DHEA
Dehydroepiandrosterone
TL;DR
DHEA is an adrenal hormone the body turns into testosterone and estrogen. Supplements reliably raise hormone levels, but trials show little benefit: a small, uncertain lift in well-being in adrenal insufficiency and none for IVF success.
Ideal For
- Women with adrenal insufficiency whose low libido, mood or energy persists despite optimised steroid replacement, under specialist care
Avoid If
- You are pregnant or breastfeeding
- You have or have had breast, ovarian, prostate or another hormone-sensitive cancer
- You compete in tested sport: DHEA is banned at all times
- You are hoping it will improve IVF success: large trials found no benefit
- It is for a child or teenager
- You take hormone therapy, unless your prescriber agrees
Frequently Asked Questions
What is DHEA and what does it do?
Does DHEA increase testosterone?
Does DHEA help fertility or IVF?
What are the side effects of DHEA?
Is DHEA legal, and is it banned in sport?
Can DHEA help menopause symptoms or low libido?
Overview
DHEA (dehydroepiandrosterone, also called prasterone) is a steroid hormone made mainly by the adrenal glands. The body uses it to make testosterone and estrogen, and levels peak in early adulthood and then fall with age. In the US it is sold over the counter as a dietary supplement, but almost every other country treats it as a controlled anabolic steroid, and it is banned in sport at all times.
DHEA does change hormone levels. Across 42 trial publications it raised testosterone by about 28 ng/dL on average, more in women and at doses above 50 mg a day, and in women it raised estradiol by about 7 pg/mL. Whether that brings benefits is another matter: in a 2-year double-blind trial in 144 older men and women with low DHEA levels, it did not meaningfully improve body composition, physical performance, insulin sensitivity or quality of life.
The best-studied medical use is adrenal insufficiency, where the adrenal glands make almost no DHEA. A meta-analysis of 10 trials in women found a small, perhaps trivial, improvement in quality of life and depression, and the Endocrine Society suggests a 6-month trial only for women whose low libido, mood or energy persists despite optimised steroid replacement. For IVF, a 2024 Cochrane review of 28 trials found DHEA likely makes little to no difference to live birth. Evidence for depression is very low quality, and in postmenopausal women DHEA did not significantly improve libido or sexual function.
Side effects are mostly androgenic (male-hormone) effects such as acne, sweat odour, scalp itching and unwanted hair growth, and DHEA may lower HDL cholesterol in women. Because it is converted into sex hormones, it is not for pregnancy, hormone-sensitive cancers or tested athletes. The pages below set out the evidence for DHEA in Addison's disease and for female infertility.
How It Works
- DHEA is a precursor hormone: tissues convert it into testosterone and estrogen, which is how a supplement changes sex hormone levels.
- Across 42 trial publications, DHEA raised testosterone by about 28 ng/dL on average, more in women and at doses above 50 mg a day.
- In women, DHEA raised estradiol by about 7 pg/mL on average across 21 trial arms, with larger rises in postmenopausal women and women aged 60 or over.
- In women with adrenal insufficiency, 50 mg a day restored DHEA, DHEAS, androstenedione and testosterone to the normal range.
- DHEA may lower HDL cholesterol in women, by about 5 mg/dL in a meta-analysis, without changing LDL, total cholesterol or triglycerides.
Quick Facts
- Adrenal hormone converted to testosterone and estrogen
- Raises testosterone about 28 ng/dL on average
- No live-birth benefit in IVF trials
- Small well-being gain in adrenal insufficiency
- Banned in sport at all times
- Controlled steroid outside the US
Benefits & Outcomes
No linked outcomes yet. Research is ongoing.
Health Concerns Addressed
Depression
Promising but weak: a small pooled benefit from small, short, older trials, rated very low quality.
Addison's Disease
A small, inconsistent benefit for well-being in women; worth a supervised 6-month trial only if symptoms persist.
Lupus (SLE)
Several trials, mostly null on disease activity, with modest well-being and flare signals in active disease; not approved and not in lupus guidelines.
