DHEA: What the Trials Found, and What the Shelf Sells
Not medical advice. DHEA is a steroid hormone, prescription-only outside the United States, and the trials below are the reason most endocrinologists do not recommend it for healthy people. Talk to a clinician before taking it, and do not take it with a hormone-sensitive cancer, in pregnancy, or in competitive sport.
Quick answer
DHEA does fall with age, and putting it back does less than the decline suggests. Blood DHEA-S peaks in the early twenties and drops to about a fifth of that by 70. Restoring it with 50 mg a day for a year in 280 people aged 60 to 79 changed skin, bone turnover and libido modestly and only in women over 70; 2 years of it in 87 men and 57 women at the Mayo Clinic changed nothing about body composition, strength, insulin or quality of life. Where it has a real job (adrenal insufficiency, and the intravaginal prescription form for menopausal dryness) it is a clinical decision, not a shelf purchase.
The shelf is dosed above the trials. On the 350 DHEA labels filed with the NIH, 37.5% deliver 25 mg a serving and 27.1% 50 mg, the two doses with human pharmacokinetic and trial data; 21.3% are above 50 mg and 20.7% at 100 mg or more. No label carries a USP Verified mark. If you and your clinician decide to try it, Life Extension DHEA 25 mg Dissolve-in-Mouth is 25 mg for $0.10 a dose. See the census →
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The decline is real
DHEA is the most abundant steroid the adrenal glands make, circulating mostly as its sulfate, DHEA-S. In a cross-sectional study of 981 men and 481 women aged 11 to 89, DHEA-S peaked at ages 20 to 24 in men (3,470 ng/mL) and 15 to 19 in women (2,470 ng/mL), then fell steadily to 670 and 450 ng/mL after 70 (Orentreich 1984, PMID 6235241). That curve is the whole sales pitch: a hormone that falls to a fifth of its youthful level looks like something to replace. The body converts DHEA into testosterone and estrogens inside tissues, so the argument runs that restoring it restores those too. The trials tested exactly that.
The replacement trials: one year, two years, and the meta-analyses
The French DHEAge study gave 280 healthy people aged 60 to 79 either 50 mg of DHEA or placebo daily for a year. DHEA-S returned to young-adult levels with a small rise in testosterone and estradiol, larger in women; bone turnover improved in women over 70, most libido measures rose in those older women, and skin hydration and thickness improved, again mostly in women. The authors noted no harmful accumulation and concluded that replacement normalized some effects of aging but "does not create supermen/women" (Baulieu 2000, PMID 10760294). The dose came from an 8-day pharmacokinetic study of 25 and 50 mg in 24 older adults, which found a blood half-life over 20 hours (so once a day is enough) and that women convert more DHEA-S back to DHEA than men (Legrain 2000, PMID 10999810).
The Mayo Clinic ran the longer, harder test: 2 years of DHEA against placebo in 87 elderly men and 57 elderly women with low DHEA-S, measuring physical performance, body composition, bone density, glucose tolerance and quality of life. DHEA-S rose as expected. Body composition did not change, nor did peak oxygen uptake, muscle strength, insulin sensitivity or quality of life; the only signals were small bone-density gains at the femoral neck in men and the wrist in women. The authors' conclusion was that DHEA replacement in elderly people has no physiologically relevant benefit (Nair 2006, PMID 17050889).
The meta-analyses agree by sex. Across 25 placebo-controlled trials in 1,353 elderly men (mean 36 weeks), DHEA reduced fat mass by a standardized -0.35, an effect that vanished once the accompanying rise in testosterone and estradiol was adjusted for, and it did nothing for lipids, glucose, bone, sexual function or quality of life (Corona 2013, PMID 23824417). Across 23 trials in 1,188 postmenopausal women with normal adrenal function, DHEA did not significantly improve libido or sexual function (standardized difference 0.35, p = 0.06) and had no effect on lipids, glucose, weight or bone density, on low-confidence evidence (Elraiyah 2014, PMID 25279571). The Endocrine Society's androgen guideline for women, built on that review, recommends against routine DHEA because the effectiveness and safety data are limited (Wierman 2014, PMID 25279570).
Where DHEA has a job
Adrenal insufficiency. Women whose adrenals make no DHEA are the one group with a deficiency to correct. Across 10 placebo-controlled trials, DHEA produced a small improvement in health-related quality of life (effect size 0.21) and in depression scores, with no significant effect on anxiety or sexual well-being; the reviewers called the gain "small and perhaps trivial" and the evidence insufficient for routine use (Alkatib 2009, PMID 19773400). It is nonetheless the setting where an endocrinologist may reasonably trial 25 to 50 mg.
