“Often, when working with women, we uncover hormone imbalances that when corrected make all the difference for how a woman feels, looks and continues vibrantly through life.” 

“It’s incredibly important to understand that all of your hormones work together in a beautiful symphony.”

DHEA Supplement Benefits For Women - Part 1

If you’ve been following my blog lately, I’ve been writing a lot about hormones and specifically women’s hormones. As a functional medicine practitioner and nurse practitioner, I’m always looking to uncover the root cause of symptoms. Often, when working with women, we uncover hormone imbalances that when corrected make all the difference for how a woman feels, looks and continues vibrantly through life. 

Today’s topic is DHEA. Although DHEA may not be at the top of your list when you think about hormones, it is incredibly important. It’s a hormone and also a supplement that is widely available. In today’s article, I will cover:

• What is DHEA and why is it important in women’s health 
• How all hormones work together
• Signs and symptoms of both low and high DHEA
• DHEA vs. DHEA-S

Then, be sure to stay tuned for Part 2 of this article, where I will dive into DHEA supplementation and it’s use for fertility. 

What Is DHEA And What Does It Do In A Woman’s Body?

Let’s start with the basics: what is DHEA? and What does DHEA do? 

DHEA is short for dehydroepiandrosterone. It’s a mouthful, but DHEA is a steroid hormone that is made in ovaries (or testes in men) and adrenal glands. The body is able to convert DHEA into estrogen or testosterone. When DHEA is low we might have low levels of these sex hormones, or when it is high, as is the case oftentimes in PCOS, you may experience hormone excess. DHEA levels naturally decline with age. 

A second form of DHEA is called DHEA-S, or dehydroepiandrosterone sulfate, and is simply DHEA with a sulfur group attached to it. DHEA-S is the most abundant form of DHEA circulating in the body and tends to stick around longer than DHEA. DHEA-S is made in the adrenal glands, the same glands that make the stress hormone cortisol, and closely linked to adrenal health. In fact, we tend to see low DHEA-S in “adrenal fatigue” or HPA-axis dysfunction. 

The body is able to convert DHEA to DHEA-S and back again, making both forms, and primarily a balance between both forms important. 

DHEA And Hormonal Balance

It’s incredibly important to understand that all of your hormones work together in a beautiful symphony. So while we will focus on DHEA today (and more to come in Part 2 of this series), we need to keep in mind that we can’t cherry pick hormones to treat and really need to understand the whole hormonal picture for each individual. Many of the signs and symptoms of low, or high, DHEA may look like other imbalances with the thyroid, estrogen, progesterone, testosterone, cortisol, insulin and others. 

This is why I always recommend comprehensive hormone testing, such as the DUTCH test, prior to any hormone supplementation, prescriptions or other interventions. 

Signs and Symptoms of Low DHEA

As mentioned above, low DHEA may occur as a natural part of aging or during the postpartum, peri-menopause or menopausal years. These are also times when other sex hormones will be lower as well. 

Low DHEA (or DHEA-S) may present as:

• Loss of lean body mass, or difficulty in building muscle
• Hard to lose weight
• Low libido
• Lower immunity
• Decreased bone density 
• Fatigue
• Depression or mood swings

Low DHEA-S may have additional symptoms that look like “adrenal fatigue” or HPA-axis dysfunction such as low blood pressure or dizziness, salt cravings and low blood sugar. 

Signs and Symptoms of high DHEA

On the other hand, an over-production of DHEA in women, may look a lot like high testosterone or the symptoms of PCOS. These include:  

• Unwanted hair on the face or chest
• Oily skin or acne
• Irregular or absent menstrual cycles
• Insulin resistance and high blood sugar
• DHEA hair loss

DHEA And DHEA-S balance

It’s also possible to have an imbalance between DHEA and DHEA-S. In my practice, I often see cases of normal or robust DHEA, but low DHEA-S. This points to the need for adrenal support, but there may be other root causes to explore, including: 

• Hidden infection, such as a gut infection or virus
• Inflammation 
• Blood sugar imbalance
• Sulfation SNP, which is a small genetic change in the genes that code for the enzyme that adds the S to DHEA-S. You can read more about this type of genetic testing here.   
• Low sulfur pool, meaning, you don’t have enough sulfur in circulation to donate to DHEA, to convert to DHEA-S. This has to do with eating enough sulfur-rich foods as well as digesting and absorbing them. 

Now you can see how important DHEA is and how it plays in concert with the other hormones. Balance is key! In Part 2 we will take a look at DHEA supplements in detail, including their use in infertility cases and how DHEA works to improve fertility. 

References 

1. Hinson, J. P., & Raven, P. W. (1999). DHEA deficiency syndrome: a new term for old age?. The Journal of endocrinology, 163(1), 1–5. Abstract: https://pubmed.ncbi.nlm.nih.gov/10495400/ 
2. Goodarzi, M. O., Carmina, E., & Azziz, R. (2015). DHEA, DHEAS and PCOS. The Journal of steroid biochemistry and molecular biology, 145, 213–225. Abstract: https://pubmed.ncbi.nlm.nih.gov/25008465/