Vaginal Dryness
Vaginal prasterone modestly eases menopausal dryness; oral DHEA supplements are not shown to help.
Erectile Dysfunction
Positive small trials from one group, a null independent trial and a null meta-analysis in older men; not a reliable treatment for ED.
Female Infertility
DHEA does not improve the chance of a live birth with IVF, even in poor responders.
Decreased Sex Drive
Placebo-controlled trials and meta-analyses find no reliable benefit of oral DHEA for low libido in women or men.
Menopause
Insufficient: oral DHEA has not been shown to relieve menopausal symptoms, while prescription vaginal DHEA modestly helps dryness and painful sex.
Supporting Research69 studies
A double-blind, placebo-controlled, clinical trial of dehydroepiandrosterone in severe systemic lupus erythematosus
van Vollenhoven RF, Park JL, Genovese MC +2 more
DHEA therapy, when added to conventional treatment for severe SLE, may at most have a small added benefit
Effects of dehydroepiandrosterone supplement on health-related quality of life in glucocorticoid treated female patients with systemic lupus erythematosus
Nordmark G, Bengtsson C, Larsson A +3 more
DHEA was given at 30 mg/20 mg ( <or= 45/ >or= 46 years) daily
Dehydroepiandrosterone in systemic lupus erythematosus. Results of a double-blind, placebo-controlled, randomized clinical trial
van Vollenhoven RF, Engleman EG, McGuire JL
28 female patients with mild to moderate SLE were given DHEA 200 mg/day
Dehydroepiandrosterone replacement in women with adrenal insufficiency
Arlt W, Callies F, van Vlijmen JC +4 more
50 mg of dehydroepiandrosterone orally each morning for four months
Placebo-controlled trial of dehydroepiandrosterone (DHEA) for treatment of nonmajor depression in patients with HIV/AIDS
Rabkin JG, McElhiney MC, Rabkin R +2 more
the response rate was 56% (43 of 77) for the DHEA group versus 31% (21 of 68)
A randomized trial of oral DHEA treatment for sexual function, well-being, and menopausal symptoms in postmenopausal women with low libido
Panjari M, Bell RJ, Jane F +4 more
resulted in no significant improvements in sexual function over PL therapy over 26 weeks
Dehydroepiandrosterone for women in the peri- or postmenopausal phase
Scheffers CS, Armstrong S, Cantineau AE +2 more
DHEA may slightly improve sexual function compared with placebo
Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction
Naik S, Lepine S, Nagels HE +3 more
DHEA likely results in little to no difference in live birth/ongoing pregnancy rates
Effects of prasterone on bone mineral density in women with active systemic lupus erythematosus receiving chronic glucocorticoid therapy
Sánchez-Guerrero J, Fragoso-Loyo HE, Neuwelt CM +4 more
may offer mild protection against bone loss in women with SLE receiving glucocorticoids
Effects of prasterone on bone mineral density in women with systemic lupus erythematosus receiving chronic glucocorticoid therapy
Mease PJ, Ginzler EM, Gluck OS +4 more
Prasterone treatment prevented BMD loss and significantly increased BMD
Effect of dehydroepiandrosterone administration before in vitro fertilization on the live birth rate in poor ovarian responders according to the Bologna criteria: A randomised controlled trial
Wang Z, Yang A, Bao H +4 more
DHEA administration prior to IVF-ET had no beneficial effect on the live birth rate
The effect of dehydroepiandrosterone on lumbar spine bone mineral density in patients with quiescent systemic lupus erythematosus
Hartkamp A, Geenen R, Godaert GL +3 more
In premenopausal women with quiescent SLE, use of DHEA does not have a significant effect on BMD
Dehydroepiandrosterone suppresses interleukin 10 synthesis in women with systemic lupus erythematosus
Chang DM, Chu SJ, Chen HC +2 more
IL10 demonstrated a greater and significant reduction from baseline
Effects of prasterone on disease activity and symptoms in women with active systemic lupus erythematosus
Petri MA, Mease PJ, Merrill JT +4 more
administration of prasterone at a dosage of 200 mg/day improved or stabilized signs and symptoms
