Dehydroepiandrosterone or DHEA is a male hormone that's necessary in order to produce testosterone. Women who have high DHEA levels can get acne as well as some male characteristics like facial hair and a deeper voice.
DHEA, or dehydroepiandrosterone, is one of many hormones made by the adrenal glands and, to a lesser extent, by ovaries and testes 3.
On its own, DHEA — a "male" hormone, or androgen — doesn’t actually do much. Without it, though, the body wouldn't be able to produce enough estrogen and testosterone, both of which are essential for reproduction.
According to the Society for Endocrinology, DHEA is responsible for about 75 percent of the estrogen in premenopausal women, and 100 percent in postmenopausal women 3. DHEA also helps make insulin growth factor-1 (IGF-1), a hormone similar to insulin which helps different types of cells grow.
DHEA levels are high at birth, decline during the childhood years, then rise again during puberty as girls mature physically, when they are primarily responsible for growing pubic and underarm hair. DHEA levels are at their highest in your 20s, after which they progressively go down.
DHEA levels vary a lot within any given day, and also from day to day, says Rashmi Kudesia, MD, a reproductive endocrinology and infertility specialist at Houston Methodist 1. Because of that, they’re not a very reliable gauge of how much DHEA you have in your body. Instead, medical professionals measure blood levels of DHEA’s “cousin,” dehydroepiandrosterone sulfate, or DHEA-S, which tends to be more stable over time 23.
High levels of DHEA can indicate the presence of ovarian or adrenal tumors. It's also a classic feature of polycystic ovarian syndrome (PCOS), which is a leading cause of infertility. “Having high androgen levels is one of the diagnostic criteria for PCOS,” says Dr. Kudesia. Currently, it's not clear which condition comes first, she adds.
Excessive levels of DHEA can produce a constellation of characteristically masculine characteristics in women, though not everyone will have the same combination. “In many cases, someone will have some elements of the syndrome and not others,” says Dr. Kudesia. “Different experiences can all be wrapped up in the same diagnosis.”
Here are some symptoms that can indicate you have high levels of DHEA:
Oily Skin and Acne
Oily skin and the acne that often comes with it don’t, on their own, mean you have an excess of DHEA. But they can provide a clue. That’s especially true if the symptoms come on suddenly and are accompanied by some of the other symptoms of high DHEA levels (see below). A study in the European Journal of Obstetrics & Gynecology and Reproductive Biology documented higher androgen levels — including DHEA-S — in 72 percent of 207 women tested who were suffering from acne 8.
Some cases of acne can be treated with hormonal medications. Others respond to treatments involving benzoyl peroxide, retinoids and/or salicylic acid, according to the American Academy of Dermatology.
Excessive Hair Growth
Also called hirsutism, this excessive hair growth would be most noticeable on your face. “When we see high levels of DHEA in women, it can cause hair overgrowth," says Dr. Kudesia. "You might get extra facial or body hair in male patterns.”
Shaving, plucking and waxing may not be enough to control the excess hair growth. However, taking medication to suppress androgens and/or permanently removing the hair via electrolysis or pulse-light therapy may be effective, according to an article in The Journal of Clinical Endocrinology & Metabolism. Oral contraceptives might also help.
Female Pattern Baldness
Also called androgenic alopecia, female pattern hair loss can be a result of higher levels of DHEA and testosterone. According to the American Academy of Dermatology, this type of balding usually starts with the area around the center part. It may or may not progress to general thinning of your hair.
A Deeper Voice
Some women with high DHEA levels have their voices deepen, another classically male characteristic. (In growing boys, testosterone makes the vocal cords both longer and thicker, lending them the deeper tone.)
Irregular or Missed Periods
Missed periods, unpredictable periods or even no periods at all can be another sign of elevated DHEA levels. Missed periods are also characteristic of women with PCOS, and can be a factor in infertility.
In women with PCOS who don’t want to get pregnant, oral contraception that contains both estrogen and progestin can not only even out irregular periods, but also reduce unwanted hair growth and acne by toning down levels of androgens, according to the American College of Obstetricians and Gynecologists 511.
“Having high androgen levels is one of the diagnostic criteria for PCOS,” says Dr. Kudesia. Excessive levels of DHEA can produce a constellation of characteristically masculine characteristics in women, though not everyone will have the same combination. “When we see high levels of DHEA in women, it can cause hair overgrowth," says Dr. Kudesia.
- Rashmi Kudesia, MD, reproductive endocrinology and infertility specialist, Houston Methodist
- University of Rochester Medical Center: “Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate.”
- Society for Endocrinology: “Dehydroepiandrosterone.”
- Mount Sinai: “DHEA-sulfate test.”
- U.S. Department of Health and Human Services: “Polycystic ovary syndrome.”
- Best Practice & Research Clinical Obstetrics and Gynaecology: “Androgen excess: Investigations and management.”
- Clinics in Dermatology: “Hormonal therapies for acne.”
- European Journal of Obstetrics & Gynecology and Reproductive Biology: “Is acne a sign of androgen excess disorder or not?”
- The Journal of Clinical Endocrinology & Metabolism: “Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline.”
- Penn State News: “Probing Question: Why do men have deep voices?”
- American College of Obstetricians and Gynecologists: “Polycystic Ovary Syndrome.”
- Mayo Clinic: “DHEA.”