What are the symptoms of high DHEA-S?
High DHEA-S can cause symptoms like acne, excessive hair growth, irregular periods in women, and mood changes. While often linked to conditions like PCOS or adrenal disorders, elevated levels may also occur from stress, certain medications, or supplements.
Understanding DHEA-S and its role in your body
Dehydroepiandrosterone sulfate (DHEA-S) is a hormone produced primarily by your adrenal glands, with smaller amounts made by the ovaries and testes. Often called the 'mother hormone,' DHEA-S serves as a precursor to other important hormones, including testosterone and estrogen. Your body converts DHEA-S into these sex hormones as needed, making it a crucial player in your endocrine system.
DHEA-S levels naturally fluctuate throughout life, peaking in your twenties and gradually declining with age. While this hormone supports various bodily functions including immune response, bone density, and muscle mass maintenance, having too much can lead to uncomfortable and sometimes concerning symptoms. Understanding these symptoms can help you identify when it might be time to check your hormone levels and seek appropriate care.
Common symptoms of elevated DHEA-S levels
When DHEA-S levels rise above the normal range, your body may respond with various symptoms that can affect both your physical appearance and overall well-being. These symptoms often develop gradually and may be mistaken for other conditions, making proper testing essential for accurate diagnosis.
DHEA-S Reference Ranges by Age and Sex
| Age Group | Women (μg/dL) | Men (μg/dL) | Clinical Notes | |
|---|---|---|---|---|
| 20-29 years | 20-29 years | 65-380 | 280-640 | Peak levels typically occur in this age range |
| 30-39 years | 30-39 years | 45-270 | 120-520 | Gradual decline begins |
| 40-49 years | 40-49 years | 32-240 | 95-530 | Continued age-related decline |
| 50-59 years | 50-59 years | 26-200 | 70-310 | Menopause may affect levels in women |
| 60+ years | 60+ years | 13-130 | 42-290 | Lowest levels in elderly populations |
Reference ranges may vary between laboratories. Always consult with your healthcare provider for interpretation.
Skin and hair changes
One of the most noticeable signs of high DHEA-S is the development of acne, particularly cystic acne that appears on the face, chest, and back. This occurs because elevated DHEA-S increases sebum production in your skin's oil glands. Additionally, many people experience hirsutism - excessive hair growth in areas where men typically have hair, such as the face, chest, and abdomen. Women may notice coarse, dark hair appearing on their chin, upper lip, or jawline.
Conversely, some individuals with high DHEA-S may experience male-pattern baldness or thinning hair on the scalp. This seemingly contradictory effect happens because DHEA-S can be converted to dihydrotestosterone (DHT), which promotes body hair growth while potentially causing scalp hair loss.
Reproductive and sexual symptoms
Women with elevated DHEA-S often experience menstrual irregularities, including:
- Irregular or missed periods
- Heavy or prolonged menstrual bleeding
- Difficulty conceiving
- Reduced fertility
Both men and women may notice changes in libido, though the effects can vary. Some people experience increased sexual desire, while others may have reduced interest in sexual activity. Women might also develop clitoral enlargement, while men could experience testicular shrinkage if levels remain elevated for extended periods.
Metabolic and body composition changes
High DHEA-S can influence your metabolism and body composition in several ways. Many people notice unexplained weight gain, particularly around the midsection. This abdominal weight gain can be frustrating and may resist typical diet and exercise efforts. Some individuals also experience increased muscle mass and strength, which might seem beneficial but can be concerning when accompanied by other symptoms.
Additionally, elevated DHEA-S may affect insulin sensitivity, potentially leading to blood sugar imbalances. This can manifest as increased hunger, energy crashes after meals, or difficulty maintaining stable energy levels throughout the day. Regular monitoring of your metabolic health becomes especially important when dealing with hormonal imbalances.
Psychological and emotional symptoms
The effects of high DHEA-S extend beyond physical symptoms, often impacting mental and emotional well-being. Common psychological symptoms include:
- Increased irritability and mood swings
- Anxiety or feelings of restlessness
- Depression or low mood
- Difficulty concentrating
- Sleep disturbances or insomnia
- Increased aggression or competitiveness
These mood changes can significantly impact daily life and relationships. The connection between DHEA-S and neurotransmitters in the brain explains why hormonal imbalances can have such profound effects on mental health. Some people describe feeling 'wired but tired,' experiencing both physical fatigue and mental hyperactivity.