Dehydroepiandrosterone treatment of women with mild-to-moderate systemic lupus erythematosus: a multicenter randomized, double-blind, placebo-controlled trial
Chang DM, Lan JL, Lin HY +1 more
Mean reductions in SLAM scores from baseline were similar and were not statistically significantly different
A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency
Alkatib AA, Cosma M, Elamin MB +4 more
DHEA may improve, in a small and perhaps trivial manner, HRQOL and depression
Long-term DHEA replacement in primary adrenal insufficiency: a randomized, controlled trial
Gurnell EM, Hunt PJ, Curran SE +4 more
50 mg daily of micronized DHEA or placebo orally for 12 months
Effects of prasterone (dehydroepiandrosterone) on markers of cardiovascular risk and bone turnover in premenopausal women with systemic lupus erythematosus: a pilot study
Marder W, Somers EC, Kaplan MJ +3 more
HDL) levels significantly decreased with Prasterone
Effects of prasterone on corticosteroid requirements of women with systemic lupus erythematosus: a double-blind, randomized, placebo-controlled trial
Petri MA, Lahita RG, Van Vollenhoven RF +4 more
Response rates were 41% in the placebo group, 44% in the 100-mg prasterone group, and 55% in the 200-mg group
Hormonal Treatments and Vaginal Moisturizers for Genitourinary Syndrome of Menopause : A Systematic Review
Danan ER, Sowerby C, Ullman KE +4 more
systemic DHEA, vaginal oxytocin, and oral raloxifene or bazedoxifene may provide no benefit
Efficacy of Dehydroepiandrosterone (DHEA) to overcome the effect of ovarian ageing (DITTO): A proof of principle double blinded randomized placebo controlled trial
Narkwichean A, Maalouf W, Baumgarten M +4 more
DHEA 75mg/day or placebo for at-least 12 weeks
Clinical review: The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis
Elraiyah T, Sonbol MB, Wang Z +4 more
DHEA use was not associated with significant improvement in libido or sexual function
A dose-response and meta-analysis of dehydroepiandrosterone (DHEA) supplementation on testosterone levels: perinatal prediction of randomized clinical trials
Li Y, Ren J, Li N +4 more
testosterone level was significantly increased after DHEA administration
DHEA in elderly women and DHEA or testosterone in elderly men
Nair KS, Rizza RA, O'Brien P +3 more
Neither treatment improved the quality of life or had major adverse effects
Replacement of dehydroepiandrosterone in adrenal failure: no benefit for subjective health status and sexuality in a 9-month, randomized, parallel group clinical trial
Løvås K, Gebre-Medhin G, Trovik TS +4 more
Eighty-nine percent of the patients receiving DHEA experienced side-effects
Efficacy of dehydroepiandrosterone priming in women with poor ovarian response undergoing IVF/ICSI: a meta-analysis
DHEA treatment didn't significantly improve the live birth rate
Improvement in mood and fatigue after dehydroepiandrosterone replacement in Addison's disease in a randomized, double blind trial
Hunt PJ, Gurnell EM, Huppert FA +4 more
39 patients with Addison's disease received either 50 mg oral DHEA daily for 12 weeks
Androgens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs. dehydroepiandrosterone in men with sexual dysfunction and androgen deficiency
Morales A, Black A, Emerson L +3 more
did not suggest a clinical benefit of OTU or DHEA supplementation
Dehydroepiandrosterone supplementation in elderly men: a meta-analysis study of placebo-controlled trials
Corona G, Rastrelli G, Giagulli VA +4 more
no effect of DHEA supplementation in comparison with placebo was observed
Dehydroepiandrosterone (DHEA) for Depression: A Systematic Review and Meta-Analysis
Peixoto C, Grande AJ, Mallmann MB +3 more
pointed to a significant effect in favor of treatment with DHEA compared to placebo
Double-blind treatment of major depression with dehydroepiandrosterone
Wolkowitz OM, Reus VI, Keebler A +4 more
Five of the 11 patients treated with DHEA, compared with none of the 11 given placebo
Dehydroepiandrosterone treatment of midlife dysthymia
Bloch M, Schmidt PJ, Danaceau MA +2 more
Sixty percent of the patients responded to dehydroepiandrosterone
