DHEA And Testosterone: Does It Help? What Studies Show

DHEA and testosterone are both androgens, but they sit at different points in the steroid production chain. DHEA (dehydroepiandrosterone) is a precursor hormone produced by the adrenal glands. The body converts it into testosterone, dihydrotestosterone (DHT), and estrogens in peripheral tissues. A 2020 meta-analysis of 42 randomized controlled trials found that oral DHEA supplementation was associated with a modest average increase in testosterone, though the effect was larger in women than in men (Li et al., 2020). Clinical guidelines don't recommend DHEA as a primary treatment for male hypogonadism (Bhasin et al., 2018).

For men concerned about low testosterone, DHEA's role is best understood as a precursor, not a replacement. A telehealth provider can assess whether DHEA-S levels, total testosterone, and related biomarkers point toward supplementation, prescription treatment, or both.

DHEA is the most abundant circulating steroid hormone in men (Papadopoulou-Marketou et al., 2023). Produced in the adrenal zona reticularis, its sulfated form (DHEA-S) peaks during the mid-20s and declines gradually after age 30, dropping substantially by later decades, though the rate varies between individuals. That decline runs parallel to the gradual testosterone decrease that begins around age 40 (Bhasin et al., 2018).

What Is DHEA and How Does the Body Use It?

DHEA acts as raw material for downstream hormone production. The adrenal glands produce it in response to adrenocorticotropic hormone (ACTH), and peripheral tissues convert it into active androgens and estrogens depending on local enzyme expression (Papadopoulou-Marketou et al., 2023). Circulating DHEA-S levels don't directly predict testosterone output in any given tissue.

DHEA is sold as an over-the-counter dietary supplement in the United States. It's not FDA-approved for any medical indication, including hypogonadism. Men exploring DHEA supplementation should understand that its regulatory status differs from prescription testosterone, a Schedule III controlled substance.

How Does DHEA Relate to Testosterone in Men?

In men, the testes produce approximately 95% of circulating testosterone (Bhasin et al., 2018). The adrenal glands contribute a small fraction through DHEA conversion, making the adrenal contribution to total testosterone modest under normal conditions.

This is the central reason DHEA supplementation doesn't substitute for testosterone replacement in men with diagnosed deficiency. A man whose provider confirms persistently low testosterone through repeated lab work (Mulhall et al., 2018) has a degree of deficiency a precursor supplement alone is unlikely to address. Interpreting lab values in the context of symptoms and history gives a clearer picture of what's driving those symptoms.

Does DHEA Supplementation Raise Testosterone in Men?

The short answer: modestly, and likely not enough to correct a clinically meaningful deficiency.

The Li et al. 2020 meta-analysis pooled 42 RCTs and reported a statistically detectable but clinically small average increase in testosterone after DHEA administration (Li et al., 2020). Even with supplementation, the modest increase is unlikely to move a man with confirmed low testosterone into a range his provider would consider sufficient. The effect was greater in women than men and more pronounced at higher doses.

Men with borderline testosterone and documented low DHEA-S may see a small upward shift, but the data don't support using DHEA as a standalone intervention for diagnosed deficiency. Prescription testosterone, under provider supervision with regular lab monitoring, remains the guideline-supported treatment for hypogonadism.

When Might a Provider Recommend DHEA Alongside TRT?

Some providers prescribe DHEA alongside testosterone replacement when lab work confirms low DHEA-S independent of the testosterone deficiency. This is a clinical decision based on individual biomarkers, not a standard part of every TRT protocol.

DHEA may also be considered when adrenal insufficiency reduces DHEA-S production alongside cortisol (Bhasin et al., 2018). Men on testosterone who also have low DHEA-S should discuss adding it with their prescribing provider, since DHEA can convert to estrogens as well as androgens. Provider-guided monitoring becomes relevant when adding a precursor that feeds multiple conversion pathways.

For men considering enclomiphene or other alternatives to direct testosterone replacement, DHEA's role is similarly limited. The full hormonal picture, assessed through individualized lab work a provider selects based on symptoms and history, determines the right approach.

Monitoring and Safety

Dosing in published DHEA research varied, and the appropriate amount for any individual depends on lab findings and provider guidance (Li et al., 2020). Short-term tolerability varies between individuals, and long-term safety is not well established. Without monitoring, DHEA use may alter hormonal balance in ways that differ between individuals, including acne, oily skin, or mood changes.

Men on TRT who add DHEA should work with their provider to monitor relevant blood markers, since both testosterone and DHEA-derived androgens may affect red blood cell production and other parameters. The 2025 FDA labeling update for testosterone products added blood pressure warnings based on TRAVERSE trial data (FDA, 2025; Lincoff et al., 2023). DHEA's own long-term safety profile in men is not well characterized in large trials, which is one more reason provider oversight matters.

DHEA and testosterone are connected through a real biochemical pathway, and DHEA supplementation can produce a small, measurable increase in circulating testosterone. That increase is not large enough to replace guideline-supported treatment for diagnosed hypogonadism. When DHEA-S is low and a provider determines supplementation is appropriate, DHEA may be considered on a case-by-case basis as part of an individualized, monitored care plan.

Disclaimer: This blog post is intended for informational purposes only and should not be considered medical advice. Always consult a healthcare professional before making changes to your health routine.

FAQ Section

Does DHEA supplementation increase testosterone in men?

A 2020 meta-analysis of 42 randomized controlled trials found that oral DHEA supplementation was associated with a modest average increase in testosterone. The effect was greater in women than in men and more pronounced at higher doses. That increase is statistically measurable but unlikely to correct a clinically meaningful testosterone deficiency on its own.

Can DHEA and testosterone be taken together?

Some providers prescribe DHEA alongside testosterone replacement when lab work confirms low DHEA-S independent of the testosterone deficiency. This is a clinical decision based on individual biomarkers, not a standard part of every protocol. Because DHEA converts to both androgens and estrogens, adding it to TRT requires provider-guided monitoring of relevant blood markers.

Is DHEA a replacement for testosterone therapy?

No. The Endocrine Society's 2018 guideline recommends testosterone therapy for men with confirmed hypogonadism, defined as symptoms along with lab-confirmed low testosterone evaluated through a process the treating provider determines. DHEA is not included in guideline recommendations for treating male hypogonadism and is classified as a dietary supplement, not a prescription medication.

What dose of DHEA is typically studied for testosterone support?

Dosing in published DHEA research varied across trials. The Li et al. 2020 meta-analysis found that higher doses produced a greater testosterone increase than lower doses. Long-term safety data remain limited, and the appropriate dose for any individual depends on lab findings, health history, and provider guidance.

How fast does DHEA-S decline with age?

DHEA-S peaks during the mid-20s and declines gradually after age 30, dropping substantially by later decades, though the pace varies based on individual health factors. This decline is one of the most consistent age-related hormonal changes observed across populations and parallels the gradual decline in testosterone.

Does DHEA have side effects in men?

Published short-term data suggest tolerability varies between individuals, and long-term safety is not well established. Without provider oversight, DHEA use may alter hormonal balance in ways that differ between individuals, including acne, oily skin, or mood changes. Because DHEA feeds multiple conversion pathways, men on testosterone replacement should follow a provider-guided monitoring schedule that includes appropriate blood work.

References

• Endotext (NCBI Bookshelf). Updated January 2023

• Exp Gerontol. 2020;141:111110

• FDA Drug Safety Communication, February 2025

• J Clin Endocrinol Metab. 2018;103(5):1715-1744

• J Urol. 2018;200(2):423-432

• N Engl J Med. 2023;389:107-117