What Are Signs of Elevated DHEA Hormone in Men?

Written By: Jillian Foglesong Stabile MD, FAAFP, DABOM

Dehydroepiandrosterone (DHEA) is a steroid hormone that affects a wide range of functions in your body. When DHEA levels are abnormal, you may experience several symptoms that can impact your quality of life. You may be wondering, what are the signs of elevated DHEA hormone in men?

What Does Elevated DHEA Mean for Men?

Whether DHEA levels are high or low, it can make you feel unwell. An elevated DHEA can be a sign of a congenital condition, a tumor, or an overgrowth of the hormone-producing tissues in the adrenal glands. [9] An elevated DHEA is usually an indication to consider further testing in order to determine the cause of the lab abnormality.

Higher levels of DHEA and testosterone can have positive effects on overall health. Elevated DHEA and testosterone levels have been associated with improved cardiovascular risks in elderly men, and studies in men who have been on prostate cancer therapies that decrease their testosterone levels have been associated with increased cardiovascular risk, though the mechanism for why this occurs is not well understood. [10] That being said, it is possible for DHEA levels to be too high.

Symptoms of Elevated DHEA in Men

DHEA imbalance in men can cause a number of symptoms. Many men and people assigned male at birth (AMAB) can develop symptoms of elevated estrogen levels. Some of the symptoms of elevated DHEA in men include [9]:

• Low sex drive
• Difficulty getting or maintaining an erection (erectile dysfunction)
• Low energy levels
• Decreased strength or muscle mass
• Aching in joints
• Decreased mental function
• Decreased bone density
• Increased cardiovascular risk
• Breast tissue growth
• Elevated blood pressure
• Changes in cholesterol balance
• Acne
• Premature puberty

These symptoms are often associated with other conditions, so if you are experiencing any of them, it is important to consider talking with your healthcare provider to determine if elevated DHEA hormone levels are to blame or if there are other causes for your symptoms.

Causes of Elevated DHEA in Men

Supplements

The most common cause of elevated DHEA levels is supplement use. DHEA supplements are used because their advocates report them to improve energy levels, increase sex drive, improve mood, improve sleep, increase muscle volume and strength, decrease fat, reverse aging, improve brain function, and lower cholesterol. [10] The United States Food and Drug Administration (FDA) does not regulate supplements, so DHEA is not approved for a specific medical indication. There are limited studies to support most of the claims regarding the purported benefits of DHEA. Athletes often use DHEA to try to improve their sports performance, but this is considered a performance-enhancing drug and is banned by many professional athletic organizations.[10]

Adrenal Tumors

Adrenal tumors are a rare cause of elevated DHEA, but when they occur, the DHEA levels are usually very high. Adrenal tumors may be benign or cancerous. [11]

Congenital Adrenal Hyperplasia

DHEA elevations may occur in congenital adrenal hyperplasia. This is a group of genetic conditions where a gene change affects an enzyme that the adrenal gland uses to produce hormones. Congenital adrenal hyperplasia has two primary forms. Classic congenital adrenal hyperplasia can cause abnormal external genitalia and androgen levels, including DHEA. This condition is usually diagnosed shortly after birth. Nonclassic congenital adrenal hyperplasia presents more often in late childhood or early adulthood. [12] This form of the disease causes early puberty, menstrual period irregularity, and some of the other symptoms associated with elevated DHEA levels.

Precocious Puberty

If DHEA or DHEAS levels are elevated, early puberty may result. Puberty is considered early in boys if symptoms start before age 9. The symptoms of precocious puberty in boys include acne, oily skin and hair, body odor, pubic hair, and hair under the armpits. Precocious puberty can cause advanced bone age on imaging. This condition is caused by genetic abnormalities in the hypothalamic-pituitary-adrenal axis. [13]

Stress

DHEA is being evaluated by researchers as a marker of acute stress. According to a 2021 meta-analysis in Frontiers in Psychiatry, DHEA levels elevated during acute stress, peak towards the end of the stressful event, and gradually return to their normal prestress level. These changes are generally more pronounced in women and people AFAB, young people, and people with obesity. [14] On the other hand, while acute stress is associated with elevated levels of DHEA, chronic stress is associated with low levels of DHEA. [15]

Obesity

Obesity is generally associated with lower levels of DHEA in both men and women. However, in children under seven, obesity is associated with elevated levels of DHEA. [16,17] This may result in precocious puberty. The reason for this relationship is unknown.[17]

Medications

In addition to DHEA supplements, there are many medications that can lead to elevated DHEA levels in the blood. Some of these include [18]:

• Alprazolam
• Heart medications such as amlodipine, nifedipine, and diltiazem
• Stimulants like methylphenidate
• Hormone blockers such as anastrozole
• Vitamin D3

This list is just a small sampling of the medications that can affect the DHEA levels in your body. You should talk to your healthcare provider or pharmacist about all the medications you are taking if you are concerned about how your medications may affect your DHEA levels (or any other medical condition).

The Role of DHEA in the Body

DHEA is produced in your adrenal glands, which are small endocrine glands that live on top of your kidneys. Specifically, DHEA is produced in the zona reticularis region of the adrenal gland. [1] DHEA affects many body systems. Some of the many roles that DHEA plays include [1-5]:

• Lengthening of the vocal cords during puberty
• Development of sperm
• Promotion of facial and chest hair growth
• Precursor hormone to androgen and estrogens (male and female sex hormones)
• Improving insulin sensitivity
• Aiding in memory and brain function
• Decreasing inflammation
• Menstrual regulation
• Improving sexual function and libido
• Red blood cell production
• Bone metabolism

DHEA levels naturally decrease with age, and low levels are associated with lower levels of physical function as well as decreased vitality. They are also associated with increased mortality from any cause and cardiovascular mortality specifically. [6]

A 2020 review study published in Experimental Gerontology showed that testosterone levels did increase in response to DHEA supplementation, though the response was higher in females, younger people, and people without chronic diseases. [7]

DHEA comes in two forms. DHEA is a weak androgen hormone that is primarily used to make other hormones. DHEAS, the sulfated form of DHEA, is specific for the adrenal glands. The relative levels of DHEA to testosterone can be used to determine where overproduction occurs such as in the case of tumors. [8]

Treatment Options for Elevated DHEA

Managing elevated DHEA in men is usually centered around identifying the underlying cause of the elevation and correcting that condition. Lifestyle modifications such as diet and exercise can help with maintaining healthy levels of DHEA. [18] Since acute stress can increase DHEA levels, managing stress is also potentially beneficial. [19]

If your DHEA levels are elevated and you are taking any medications or supplements that could be a contributing factor, discuss it with your healthcare provider before stopping them. If you are taking DHEA supplements that are not prescribed, stop them immediately.

Medications used to treat elevated DHEA levels include steroids, spironolactone, and anti-androgen medications such as those used to treat prostate cancer. [20]

Adrenal tumors are generally treated with surgery. [21]

Your Hormonal Health from Home With Everlywell

If you’re experiencing symptoms of elevated DHEA or other signs of hormonal imbalance, Everlywell is here to help. Our certified healthcare providers can guide you in your healthcare journey with a virtual visit from the comfort of home. Hormone imbalances can cause a number of symptoms and can be difficult to tease out. This makes guidance from a healthcare provider that much more important.

At Everlywell, we also have a range of lab options that you can take at home. This includes our Men’s Health Test, which looks at four key biomarkers, including DHEA and testosterone. This test can be completed with a simple saliva sample. Take control of your hormonal health and let Everlywell be your partner in your healthcare journey.

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