DHEA analysis in men and women: steps, uses, and how to read the results

Have you ever noticed unexplained changes in your body such as increased body hair, acne, or persistent fatigue? Or are you wondering about the causes of irregular menstrual cycles or puberty-related disorders in children? In many cases, the answer lies in Dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands that plays a crucial role in the production of sex hormones such as testosterone and estrogen.In this Dalily Medical article, we provide a complete guide to the DHEA blood test, including the reasons for performing the test, how it is done, normal reference values, causes of high or low levels, and how to accurately interpret the results. We also highlight important medical advice for individuals who may be at higher risk of hormonal imbalances.Whether you are seeking reliable medical information or trying to better understand your hormonal health, this comprehensive guide will help you fully understand the DHEA test and its importance.

What Is the DHEA Test?

The DHEA test measures the level of Dehydroepiandrosterone in the blood. DHEA is a hormone produced mainly by the adrenal glands and plays an important role in the production of sex hormones such as testosterone and estrogen.

Difference Between DHEA and DHEA-S

Total DHEA: Measures the total amount of DHEA circulating in the blood.
DHEA-S (Dehydroepiandrosterone Sulfate): The sulfated form of DHEA, which is more stable in the bloodstream and provides a more accurate assessment of adrenal gland function.

When Is the DHEA Test Ordered?

Symptoms of excess androgens such as excessive hair growth, acne, or irregular menstrual cycles in women
Evaluation of early or delayed puberty in children and adolescents
Assessment of adrenal gland function
Monitoring conditions such as Polycystic Ovary Syndrome (PCOS) or other adrenal disorders

Does the Test Require Fasting?

Fasting is not usually required
The test is preferably performed in the morning, as DHEA-S levels are naturally higher and results are more accurate

Is the Test Painful?

The test is safe and simple, requiring only a venous blood sample
You may feel a brief needle prick or develop a small bruise, which usually resolves quickly

Normal Reference Ranges for DHEA

(Values may vary slightly depending on the laboratory)

Men: 80–560 µg/dL
Women: 35–430 µg/dL
Children: 10–50 µg/dL

Is the DHEA Test Safe During Pregnancy?

✔️ Yes, it is completely safe during pregnancy since it involves only a blood sample.
It may be requested when hormonal imbalance is suspected.

Does the Test Need to Be Repeated?

The need for repeat testing depends on the clinical condition, such as:

Monitoring hormonal therapy
Follow-up of adrenal gland disorders
Monitoring PCOS

Why Is the DHEA Test Performed?

To evaluate adrenal gland activity
To investigate causes of excessive hair growth, acne, or menstrual irregularities
To assess puberty disorders in children and adolescents

How Is the Test Performed?

A venous blood sample is collected
No fasting is required, but morning testing is recommended

Are the Results Accurate?

Most laboratories provide accurate results
Some medications or supplements may affect DHEA-S levels
Repeat testing may be required to confirm abnormal results

Interpretation of Results

High DHEA Levels May Indicate:

Adrenal gland overactivity or adrenal tumors
Polycystic Ovary Syndrome (PCOS)
Use of hormonal supplements or chronic stress

Low DHEA Levels May Indicate:

Adrenal insufficiency
Normal aging
Effects of medications such as corticosteroids or immunosuppressants

Symptoms Associated With DHEA Levels

High levels: Excessive hair growth, acne, menstrual irregularities, possible weight gain
Low levels: Fatigue, muscle weakness, low libido, reduced stress tolerance

Do DHEA Levels Change Over Time?

Yes. DHEA-S levels vary with:

Age
Menstrual cycle
Stress levels
Chronic illnesses

Is the Test Safe for All Age Groups?

✔️ Yes. It is safe for children, adults, and pregnant women.

When Should You See a Doctor After the Test?

Extremely high or low results
Persistent symptoms such as excessive hair growth, menstrual problems, or severe fatigue

Types of DHEA Tests and Their Uses

1. Total DHEA Test

Measures total circulating DHEA
Used to assess general hormone production and adrenal function

2. DHEA-S Test (Most Common)

Measures the stable sulfated form
Helps determine whether androgen excess originates from the adrenal glands or ovaries
Used in diagnosing adrenal disorders and PCOS

3. Free DHEA Test (Less Common)

Measures biologically active free DHEA
Used mainly in specialized or research settings

High-Risk Groups for Abnormal DHEA-S Levels

Women of Reproductive Age

High levels: PCOS, hirsutism, acne
Low levels: Long-term corticosteroid use

Children and Adolescents

High levels: Early puberty or adrenal hyperactivity
Low levels: Delayed puberty or adrenal insufficiency

Older Adults

Natural decline with age
Excessive decline may cause fatigue, muscle loss, and low libido

Patients With Adrenal or Pituitary Disorders

Adrenal tumors
Adrenal insufficiency

Medication Users

Corticosteroids, immunosuppressants, chemotherapy drugs, or hormonal supplements

Pregnant Women

Abnormal levels may affect hormonal balance
Testing is done when clinically indicated

Uses of the DHEA-S Test

Evaluation of adrenal gland disorders
Diagnosis of androgen excess
Assessment of infertility causes
Diagnosis and monitoring of PCOS
Monitoring hormonal treatments
Investigation of chronic fatigue and mood changes

What Is the DHEA-S Test?