Menopausal vaginal symptoms, by the vaginal route. Prasterone is 6.5 mg of DHEA in an intravaginal insert, prescription-only. In its phase III trial (325 women on DHEA, 157 on placebo, 12 weeks) it shifted vaginal cell maturation, lowered pH and reduced pain at sexual activity, with serum steroids staying in the postmenopausal range (Labrie 2016, PMID 26731686). That is a local effect an oral capsule does not reproduce.
IVF poor responders: probably not. The 2024 Cochrane review pooled 9 trials (1,433 women) of DHEA pre-treatment before assisted reproduction and found it likely makes little or no difference to live birth or ongoing pregnancy (odds ratio 1.3, 95% CI 0.95 to 1.76, moderate certainty): a 12% chance becomes 12 to 20%. Testosterone pre-treatment, in the same review, did improve live birth (Naik 2024, PMID 38837771).
Depression, at doses no supplement label suggests. An NIMH crossover trial in 46 adults with midlife-onset depression gave 90 mg a day for three weeks then 450 mg for three; 23 responded on DHEA against 13 on placebo (Schmidt 2005, PMID 15699292). Those doses are nine times the shelf's 50 mg and were given under psychiatric supervision; the result is a lead for clinicians, not a reason to self-treat.
We read 350 DHEA labels: a fifth are dosed above any trial
Original research351 labels retrieved from the NIH Dietary Supplement Label Database by paging its DHEA search; 350 sold as DHEA from 141 brands, 609 DHEA-bearing labels on the market. Milligrams are read from the Supplement Facts row and multiplied by the maximum daily servings in the directions. Every figure was recomputed in two halves; 14 of 16 held and only those are printed.
The doses cluster at 25 and 50 mg, then jump. 37.5% of labels deliver exactly 25 mg a serving and 27.1% exactly 50 mg; the median daily dose is 50 mg and a quarter of labels sit at 25 mg a day or below. 11.5% are 10 mg or less, the tier a woman would start at. Above that, 21.3% of labels exceed 50 mg a serving and 20.7% deliver 100 mg or more. Most of the top tier is not DHEA: 18% of labels are 7-keto DHEA, a metabolite sold at 100 mg twice a day that is not converted to sex hormones and to which none of the trials above apply. Quality marks are absent: 0% of labels state USP Verified, while 99.1% carry a hormone or consult-your-physician warning. 17.1% claim micronized, 1.7% are dissolve-in-mouth or sublingual, and 0.9% are sold as a women's line despite women being the sex the trials found responsive.
| Item | Value (%) |
|---|---|
| 10 mg or less per serving | 11.5% |
| 25 mg | 37.5% |
| 50 mg | 27.1% |
| More than 50 mg | 21.3% |
| 100 mg or more | 20.7% |
How we read the labels, and what did not hold
Method, 350 labels: DHEA milligrams are the Supplement Facts row for the panel serving; the daily figure multiplies by the maximum servings in the directions. 7-keto is read from the name and ingredient rows; micronized, sublingual and dissolve-in-mouth from the name, form and directions; blends from any second hormone (pregnenolone, 7-keto alongside DHEA); women's lines from the product name; USP from a printed statement; warnings from the label's warning text. Split-half by label-id parity: 14 of 16 checks agreed. Not printed (2): median DHEA mg per serving; p75 daily mg. Open data at /dhea/best-overall.json (CC BY 4.0). What it cannot tell you: whether the capsule contains what the label says (no label here carries a USP mark), or anything about a product that has not filed with the NIH.
If you and your clinician decide to try it
Product links go to Amazon and we may earn a commission if you buy. It never changes which product we pick or what we say about it. How we choose.
All 4 tracked products, ranked by cost per 25 mg with the low-dose and 50 mg options, are on the best-overall page.
Safety, and who should not take it
DHEA is a hormone precursor: it becomes testosterone and estradiol in tissues, more so in women. The one-year and two-year trials at 50 to 75 mg in people over 60 recorded no major adverse effects and no harmful accumulation, which is reassuring for that population and that duration and says nothing about younger people, higher doses or longer use. Women at 50 mg commonly report oily skin, acne and facial hair; men can see a rise in estradiol. Anyone with a hormone-sensitive cancer or a family history of one, anyone pregnant or breastfeeding, and anyone under 40 without adrenal insufficiency should not take it. It is prohibited in competition by WADA and the NCAA as an anabolic-steroid precursor, and it is a prescription medicine in Canada, the United Kingdom, Australia and the European Union. The guideline position for healthy women is the practical one: not routinely, and not without a clinician who will measure DHEA-S first.
Frequently asked questions
What does DHEA do?