Effects of dehydroepiandrosterone supplementation on cognitive function and quality of life: the DHEA and Well-Ness (DAWN) Trial
Kritz-Silverstein D, von Mühlen D, Laughlin GA +1 more
DHEA supplementation has no benefit on cognitive performance or well-being in healthy older adults
Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause
Labrie F, Archer DF, Koltun W +4 more
pain at sexual activity decreased by 1.42 severity score unit from baseline
Intravaginal dehydroepiandrosterone for the treatment of vulvovaginal atrophy: a systematic review and meta-analysis
Lemos MJ, Queiroz LF, Diniz AF +4 more
Intravaginal DHEA significantly improves vulvovaginal symptoms
Dehydroepiandrosterone in the treatment of erectile dysfunction in patients with different organic etiologies
Reiter WJ, Schatzl G, Märk I +3 more
treated with 50 mg DHEA p.o. for 6 months
Intravaginal dehydroepiandrosterone (Prasterone), a physiological and highly efficient treatment of vaginal atrophy
Labrie F, Archer D, Bouchard C +4 more
induced a highly significant beneficial change
Combined data of intravaginal prasterone against vulvovaginal atrophy of menopause
Labrie F, Archer DF, Martel C +2 more
severity score of MS vaginal dryness decreased by 0.31 unit
Evaluating the efficacy of vaginal dehydroepiandosterone for vaginal symptoms in postmenopausal cancer survivors: NCCTG N10C1 (Alliance)
Barton DL, Sloan JA, Shuster LT +4 more
Neither DHEA dose was statistically significantly different from PM at 12 weeks
Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study
Wiser A, Gonen O, Ghetler Y +3 more
75 mg of DHEA once a day before starting the next IVF cycle
Decreased efficacy of twice-weekly intravaginal dehydroepiandrosterone on vulvovaginal atrophy
Bouchard C, Labrie F, Archer DF +4 more
twice-weekly dosing is a suboptimal treatment
Systemic and local effects of vaginal dehydroepiandrosterone (DHEA): NCCTG N10C1 (Alliance)
Barton DL, Shuster LT, Dockter T +4 more
Circulating DHEA-S and testosterone levels were significantly increased
The Role of Dehydroepiandrosterone in Improving in vitro Fertilization Outcome in Patients with DOR/POR: A Systematic Review and Meta-Analysis
Wang J, Liu B, Wen J +1 more
there was no difference in live birth rate
Effects of dehydroepiandrosterone on fatigue and well-being in women with quiescent systemic lupus erythematosus: a randomised controlled trial
Hartkamp A, et al
The trial does not indicate an effect of daily 200 mg oral DHEA on fatigue
Dehydroepiandrosterone for systemic lupus erythematosus
Crosbie D, Black C, McIntyre L +2 more
a modest but clinically significant impact on health related quality of life
The use of dehydroepiandrosterone in the treatment of hypoactive sexual desire disorder: a report of gender differences
Bloch M, Meiboom H, Zaig I +2 more
no efficacy was demonstrated in men, indicating a possible gender difference
Effects of dehydroepiandrosterone (DHEA) supplementation on the lipid profile: A systematic review and dose-response meta-analysis of randomized controlled trials
Qin Y, O Santos H, Khani V +2 more
it may decrease HDL-C levels
The effect of dehydroepiandrosterone (DHEA) supplementation on estradiol levels in women: A dose-response and meta-analysis of randomized clinical trials
Zhu Y, Qiu L, Jiang F +4 more
estradiol significantly increased following the administration of DHEA
Effect of intravaginal dehydroepiandrosterone (Prasterone) on libido and sexual dysfunction in postmenopausal women
Labrie F, Archer D, Bouchard C +4 more
beneficial effects on all four aspects of sexual dysfunction
Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression
Schmidt PJ, Daly RC, Bloch M +4 more
90 mg/d for 3 weeks and 450 mg/d for 3 weeks
Dehydroepiandrosterone for depressive symptoms: A systematic review and meta-analysis of randomized controlled trials
Peixoto C, José Grande A, Gomes Carrilho C +3 more
DHEA was associated with a beneficial effect on depressive symptoms compared to placebo
Does dehydroepiandrosterone supplementation really affect IVF-ICSI outcome in women with poor ovarian reserve?
