DHEA and Testosterone Levels in Females
Yes, DHEA supplementation does increase testosterone levels in females, with the magnitude of increase being greater in women than in men. 1
Evidence for Testosterone Elevation
DHEA supplementation effectively raises testosterone levels in women through peripheral conversion of this androgenic precursor:
A comprehensive meta-analysis of 42 randomized controlled trials demonstrated that DHEA significantly increased testosterone levels, with females showing a greater magnitude of increase (30.98 ng/dL) compared to males (21.36 ng/dL). 1
The testosterone elevation is dose-dependent, with DHEA dosages >50 mg/day producing greater increases (57.96 ng/dL) compared to ≤50 mg/day (19.43 ng/dL). 1
In a 6-month trial using 100 mg daily DHEA, women experienced increases in serum androstenedione, testosterone, and dihydrotestosterone to levels above gender-specific young adult ranges, while men showed no detectable changes in these androgens. 2
Clinical Monitoring Requirements
When prescribing DHEA to women, testosterone monitoring is essential:
Treatment efficacy should be guided by monitoring serum DHEA sulfate (DHEAS), androstenedione, and testosterone levels, with measurements taken in the morning prior to DHEA ingestion. 3, 4
The typical dose range is 10-50 mg daily, with 25 mg being a common starting dose. 3, 4
Baseline hormone levels should be established before initiating therapy, with follow-up measurements to ensure levels remain in the normal range. 3
Androgenic Side Effects
The testosterone elevation from DHEA carries predictable androgenic consequences:
DHEA is associated with a 3.77-fold increased odds of androgenic side effects, primarily acne, compared to placebo. 5
Women on 100 mg daily DHEA experienced a 40% reduction in sex hormone-binding globulin (SHBG) levels, which amplifies the bioavailability of free testosterone. 2
Important Clinical Caveats
Several safety considerations warrant caution:
DHEA should be used with caution in women receiving aromatase inhibitor therapy, as vaginal DHEA increases circulating androgen levels. 3, 4
Long-term effects of DHEA replacement therapy are not fully known, necessitating cautious use. 3, 4
DHEA treatment should be offered as a 6-month trial and continued only if clinically effective in improving target symptoms (libido, energy, sexual function). 3
The American College of Obstetricians and Gynecologists recommends DHEA primarily for vaginal dryness and dyspareunia in postmenopausal women, where it has shown significant improvements in sexual desire, arousal, pain, and overall sexual function. 4