DHEA (dehydroepiandrosterone) is the most abundant steroid the adrenal glands make, and the body converts it into testosterone and estrogens in tissues. Its sulfate, DHEA-S, peaks in the early twenties and falls to about a fifth of that by 70. Supplementing raises DHEA-S back to young-adult levels within days; what the trials tested is whether that restores anything else. In healthy older people, a 2-year trial in 87 men and 57 women found no effect on body composition, strength, insulin sensitivity or quality of life, and a 50 mg one-year trial in 280 people found modest changes in skin, bone turnover and libido in women over 70.
Does DHEA raise testosterone?
Slightly, and mostly in women. DHEA is converted to testosterone and estradiol in tissues, and oral doses of 25 to 50 mg produce a small rise in both, larger in women than men. In elderly men, a meta-analysis of 25 trials (1,353 men) found a small fat-mass reduction that disappeared once the rise in testosterone and estradiol was accounted for, and no effect on lipids, glucose, bone, sexual function or quality of life. It is not a testosterone booster in any useful sense, and it is banned in sport as a steroid precursor.
Is DHEA safe?
It is a hormone, sold without a prescription only in the United States. Short trials at 25 to 50 mg in older adults recorded no harmful accumulation, but no trial runs past two years and the women's androgen guideline recommends against routine use because effectiveness and long-term safety data are limited. Women commonly get acne or oily skin at 50 mg. Anyone with a hormone-sensitive cancer (breast, prostate, ovarian), anyone under 40 without adrenal insufficiency, and anyone pregnant should not take it; it interacts with testosterone, estrogen and some psychiatric drugs, and it is prohibited by WADA and the NCAA.
What is 7-keto DHEA?
A metabolite of DHEA that is not converted into testosterone or estrogen, sold for weight loss at 100 mg twice a day. Because it does not raise sex hormones, none of the DHEA trials on this page apply to it, and its own evidence is a couple of small industry-funded trials. On the 350 labels we read, 18% are 7-keto products, and they account for most of the 20.7% of labels at 100 mg or more.
Does DHEA help with fertility or IVF?
The 2024 Cochrane review of 9 trials (1,433 women, mostly poor responders) found DHEA pre-treatment likely makes little or no difference to live birth (odds ratio 1.3, 95% CI 0.95 to 1.76): a 12% baseline becomes 12 to 20%. Testosterone pre-treatment did improve live birth in the same review. Over-the-counter DHEA for fertility is a decision for the clinic running the cycle, not a supplement to add alone.
Is DHEA the same as the vaginal DHEA prescription?
No. Prasterone (Intrarosa) is 6.5 mg of DHEA delivered intravaginally for menopausal vaginal dryness and painful sex; its phase III trial (325 women on DHEA, 157 on placebo) improved vaginal cell counts, pH and pain over 12 weeks with serum hormones staying in the postmenopausal range. An oral capsule does not do that job, and the meta-analysis of oral DHEA in 1,188 postmenopausal women found no significant effect on libido or sexual function.
Related guides
- DHEA dosage guide: the trial doses, by sex and goal
- Best DHEA supplement, ranked by cost per 25 mg
- Tongkat ali: the testosterone evidence
- Does boron raise testosterone?
- Creatine for men: the hormone and hair questions
Sources
- Orentreich N, et al. “Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood.” J Clin Endocrinol Metab. 1984. PMID: 6235241
- Baulieu EE, et al. “Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study.” Proc Natl Acad Sci USA. 2000. PMID: 10760294
- Legrain S, et al. “Dehydroepiandrosterone replacement administration: pharmacokinetic and pharmacodynamic studies in healthy elderly subjects.” J Clin Endocrinol Metab. 2000. PMID: 10999810
- Nair KS, et al. “DHEA in elderly women and DHEA or testosterone in elderly men.” N Engl J Med. 2006. PMID: 17050889
- Corona G, et al. “Dehydroepiandrosterone supplementation in elderly men: a meta-analysis study of placebo-controlled trials.” J Clin Endocrinol Metab. 2013. PMID: 23824417
- Elraiyah T, et al. “The benefits and harms of systemic DHEA in postmenopausal women with normal adrenal function: a systematic review and meta-analysis.” J Clin Endocrinol Metab. 2014. PMID: 25279571
- Wierman ME, et al. “Androgen therapy in women: a reappraisal. An Endocrine Society clinical practice guideline.” J Clin Endocrinol Metab. 2014. PMID: 25279570
- Alkatib AA, et al. “A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency.” J Clin Endocrinol Metab. 2009. PMID: 19773400
- Naik R, et al. “Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction.” Cochrane Database Syst Rev. 2024. PMID: 38837771
- Schmidt PJ, et al. “Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression.” Arch Gen Psychiatry. 2005. PMID: 15699292
- Labrie F, et al. “Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness.” Menopause. 2016. PMID: 26731686
- NIH Office of Dietary Supplements. Dietary Supplement Label Database. dsld.od.nih.gov (labels retrieved 2026-09-18).