What causes DHEA-S levels to rise?
Understanding the root causes of elevated DHEA-S is crucial for proper treatment. Several conditions and factors can lead to increased production of this hormone:
Medical conditions
Polycystic ovary syndrome (PCOS) is one of the most common causes of elevated DHEA-S in women. This hormonal disorder affects up to 10% of women of reproductive age and often presents with high androgen levels, including DHEA-S. Congenital adrenal hyperplasia (CAH), a genetic condition affecting the adrenal glands, can also cause excessive DHEA-S production.
Adrenal tumors, though rare, can produce excess DHEA-S. These may be benign (adenomas) or malignant (carcinomas). Cushing's syndrome, characterized by excessive cortisol production, may also be associated with elevated DHEA-S levels. Additionally, certain pituitary disorders can stimulate the adrenal glands to overproduce hormones.
Lifestyle and external factors
Chronic stress can significantly impact DHEA-S levels, as the adrenal glands produce both stress hormones and DHEA-S. Certain medications, including corticosteroids and some psychiatric drugs, may influence DHEA-S production. DHEA supplements, available over-the-counter in many countries, can obviously raise blood levels if taken in excess.
Intensive exercise, particularly resistance training, can temporarily elevate DHEA-S levels. While this is generally not concerning for most people, those with underlying hormonal imbalances may experience more pronounced effects. Poor sleep quality and irregular sleep patterns can also disrupt hormonal balance, potentially affecting DHEA-S levels.
Testing and diagnosis
If you're experiencing symptoms of high DHEA-S, getting tested is the first step toward understanding your hormonal health. DHEA-S testing is typically done through a simple blood draw, and because DHEA-S levels remain relatively stable throughout the day, the test can be performed at any time without fasting requirements.
Normal DHEA-S ranges vary by age and sex. For adult women, typical ranges are 35-430 μg/dL, while men usually have levels between 80-560 μg/dL. However, these ranges can vary between laboratories, and your healthcare provider will interpret your results in the context of your symptoms and overall health picture.
It's important to test DHEA-S alongside other hormones for a complete picture of your endocrine health. Related tests might include testosterone (total and free), estradiol, cortisol, and thyroid hormones. This comprehensive approach helps identify whether elevated DHEA-S is an isolated finding or part of a broader hormonal imbalance.
Treatment approaches for high DHEA-S
Treatment for elevated DHEA-S depends on the underlying cause and the severity of symptoms. The goal is not just to lower DHEA-S levels but to address the root cause and alleviate symptoms while supporting overall hormonal balance.
Medical treatments
For women with PCOS-related high DHEA-S, oral contraceptives are often the first-line treatment. These medications can help regulate menstrual cycles, reduce androgen levels, and improve symptoms like acne and hirsutism. Anti-androgen medications such as spironolactone may be prescribed to block the effects of excess androgens on target tissues.
In cases where adrenal tumors or hyperplasia are causing elevated DHEA-S, more specific treatments may be necessary. These could include surgery for tumor removal or medications like glucocorticoids for congenital adrenal hyperplasia. Metformin, commonly used for diabetes management, may help improve insulin sensitivity and indirectly affect DHEA-S levels in some individuals.
Lifestyle modifications
Natural approaches to managing high DHEA-S focus on supporting overall hormonal balance through lifestyle changes:
- Stress management through meditation, yoga, or counseling
- Regular moderate exercise (avoiding excessive high-intensity training)
- Maintaining a healthy weight through balanced nutrition
- Prioritizing sleep quality and consistency
- Limiting caffeine and alcohol intake
- Incorporating anti-inflammatory foods like omega-3 fatty acids
Some supplements may help support hormonal balance, including saw palmetto, spearmint tea, and zinc. However, it's crucial to consult with a healthcare provider before starting any supplement regimen, as some may interact with medications or affect hormone levels in unexpected ways.
