Dehydroepiandrosterone Sulfate: What Is DHEA-S And Why Does It Matter?

Dehydroepiandrosterone Sulfate: What Is DHEA-S And Why Does It Matter?

DHEA-S is used to build sex hormones that support reproductive health in men and women. Low or elevated DHEA-S levels affect fertility, bone health, and even cognition.

Sex hormones are critical to human health. Both sexes have male and female sex hormones in varying amounts that ensure the reproductive system develops and functions correctly. When sex hormone levels are off, it can cause a wide range of health issues.

☝️DISCLAIMER☝This article is for informational purposes only. It is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment.


Table of contents


What is DHEA-S?

Dehydroepiandrosterone sulfate (DHEA-S) is a precursor hormone that belongs to the family of androgens[1]. The body converts DHEA-S into primary sex hormones, like testosterone and estradiol, which is why low or elevated DHEA-S levels can affect human health and fertility.

Too much or too little DHEA-S can affect fertility by Melani Sosa for Unsplash.
Too much or too little DHEA-S can affect fertility

Dehydroepiandrosterone is made from cholesterol. It is mainly produced by the adrenal cortex, a gland located on top of the kidneys. As a result of sulfation[2] in the adrenal cortex, it gains a sulfate molecule and becomes dehydroepiandrosterone sulfate (DHEA-S). Then, it is released into the bloodstream.

The adrenal cortex is part of the endocrine system that produces hormones and regulates hormone levels. It includes a range of glands and organs, such as the pituitary gland, thyroid, pancreas, and reproductive organs. Small amounts of DHEA are produced directly by the reproductive organs (testes and ovaries).

  • [1] Androgens are important for both sexes. In men, androgens determine typical male characteristics, such as muscle mass, deep voice, and hairiness. In women, androgens play an essential role in libido and participate in estrogen synthesis (the primary female sex hormone).
  • [2] Sulfation is a process that increases the water solubility of a molecule and enables it to be transported in the blood to other tissues.

DHEA-S functions

The body ramps up DHEA production at age 9–10. Peak DHEA levels are reached in the 20s, and then gradually decline as a person ages. Dehydroepiandrosterone sulfate is converted into primary sex hormones: estrogen in women and testosterone in men.

Atlas DNA Test for DHEA-S

The female body relies heavily on DHEA and DHEA-S to produce estrogens, and researchers believe that the age-related decline of these hormones could partially explain low sex drive and impaired cognition in postmenopausal women.

In women, DHEA-S participates in the formation and development of healthy eggs in the ovaries. In men, it participates in the sexual maturation during puberty: development of reproductive organs, hair growth, and sperm production.

DHEA-S levels

Normal levels of DHEA-S vary depending on age and sex. This precursor hormone is particularly important for female health, and fluctuations in dehydroepiandrosterone sulfate have a variety of consequences for women’s wellbeing.

High DHEA-S

Male Health Female Health
Mild increases in DHEA-S levels generally don’t cause symptoms Elevated DHEA and DHEA-S can result in hyperandrogenism.

Hyperandrogenism is a term used to describe the development of masculine physical traits due to high levels of androgens (including DHEA-S) in women. DHEA-S is a male hormone that is used to make female estrogens, but excess levels can lead to a range of noticeable characteristics that affect the body’s morphology:

  • deepening of the voice
  • acne and oily skin
  • hirsutism (excess body hair)
  • hair loss
  • increased muscle mass
  • absent or infrequent menstruation
  • infertility
  • ambiguous genitalia

Hyperandrogenism affects about 5–10% of women, the majority of which have polycystic ovary syndrome (PCOS), according to a 2006 study. Elevated DHEA-S is found in 20–30% of women diagnosed with polycystic ovary syndrome.

High DHEA and DHEA-S levels are found in people with specific subtypes of congenital adrenal hyperplasia (CAH), a rare hereditary disease that manifests in childhood:

  • 3 beta-hydroxysteroid dehydrogenase deficiency
  • 21-hydroxylase deficiency (the most common type)
  • 11-Beta hydroxylase deficiency

A strong increase in DHEA and DHEA-S levels may also be a sign of androgen-producing adrenal tumors, which may be benign (harmless) or malignant (aggressive). Sex-hormone producing tumours are very rare and only affect 2 in every 2 million people.

A person’s DNA can influence DHEA-S levels. Genome-wide association studies show that genetics can account for 5% of the variance observed in DHEA-S levels. In particular, people who carry a specific variant of the ZNF789 gene may have above-average dehydroepiandrosterone sulfate levels, compared to the rest of the population.

Low DHEA-S

DHEA-S is turned into estrogen that regulates the menstrual cyle
DHEA-S is the body’s primary steroid for the production of sex hormones. Low levels of dehydroepiandrosterone sulfate impair the body’s ability to produce sufficient estrogens and androgens with knock-on effects for reproductive health and the whole body. DHEA-S deficiency is associated with the following health problems:
  • infertility
  • low sex drive
  • impaired cognition
  • osteoporosis

DHEA-S appears to have neuroprotective properties for the brain. It’s not exactly clear how this works, but low DHEA-S levels are associated with the deterioration of cognitive function, particularly in old age.

Low DHEA-S is also linked to osteoporosis. Sex hormones participate in bone growth during adolescence and the maintenance of bone health in adulthood. However, levels of sex hormones and their precursor, DHEA-S, decline with age, especially with menopause for women.

The mechanisms underpinning the relationship of DHEA-S and osteoporosis are not quite clear, but higher DHEA-S in old age seems to protect bone mineral density, whereas low DHEA-S is associated with osteoporosis (loss of bone density, and increased risk of fractures). Researchers believe that this is partially due to the effect of sex hormones on the skeleton.

DHEA-S lab tests

DHEA-S lab tests may be required by your doctor to assess adrenal gland function. A blood sample is taken from the arm and then sent to a laboratory. DHEA-S testing is used in the diagnosis of:

  • adrenal tumours and cancers
  • health conditions that affect the reproductive organs
  • early puberty in boys
  • masculine physical traits in women

The Atlas DNA Test assesses your genetic make-up for a predisposition to elevated DHEA-S levels that still fall within the normal range.

Leigh Stewart
Leigh Stewart Head of Atlas Biomed content, trained chef and avid fermenter of edible bacteria.

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