Alternative names for dehydroepiandrosterone

DHEA; 3-beta-Hydroxy-5-androsten-17-one; synthetic versions – prastera, prasterone, fidelin and fluasterone

What is dehydroepiandrosterone?

Dehydroepiandrosterone is a precursor hormone, which means it has little biological effect on its own, but has powerful effects when converted into other hormones such as testosterone and oestradiol. Dehydroepiandrosterone is produced from cholesterol mainly by the outer layer of the adrenal glands, known as the adrenal cortex, although it is also made by the testes and ovaries in small amounts. It circulates in the blood, mainly attached to sulphur as dehydroepiandrosterone sulphate, which prevents the hormone being broken down. In women, dehydroepiandrosterone is an important source of oestrogens in the body – it provides about 75% of oestrogens before the menopause, and 100% of oestrogens in the body after menopause.

Dehydroepiandrosterone production increases from around nine or ten years of age, peaks during the 20s and gradually decreases into old age. Dehydroepiandrosterone is also produced in small amounts by the brain, although its precise role there is not clear.

How is dehydroepiandrosterone controlled?  

Dehydroepiandrosterone production is controlled by the brain in a negative feedback loop. This means that when dehydroepiandrosterone levels in the body fall, the system is 'switched on' and, as levels rise, it 'switches off' again.

The system is 'switched on' by corticotrophin-releasing hormone being produced by the hypothalamus. This travels to the anterior pituitary gland and causes it to release adrenocorticotropic hormone into the bloodstream. Both of these hormones cause the adrenal glands to produce dehydroepiandrosterone. When dehydroepiandrosterone levels rise, the body shuts off production by stopping corticotrophin-releasing hormone and adrenocorticotropic hormone.

What happens if I have too much dehydroepiandrosterone?

Women with polycystic ovary syndrome and hirsutism and children with congenital adrenal hyperplasia have higher levels of dehydroepiandrosterone/dehydroepiandrosterone sulphate. In addition, levels may be raised in individuals with cancer of the adrenal glands (adrenal carcinoma).

High levels of dehydroepiandrosterone have also been linked to reducing the risk of depression, cardiovascular disease and even death in some studies. Some experts have suggested dehydroepiandrosterone supplements might overcome age-related decline (a so-called 'elixir of youth') but this is not supported by current evidence.

Some athletes and bodybuilders also take dehydroepiandrosterone (an anabolic steroid) to increase muscle mass and strength. Serious side-effects from taking manufactured dehydroepiandrosterone have been reported and it is banned by the World Anti-Doping Agency. However, exercise and calorie-restriction have been shown to increase natural dehydroepiandrosterone levels in the body and may lead to longer life.

Since 2000, dehydroepiandrosterone supplementation in combination with gonadotropins has been used in reproductive medicine as a way to treat female infertility.

What happens if I have too little dehydroepiandrosterone?

Low levels of dehydroepiandrosterone have been linked with shorter lifespan in men but not women. However, the reason for this is not fully understood. Decreased dehydroepiandrosterone levels are associated with increased risk of cardiovascular disease in men with type 2 diabetes mellitus and may also cause a shorter lifespan, although further research is needed to confirm this.

In women, low levels of dehydroepiandrosterone are associated with low libido, reduced bone mineral density and osteoporosis. However, supplementation with commercially available dehydroepiandrosterone is not recommended as there is concern about numerous possible side-effects.