Kara M, Aydin T, Aran T +2 more
DHEA 75 mg daily for 12 weeks
A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA supplementation of bone mineral density in healthy adults
DHEA replacement therapy can partially increase BMD of hip and trochanter in women
The safety of 52 weeks of oral DHEA therapy for postmenopausal women
Panjari M, Bell RJ, Jane F +3 more
did not significantly alter lipid profile, insulin sensitivity
Therapeutic management in women with a diminished ovarian reserve: a systematic review and meta-analysis of randomized controlled trials
dehydroepiandrosterone (WMD 0.60, 95% CI: 0.07-1.13; 4 studies, n = 418 patients)
Effect of dehydroepiandrosterone therapy on cognitive performance among postmenopausal women: a systematic review of randomized clinical trial data
Sultana F, Davis SR, Islam RM
does not support a beneficial effect of DHEA therapy on cognitive performance
Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study
Reiter WJ, et al.
oral DHEA treatment may be of benefit in the treatment of ED
Dehydroepiandrosterone supplementation and bone turnover in middle-aged to elderly men
DHEA) supplementation (90 mg orally/d)
Dehydroepiandrosterone augmentation in the management of negative, depressive, and anxiety symptoms in schizophrenia
Strous RD, Maayan R, Lapidus R +4 more
as well as in depressive (P<.05) and anxiety (P<.001) symptoms in individuals receiving DHEA
Lack of effect of intravaginal dehydroepiandrosterone (DHEA, prasterone) on the endometrium in postmenopausal women
Portman DJ, Labrie F, Archer DF +4 more
Endometrial atrophy or inactive endometrium (668 women) was found in all women treated
The Relationships of Dehydroepiandrosterone Sulfate, Erectile Function and General Psychological Health
Li K, Liang S, Shi Y +4 more
patients with ED had a significant lower serum levels of DHEAS
Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study
Feldman HA, Goldstein I, Hatzichristou DG +2 more
inversely correlated with serum dehydroepiandrosterone
TEAS, DHEA, CoQ10, and GH for poor ovarian response undergoing IVF-ET: a systematic review and network meta-analysis
Zhu F, Yin S, Yang B +4 more
DHEA (OR 1.92, 95% CI: 1.16 to 3.16)
The effect of 12-month dehydroepiandrosterone supplementation on the menstrual pattern, ovarian reserve markers, and safety profile in women with premature ovarian insufficiency
Wong QHY, Yeung TWY, Yung SSF +3 more
DHEA supplements (25 mg three times daily) for 12 months
Serum dehydroepiandrosterone sulfate concentrations in men with erectile dysfunction
Reiter WJ, Pycha A, Schatzl G +4 more
the mean serum level of DHEAS is lower in patients with ED than in healthy volunteers
Are dehydroepiandrosterone sulphate and lipids associated with erectile dysfunction?
Tomova A, Kumanov P
the decline in DHEAS is an age-related process rather than a causative factor of erectile dysfunction
Dehydroepiandrosterone for the treatment of hot flashes: a pilot study
Barton DL, Loprinzi C, Atherton PJ +4 more
The mean hot flash score decreased 50% from baseline
Six-month oral dehydroepiandrosterone supplementation in early and late postmenopause
Stomati M, Monteleone P, Casarosa E +4 more
progressive improvement of the Kupperman score in all groups
Safety of prasterone in breast cancer survivors treated with aromatase inhibitors: the VIBRA pilot study
Mension E, Alonso I, Cebrecos I +4 more
Mean serum estradiol remained low
Safety Information
Potential Side Effects
Mostly androgenic (male-hormone) effects. In a 9-month trial in women with adrenal failure, 89% of those taking 25 mg a day reported side effects, mainly increased sweat odour and scalp itching. In lupus trials, androgenic effects such as acne were about twice as common as with placebo. Some older women taking 50 mg a day reached above-normal hormone levels with mild androgenic effects. Unwanted facial hair, scalp hair loss, a deeper voice and rising blood pressure have also been described. In women, DHEA may lower HDL cholesterol.
