DHEA (dehydroepiandrosterone) is one of those supplements that sounds almost too good to be true. The pitch is straightforward: your body makes less of this hormone as you age, so topping up with supplements should help counteract age-related decline. The reality is quite a bit more complicated.

I’ve gone through the research on DHEA, and there are some genuine findings worth knowing about. But there are also significant safety concerns that make this supplement one to approach with caution. Here’s what the evidence actually shows.

What is DHEA?

DHEA and its sulphate form (DHEAS) are the most abundant steroid hormone precursors in the human body. Your adrenal glands produce most of it, though smaller amounts come from the ovaries, testes, brain, and skin.

What makes DHEA interesting is that it acts as a building block. In your tissues, DHEA converts into either androgens (male hormones like testosterone) or oestrogens (female hormones like oestradiol), depending on what receptors are present. This dual role is why DHEA research spans such a wide range of conditions.

According to the Mayo Clinic, DHEA levels peak around age 20, then decline by roughly 10% each decade. By age 70-80, you might only have 10-20% of your youthful levels. This decline has led researchers to investigate whether DHEA supplements might slow various aspects of ageing.

Beyond being a hormone precursor, DHEA also appears to interact directly with various receptors involved in blood vessel function, inflammation, insulin sensitivity, immunity, and brain function. Whether supplements can meaningfully influence these pathways is the central question.

Does DHEA affect cholesterol levels?

This is important to address upfront because cardiovascular effects matter for long-term safety.

A systematic review and meta-analysis of 27 randomised controlled trials examined DHEA supplementation at doses from 25 to 1600 mg daily over periods ranging from 4 weeks to 2 years. The findings were mixed Note 1.

The good news: DHEA did not change total cholesterol, LDL (“bad”) cholesterol, or triglyceride levels compared to placebo.

The concerning finding: DHEA significantly reduced HDL (“good”) cholesterol levels, particularly in women.

This matters because low HDL cholesterol is associated with increased cardiovascular risk. The researchers also noted that since DHEA is a precursor to both testosterone and oestrogen, and since hormone replacement therapy is linked to increased risk of blood clots, we need longer trials examining whether DHEA affects cardiovascular events like heart attacks and strokes.

My take: the HDL reduction is concerning enough that people with existing heart disease risk factors should discuss this with their doctor before taking DHEA.

What are the evidence-based benefits of DHEA?

1. Blood sugar regulation

Diabetes affects over 37 million Americans, with 90-95% having type 2 diabetes according to the CDC. Finding ways to improve blood sugar control without medication is understandably appealing.

A systematic review and meta-analysis of 12 randomised controlled trials looked at DHEA supplementation at doses from 50 to 400 mg daily, with treatment lasting 8 weeks to 12 months Note 2.

The results showed that DHEA significantly reduced fasting blood glucose levels. However, it did not change insulin levels or insulin resistance (measured by HOMA-IR index).

Subgroup analysis found the blood glucose reduction was most pronounced when:

Daily dose was 50 mg or less
Treatment lasted less than 12 weeks
Participants were aged 60 or older

What struck me is that the effect didn’t scale with dose. Lower doses actually worked better, which suggests the relationship between DHEA and blood sugar is more nuanced than simply “more hormone equals better results.”

The researchers cautioned that heterogeneity between studies was high, meaning we need more consistent evidence before drawing firm conclusions.

2. Depression symptoms

Depression is the leading cause of disability worldwide, according to the WHO. Anything that might help is worth investigating.

A systematic review and meta-analysis pooled data from 2 randomised controlled trials involving 68 people with depression Note 3. Participants took 30-450 mg of DHEA daily for 6 weeks.

Compared to placebo, DHEA was associated with improved depression scores on the Hamilton Depression Rating Scale.

I want to be clear about the limitations here: 68 participants across 2 studies is a very small evidence base. This finding is interesting but preliminary. If you’re struggling with depression, evidence-based treatments like therapy and established antidepressants have much stronger research support. For information on supplements studied for depression, see our article on SAM-e and depression.

3. Bone health in women

Osteoporosis affects around 10 million Americans, with another 44 million having low bone density. Since DHEA declines with age around the same time osteoporosis risk rises, researchers have wondered whether supplementation might help.

A pooled analysis of 4 double-blind randomised controlled trials included 585 participants over age 55 Note 4.

In women, oral DHEA increased levels of DHEAS, testosterone, oestradiol, and IGF-1 (insulin-like growth factor 1). More importantly, DHEA maintained total hip bone density compared to placebo.

In men, however, the bone density benefit was not observed.

This sex difference makes biological sense. Women experience more dramatic hormone declines at menopause, so they may have more to gain from hormone precursor supplementation. For more on bone health supplements, see our article on supplements for osteoporosis.

The NHS guidance on osteoporosis emphasises that calcium, vitamin D, weight-bearing exercise, and avoiding smoking remain the primary interventions. DHEA is not part of standard treatment recommendations.

4. IVF success rates

IVF accounts for 1-3% of births annually in the US and Europe. Any intervention that might improve success rates deserves attention.

A systematic review and meta-analysis of 6 randomised controlled trials examined DHEA supplementation in 745 women undergoing IVF Note 5.

DHEA supplementation significantly improved:

Clinical pregnancy rates
Live birth rates
Endometrial thickness
Number of eggs retrieved

However, DHEA did not significantly affect:

Embryo transfer success
Miscarriage rates
Oestradiol levels after hCG administration

This finding is genuinely promising for women with diminished ovarian reserve who are trying to conceive. However, sample sizes were small, and the researchers called for larger trials to confirm these results.

If you’re considering DHEA for fertility purposes, this is definitely a conversation to have with your fertility specialist rather than something to self-prescribe. For more on fertility-related supplements, see our article on male fertility supplements.

