sun it was determined that I had very low/undetectable Testosterone, low estrogen, low progesterone and low DHEA. May 25, 2022 I started taking; 200mg progesterone 4mg testosterone, 20mg of DHEA, and 0.0375mg(patch) of Estradiol. It’s been 4 months and my levels are all still low except now I have high progesterone. I am so tired of feeling crappie; hair loss, acne, bad mood, and more. My testosterone is still so low. I’m hoping at 6 months I will feel better. I need a second opinion and help. I’ve done recent blood work and urine test.
Hello Arrieanna,
Thank you for reaching out! I am sorry that you haven’t seen the improvement you were hoping for. Managing female hormones, especially during the perimenopausal period, can be tricky. That doesn’t mean, however, that you can attain relief!
Using DHEA when testosterone is being supplemented doesn’t impact anything unless the sole reason for your testosterone deficiency is DHEA deficiency, and this is rarely the case. Next, oral testosterone is very hard on the liver and not a modality of delivery I trust. That said, my usual plan of attack is testosterone by injection (pellets are an option if done right), oral progesterone, and topical estrogen. Moreover, the use of bioidentical estradiol and/or estriol (not conjugated equine estrogens) and bioidentical progesterone (not progestins, or generic “micronized” progesterone) matters…a lot.
After the modalities are selected appropriately, the titration of dosing is the next step. I review labs and symptomatic response five weeks after every dose adjustment and every ninety days only after we have correctly balanced everything. I hope that insight helps!
Best regards,
Augie Galindo MPAS, PA-C
Testosterone Centers of Texas | Managing Partner
Thanks so much for your quick response. I am taking all bioidentical hormones with the exception of the DHEA. I wish I lived in Texas. Do you have any referrals for services in California.
Hi Arrienna!
I just received and responded to your email!
Best regards,
Augie Galindo MPAS, PA-C
Testosterone Centers of Texas | Managing Partner
Hi, I have been battling high androgens, DHEAS since going into puberty. I’m 45 now and have been suffering from hair loss, hirsutism, acne and oily skin my whole life. Now, my main issue is hair loss (alopecia androgenic) due to the high DHEAS. I also have Hashimotos but my thyroid hormone are normal. I do not meet the criteria for PCOS, and tested negative (genetic test) for CAH. Why is my DHEAS high and how to lower it?
Hello Angelika,
I am sorry to hear about your struggles. Many things can cause DHEA elevations. If CAH has already been ruled out, some still serious conditions associated with high DHEA/DHEA-S levels are PCOS (which could still be present despite not meeting the criteria), hyperprolactinemia, PTSD, or even adrenal tumors. Stress conditions that don’t rise to the level of PTSD but are still severe enough to cause a chronic stress response can also be a frequent culprit.
“Adrenal Fatigue: The 21st-Century Stress Syndrome” by James L. Wilson is one of my favorite books on adrenal fatigue, and it may shed some light on how stress could be affecting your DHEA levels. Additionally, you will feel best when your thyroid function is optimized if you have a thyroid disorder. This can look quite different than just having “normal labs.” Many behavior modifications, like weight loss, reduction of meat consumption, use of vitamin E supplements, and oral contraceptives, have been shown to lower DHEA/S levels, but reducing stress and cortisol is vitally crucial to balancing DHEA’s influence.
Best regards,
Augie Galindo MPAS, PA-C
Testosterone Centers of Texas | Managing Partner
Dear Dr. Galindo,
Are there any practitioners like yourself in or near the Philadelphia Pa. region? Thank you in advance!
-Melissa
Hello Melissa,
Unfortunately, I don’t have any contacts in PA. You may want to start with searching for wellness groups and seeing which ones have providers that are willing to conduct a free question and answer session. If a provider is not willing to field some questions in a brief conversation without obligating you to an appointment and payment, they are probably not worth your time or money.
Best regards,
Augie Galindo MPAS, PA-C
Testosterone Centers of Texas | Managing Partner
Hello Augie,
I’m 55yo. My last period was in Oct of 2021. I had no energy, brain fog, anxiety, joints stiff, boobs swollen, bloating, water retention, unable to sleep at night due to hot flashes & inability to fall back to sleep after waking up in Feb 2022. I started on Prometrium 200mg in Feb 2022 from a functional medicine NP & felt 75% better. The sleep still wasn’t that good. I couldn’t afford paying out of pocket for the NP. So I switched to a GYN who takes my insurance. She started me on estradiol .025 in March of 2022 & my sleep has been SO MUCH better. BUT I’m gaining weight while I sleep! I put 5 lbs on since I started estradiol & 10lbs since last year! I’ve NEVER weighted this much in my entire life! I’m at the gym 3x/wk & go for acupuncture. I’m eating less food that ever. I had to BEG my new gyn doctor to do blood work! The results are: Progesterone – 4.79, Estradiol – 364, TSH – 2, Total T3 – 89, Free T4 – 0.9, Testosterone – 9, DHEA – 0.6ng/ml. What do you think of my blood work? What is a normal DHEA level, progesterone level? What is causing my weight gain? Looking forward to hearing from you. Thank you so much, Dawn
Hello Dawn,
I am sorry to hear that your symptoms are not under control. Unfortunately, what you are going through is all too common. Snapshot labs vs. lab trending can make for shaky assumptions, but overall, your estradiol levels are much higher than they need to be. Your progesterone would probably be best a little higher, but the balance matters most. Remember, Prometrium is not progesterone. It is a progestin. I much prefer compounded, bioidentical medications for estradiol and progesterone supplementation. The number that matters most for your thyroid panel is your Free T3, but it’s not surprising that they did not run it. If your total testosterone level is 9 ng/dL, your calculated free testosterone, the number that matters, is likely severely deficient.
Fixing your DHEA levels won’t have much of an impact here. In perimenopause, your ovaries are failing to produce hormones at adequate rates, so flooding it with precursor hormones is like stocking up on raw materials in inventory for a factory that is in the process of closing its doors.
Best regards,
Augie Galindo MPAS, PA-C
Testosterone Centers of Texas | Managing Partner