Contraindications
Pregnancy and breastfeeding, where safety is unknown. Current or past hormone-sensitive cancer (breast, ovarian or prostate), because DHEA is converted into estrogen and testosterone. Competitive athletes, since DHEA is banned in sport at all times, including in supplements.
Drug Interactions
- Estrogen, testosterone or other hormone therapy: DHEA raises both hormones, so effects can add up; take it only if your prescriber agrees.
- Hydrocortisone and fludrocortisone for adrenal insufficiency: DHEA is an add-on, never a replacement; keep your steroid doses and sick-day rules unchanged.
- IVF stimulation medicines: tell your fertility clinic before taking DHEA; guidelines do not recommend it.
- Other prescription medicines: formal interaction studies are lacking; check with a pharmacist first.
Pregnancy & Breastfeeding
Pregnancy: Not enough evidence to judge
Breastfeeding: Not enough evidence to judge
Dosage Guidelines
Dosage Used in Studies
25-50 mg
Best Time to Take
Adrenal insufficiency trials gave DHEA once daily in the morning, and the Endocrine Society suggests measuring DHEAS in the morning before the daily dose.
Best Form
Oral DHEA is the only form with trial data for the uses on this page; the 12-month Addison's disease trial used micronized DHEA. Creams, gels and wild yam products are not equivalent.
Bioavailability
Oral DHEA is absorbed well enough to raise blood levels: 90 mg a day raised DHEA about 3-fold and DHEAS about 4.5-fold in men aged 56-80, and some older women taking 50 mg a day reached above-normal DHEAS levels.
Dosing by Goal
| Goal | Dose | Notes |
|---|---|---|
| Adrenal insufficiency (women, specialist care) | 25-50 mg once daily in the morning | Trials used 25 mg or 50 mg. The Endocrine Society suggests a 6-month trial, stopping if there is no sustained benefit, with morning DHEAS tests aiming for the mid-normal range. |
| IVF poor responders (as studied) | 75 mg daily for at least 12 weeks before stimulation | Large trials and a Cochrane review found no improvement in live birth, and ESHRE's 2019 guideline does not recommend it. |
| Midlife-onset depression (as studied) | 90 mg daily for 3 weeks, then 450 mg daily for 3 weeks | One crossover trial in 46 adults aged 45-65; doses far above usual supplement amounts. Not a substitute for depression treatment. |
| Healthy older adults | No recommended dose | A 2-year trial found no meaningful benefit for body composition, strength, insulin sensitivity or quality of life. |
Forms Compared
Oral DHEA capsules or tablets
Best for The form with trial data
The form used in nearly all trials, usually 25-50 mg a day; IVF trials used 75 mg a day.
Micronized DHEA
Best for Adrenal insufficiency (as studied)
Finely milled DHEA, used at 50 mg a day in the 12-month Addison's disease trial. No trial has compared it with standard DHEA.
Vaginal prasterone
Best for Menopausal vaginal symptoms, on prescription
A prescription vaginal insert used in the US for some menopause symptoms. It is a medicine, not a supplement.
Creams and gels
Best for Not covered by these trials
Sold as topical products, but the trials on this page tested oral DHEA, so their results don't transfer.
Wild yam or diosgenin
Best for Not a DHEA source
Advertised as a natural source of DHEA, but the body is not believed to convert diosgenin into DHEA, so it is unlikely to raise DHEA levels.
Food & Timing
The trials reviewed here did not report whether DHEA was taken with or without food.
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.