Long-term outlook and monitoring
With proper diagnosis and treatment, most people with elevated DHEA-S can effectively manage their symptoms and prevent long-term complications. Regular monitoring is essential to track treatment effectiveness and adjust approaches as needed. This typically involves periodic blood tests to measure DHEA-S and related hormones, along with symptom assessment.
The frequency of monitoring depends on your specific situation but often includes testing every 3-6 months initially, then annually once levels stabilize. It's important to maintain open communication with your healthcare provider about any new or changing symptoms, as these may indicate the need for treatment adjustments.
Remember that hormonal balance is dynamic and can be influenced by many factors throughout life. What works at one stage may need modification as you age, experience life changes, or develop other health conditions. Staying proactive about your hormonal health through regular testing and lifestyle optimization gives you the best chance of maintaining balance and preventing symptoms from recurring.
Taking control of your hormonal health
High DHEA-S levels can cause a wide range of symptoms that affect both physical appearance and emotional well-being. From acne and unwanted hair growth to mood changes and menstrual irregularities, these symptoms can significantly impact quality of life. However, with proper testing, diagnosis, and treatment, most people can successfully manage elevated DHEA-S and find relief from their symptoms.
The key is to recognize the symptoms early and seek appropriate testing to understand your hormonal profile. Whether through medical treatments, lifestyle modifications, or a combination of both, there are effective strategies for bringing DHEA-S levels back into balance. By taking a proactive approach to hormonal health and working with knowledgeable healthcare providers, you can address the root causes of elevated DHEA-S and optimize your overall well-being for the long term.
References
- Labrie F, Bélanger A, Cusan L, Gomez JL, Candas B. Marked decline in serum concentrations of adrenal C19 sex steroid precursors and conjugated androgen metabolites during aging. J Clin Endocrinol Metab. 1997;82(8):2396-402.[PubMed][DOI]
- Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016;2:16057.[PubMed][DOI]
- Rutkowski K, Sowa P, Rutkowska-Talipska J, Kuryliszyn-Moskal A, Rutkowski R. Dehydroepiandrosterone (DHEA): hypes and hopes. Drugs. 2014;74(11):1195-207.[PubMed][DOI]
- Goodarzi MO, Carmina E, Azziz R. DHEA, DHEAS and PCOS. J Steroid Biochem Mol Biol. 2015;145:213-25.[PubMed][DOI]
- Kushnir MM, Blamires T, Rockwood AL, et al. Liquid chromatography-tandem mass spectrometry assay for androstenedione, dehydroepiandrosterone, and testosterone with pediatric and adult reference intervals. Clin Chem. 2010;56(7):1138-47.[PubMed][DOI]
- Maninger N, Wolkowitz OM, Reus VI, Epel ES, Mellon SH. Neurobiological and neuropsychiatric effects of dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS). Front Neuroendocrinol. 2009;30(1):65-91.[PubMed][DOI]
Was this article helpful?
Frequently Asked Questions
How can I test my DHEA-S at home?
You can test your DHEA-S at home with SiPhox Health's Hormone Focus Program, which includes DHEA-S testing along with other key hormone biomarkers. This CLIA-certified program provides lab-quality results from the comfort of your home.
What is the normal range for DHEA-S?
Normal DHEA-S ranges vary by age and sex. For adult women, typical ranges are 35-430 μg/dL, while men usually have levels between 80-560 μg/dL. These ranges can vary between laboratories, and levels naturally decline with age.
Can high DHEA-S cause weight gain?
Yes, elevated DHEA-S can contribute to weight gain, particularly around the midsection. This occurs because DHEA-S can affect insulin sensitivity and metabolism. The weight gain may be resistant to typical diet and exercise efforts until hormone levels are addressed.
How long does it take to lower DHEA-S levels?
The timeline for lowering DHEA-S levels depends on the underlying cause and treatment approach. With appropriate treatment, some people see improvements in 3-6 months, though it may take longer for symptoms like hirsutism to resolve. Regular monitoring helps track progress.
Can stress cause high DHEA-S?
Yes, chronic stress can elevate DHEA-S levels since the adrenal glands produce both stress hormones and DHEA-S. Managing stress through techniques like meditation, regular exercise, and adequate sleep can help support healthy DHEA-S levels.
This article is licensed under CC BY 4.0. You are free to share and adapt this material with attribution.
