DHEA and Hormone Balance: The Forgotten Hormone You Need to Know About

The Hormone Most Providers Never Test

DHEA — dehydroepiandrosterone — is the most abundantly produced steroid hormone in the human body. The adrenal glands churn out DHEA-S (DHEA sulfate, the storage form) in quantities that dwarf cortisol, testosterone, and estrogen combined. Yet DHEA testing is absent from most standard hormone panels, and DHEA deficiency is rarely diagnosed despite being nearly universal in aging adults.

Understanding DHEA’s role in the hormonal system explains why so many patients with comprehensive hormone replacement still experience incomplete recovery — because a crucial piece of the hormonal puzzle is missing.

What DHEA Does in the Body

DHEA serves two primary functions: it is a direct bioactive hormone with its own receptor activity, and it is the most important precursor hormone for both testosterone and estrogen production in peripheral tissues. This dual role makes it physiologically critical in ways that go beyond any single downstream hormone.

As a direct hormone, DHEA exerts effects on:

• Immune function: DHEA has well-documented immunomodulatory effects — it supports T-cell function, reduces inflammatory cytokine production, and counterbalances cortisol’s immunosuppressive effects
• Bone metabolism: DHEA stimulates osteoblast activity and has been shown to improve bone mineral density, particularly in older women
• Neurological function: DHEA acts as a neurosteroid — directly modulating GABA-A and NMDA receptors in the brain — contributing to mood, cognitive function, and neuroprotection
• Skin health: DHEA receptors in the skin regulate sebum production, hydration, and collagen synthesis
• Cardiovascular health: DHEA has vasodilatory effects and is inversely associated with cardiovascular disease risk in epidemiological studies

As a prohormone, DHEA is converted locally in peripheral tissues (muscle, fat, brain, skin) into testosterone and estrogen — providing targeted hormone availability where cells need it, without driving systemic hormone levels to excess.

DHEA Decline with Age: Adrenopause

DHEA peaks in the mid-20s and declines continuously and dramatically throughout life — more steeply than any other hormone. By age 70, most adults have DHEA-S levels only 10–20% of their peak values. This age-related adrenal decline is sometimes called “adrenopause” and is distinct from sex hormone menopause or andropause.

The symptoms of DHEA deficiency overlap significantly with other hormone deficiencies — fatigue, low libido, mood depression, reduced cognitive sharpness, decreased immune resilience — making it easy to overlook when evaluating hormonal health.

DHEA Supplementation: Evidence and Practice

DHEA supplementation has been studied in multiple randomized trials. Evidence supports benefits in:

• Menopausal symptom relief (particularly vaginal atrophy — intravaginal DHEA/prasterone is FDA-approved for dyspareunia)
• Improved mood and sense of wellbeing in older adults with documented DHEA deficiency
• Sexual function improvement in women with adrenal insufficiency or low DHEA
• Improved bone mineral density with long-term supplementation
• Modest improvements in body composition (lean mass, fat mass ratio)

At Multigen Wellness, DHEA-S is included in the comprehensive hormone panel for all patients. When deficiency is confirmed, supplementation is considered in the context of the complete hormone picture — ensuring that DHEA is optimized appropriately alongside sex hormones and thyroid function rather than in isolation.

If you have never had your DHEA levels tested as part of a hormone evaluation, you may be missing a critical piece of your hormonal health picture. Call Multigen Wellness at (800) 259-0015 to get a complete hormone panel today.