The DHEA-S test measures the level of Dehydroepiandrosterone Sulfate in the blood. It is produced by the adrenal glands and contributes to the production of testosterone and estrogen.

Indications for the DHEA-S Test

1. Evaluation of Adrenal Disorders

Suspected adrenal hormone overproduction
Detection or monitoring of adrenal tumors

2. Diagnosis of Sex Hormone Disorders

In women: hirsutism, severe acne, menstrual irregularities, infertility evaluation
In children and adolescents: early or delayed puberty

Additional Uses of the DHEA-S Test

3️⃣ Diagnosis of Polycystic Ovary Syndrome (PCOS)

Elevated DHEA-S levels help differentiate the source of excess androgens, whether they originate from the ovaries or the adrenal glands.

4️⃣ Monitoring Hormonal Therapy

The test is used to evaluate a patient’s response to treatments related to:

Adrenal gland disorders
Polycystic Ovary Syndrome (PCOS)

5️⃣ Evaluation of Chronic Fatigue or Mood Disorders

Abnormal DHEA-S levels may be associated with:

Chronic fatigue
Mood disorders
Depression

6️⃣ As Part of a Comprehensive Hormonal Panel

DHEA-S testing is often included in a full hormonal evaluation to assess:

Adrenal gland function
Sex hormone balance

Causes of Low DHEA-S Levels

Low DHEA-S levels indicate reduced production of adrenal androgens and may be associated with:

1️⃣ Adrenal Insufficiency

Symptoms may include:

Severe fatigue
Muscle weakness
Weight loss
Low blood pressure
Dizziness

2️⃣ Chronic Diseases

Conditions such as:

Liver disease
Kidney disease
Chronic inflammatory disorders
may reduce DHEA-S production.

3️⃣ Aging

A natural decline in DHEA-S levels occurs after the age of 40 as part of normal hormonal aging.

4️⃣ Use of Immunosuppressive Drugs or Corticosteroids

Medications such as Prednisone or Hydrocortisone suppress adrenal hormone production.

5️⃣ Pituitary Gland Disorders

Pituitary dysfunction (e.g., low ACTH levels) can lead to reduced adrenal stimulation and lower DHEA-S levels.

⚠️ Note: Low levels do not always indicate a serious condition but require comprehensive medical evaluation.

How the DHEA-S Test Is Performed

1️⃣ Preparation Before the Test

Fasting is usually not required
Morning testing is preferred for optimal accuracy
Inform your doctor about all medications and supplements

2️⃣ Blood Sample Collection

A venous blood sample is drawn from the arm
Mild pain or a brief needle prick may be felt

3️⃣ Laboratory Processing

Blood serum is separated
A specific immunoassay is used to measure DHEA-S accurately

4️⃣ After the Test

No special care is required
Mild bruising or tenderness may occur at the puncture site

Risks of the DHEA-S Test

1️⃣ Direct and Minor Risks

Mild pain or discomfort at the needle site
Small bruise or discoloration
Dizziness or nausea (more common in fasting individuals or those afraid of needles)
Local infection (very rare)

2️⃣ Indirect Risks

Anxiety related to abnormal results, which may indicate:

Adrenal gland disorders
Sex hormone imbalances
Polycystic Ovary Syndrome in women

3️⃣ During Pregnancy

✔️ Completely safe, as it involves only a blood draw.

Tips to Minimize Discomfort

Before the Test

Stay well hydrated
Eat a light meal unless fasting is required
Wear comfortable clothing
Inform your doctor about medications and supplements

During Blood Draw

Sit or lie down to avoid dizziness
Relax your arm and breathe deeply

After Blood Draw

Apply pressure to the puncture site for several minutes
Keep the arm elevated briefly
Avoid heavy lifting immediately afterward
Seek medical advice if pain or redness lasts more than two days

Managing Dizziness

Sit or lie down until symptoms resolve
Drink water or light juice

DHEA-S Test Results

Normal Reference Ranges (µg/dL)

Men: 80–560
Women: 35–430
Children: 10–50

High DHEA-S Levels May Indicate:

Adrenal hyperactivity or adrenal tumors
Polycystic Ovary Syndrome (PCOS)
Hormonal supplements or chronic stress

Low DHEA-S Levels May Indicate:

Adrenal insufficiency
Normal aging
Effects of corticosteroids or immunosuppressive medications

⚠️ Important: Abnormal results are not always a sign of serious disease but require proper medical interpretation.

Normal DHEA-S Levels in Females by Age

Age Group	Normal Range (µg/dL)
18–19 years	145 – 395
20–29 years	65 – 380
30–39 years	45 – 270
40–49 years	32 – 240
50–59 years	26 – 200
60–69 years	13 – 130
Over 69 years	17 – 90