5. Sexual function

Sexual dysfunction affects both men and women but has historically been studied more in men. Female sexual dysfunction is more complex and includes issues with desire, arousal, painful intercourse, and difficulty reaching orgasm.

A systematic review of 38 studies examined DHEA’s effects on sexual function Note 6.

DHEA helped improve:

Sexual interest
Lubrication
Pain during intercourse
Arousal
Orgasm
Sexual frequency

The effects were strongest in people who already had sexual dysfunction, particularly perimenopausal and postmenopausal women. This connects to the hormonal changes of menopause that affect vaginal tissue and arousal. For related information, see our guide on atrophic vaginitis, a condition where vaginal tissue thins due to oestrogen decline.

For broader information on menopause supplements, see our article on health foods for women’s menopause.

6. Muscle strength and physical function

Adults lose 3-8% of muscle mass per decade after age 30. This decline accelerates later in life and is associated with falls, fractures, and loss of independence.

A systematic review of 8 studies involving 661 adults over age 50 examined whether DHEA could help Note 7.

Some studies found improvements in grip strength, chest press, leg press, and knee extension/flexion. However, results were inconsistent across studies.

The conclusion from this research: currently available evidence does not support using DHEA supplements specifically for improving muscle strength or physical function in older adults.

This one was disappointing. The biological rationale seemed sound, but the clinical evidence did not hold up. Sometimes that happens in supplement research.

Side effects of DHEA

DHEA is a hormone, not a vitamin or mineral. This distinction matters because hormones have powerful effects throughout the body.

According to the Mayo Clinic, short-term use at doses under 50 mg daily for up to 6 months is considered possibly safe when supervised by medical professionals.

Common side effects include:

Acne
Hair loss
Stomach upset
Dizziness
High blood pressure

Women may experience:

Menstrual irregularities
Abnormal facial or body hair growth
Deeper voice

Men may experience:

Breast tenderness or enlargement

These side effects occur because DHEA converts to sex hormones in your body. Taking too much essentially mimics having high testosterone or oestrogen, with the associated consequences.

Safety precautions (16 contraindications)

This is the section that matters most. DHEA is not appropriate for everyone, and the list of contraindications is longer than for most supplements.

Liver or kidney dysfunction: Do not use if you have impaired liver or kidney function. Safety has not been established in these populations.
Pregnancy and breastfeeding: Do not use. DHEA affects hormone levels, which could harm fetal development or pass into breast milk.
Addiction research note: Interestingly, some research has examined DHEA for helping regulate addictive behaviours through its effects on brain neurotransmitters Note 8. However, this remains experimental and requires larger studies.
Hormone-sensitive cancers: Do not use if you have or have a family history of breast, prostate, ovarian, adrenal, or testicular cancer. DHEA is a precursor to oestrogen and testosterone, which can fuel these cancers.
Endometriosis or polycystic ovary syndrome (PCOS): Use with caution. DHEA may worsen symptoms of these hormone-sensitive conditions.
Depression, bipolar disorder, or mood disorders: Use with caution. DHEA may cause excitability, impulsivity, irritability, or manic episodes.
Diabetes: DHEA may affect insulin function. Monitor blood sugar closely if taking DHEA. For related information on diabetes and bladder health, see our article on diabetic bladder dysfunction.
Women and masculinisation: Excessive DHEA may increase androgen production, leading to male-pattern hair loss, deeper voice, facial hair, and acne.
Men and hormonal effects: High DHEA intake may cause testicular shrinkage, male-pattern baldness, high blood pressure, or increase risk of testosterone-related cancers.
HDL cholesterol: May lower good cholesterol or increase triglycerides.
High doses or long-term use: Increases the chance of serious side effects. Stick to recommended doses and durations.
Professional sports: DHEA may increase testosterone levels and is banned by many sports organisations.
Breast cancer medications: Do not combine with selective oestrogen receptor modulators like tamoxifen, anastrozole, exemestane, fulvestrant, or letrozole. DHEA may reduce the effectiveness of these drugs.
CYP450 enzyme substrates: Do not combine with medications processed by liver CYP450 enzymes, as DHEA may increase drug side effects. These include lovastatin, ketoconazole, itraconazole, fexofenadine, and triazolam.
Corticosteroids: May interfere with DHEA supplement effectiveness. These include dexamethasone, hydrocortisone, methylprednisolone, and prednisone.
Other hormone supplements: Do not combine with oestrogen, testosterone, or progesterone supplements. May cause false-positive results on progesterone tests.

Dosage and administration

DHEA is available as oral tablets, sublingual sprays, and topical creams/gels. The doses studied in research vary widely:

Depression: 30-50 mg daily for 6-8 weeks
Diminished ovarian reserve (IVF): 50-75 mg daily in divided doses
Skin ageing: 50 mg daily for up to 1 year

The NHS does not recommend DHEA as a standard treatment for any condition. Always consult a healthcare provider before using DHEA, particularly if you have any of the contraindications listed above.

The bottom line

DHEA is a hormone precursor with some genuine research backing certain uses: blood sugar regulation, bone density in women, IVF outcomes, and sexual function in menopausal women all have at least preliminary evidence of benefit.

However, the safety profile gives me pause. The HDL cholesterol reduction, the long list of contraindications, and the hormone-related side effects mean this is not a supplement to take casually. Unlike vitamin C or fish oil, DHEA directly affects your hormonal system.

If you’re considering DHEA, the smart approach is to discuss it with your doctor, get baseline hormone and cholesterol levels checked, and use the lowest effective dose for the shortest duration that makes sense for your situation. Self-prescribing hormones rarely ends well.

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