DHT Levels by Age: What to Expect at Each Life Stage

Dihydrotestosterone, or DHT, is an androgen, a type of hormone that stimulates the development of male characteristics. It is derived from testosterone through the action of an enzyme called 5-alpha-reductase. This conversion happens in tissues such as the skin, liver, prostate, and hair follicles. While only about 5 to 7% of testosterone is converted into DHT, it is a potent hormone that plays a distinct role in the body throughout a person’s life.

DHT Levels in Infancy and Childhood

The influence of DHT begins before birth, where it is instrumental in the development of male external genitalia. In male infants, a surge of hormones often called “mini-puberty” occurs within the first few months of life, leading to a temporary increase in testosterone and consequently DHT. Following this neonatal phase, DHT levels in both boys and girls decrease significantly and remain low throughout childhood.

The binding of DHT to a protein in the blood called sex hormone-binding globulin (SHBG) is highest in young males between 6 months and 2 years of age, at about 90%. This high level of binding reduces the amount of free, active DHT available to tissues. As childhood progresses, the concentration of SHBG gradually declines.

DHT Levels During Puberty

Puberty marks an increase in the production of testosterone and a surge in DHT levels, particularly in males. This rise in DHT is a primary driver for the development of many secondary sexual characteristics. These changes include the growth of facial hair and body hair on the chest, limbs, and in the pubic area. The voice also deepens as the larynx grows in response to androgens like DHT.

The hormone also stimulates the prostate gland, causing it to develop and grow. Sebum production in the skin increases under the influence of DHT, which can lead to the development of acne. In females, DHT levels also rise during puberty but remain much lower than in males. Sourced from the adrenal glands and ovaries, DHT in females contributes to the growth of pubic and underarm hair.

DHT Levels in Adulthood

In adulthood, DHT levels stabilize, though they are substantially different between sexes. For adult men, DHT is most commonly associated with two conditions that can arise in adulthood: male pattern baldness (androgenetic alopecia) and benign prostatic hyperplasia (BPH), which is an enlargement of the prostate gland. Even if testosterone levels begin to decline with age, local production of DHT in hair follicles and the prostate can remain significant, leading to these effects.

For adult women, DHT levels are normally low. In premenopausal women, circulating DHT levels are about one-tenth of the concentration of testosterone. In conditions such as Polycystic Ovary Syndrome (PCOS), elevated androgen levels, including DHT, can contribute to symptoms like excess hair growth (hirsutism) and acne.

DHT Levels and Aging

As men age, their DHT levels tend to decrease, though not always in a linear fashion. One study noted a significant decline in men between 80-89 years old compared to those aged 30-39. Another large study of men aged 40 to 70 found that DHT levels tended to remain constant while testosterone levels dropped. The prevalence of BPH and male pattern hair loss often increases with age, reflecting the long-term exposure of these tissues to the hormone.

In women, the hormonal landscape shifts after menopause. As estrogen production declines, the balance between estrogens and androgens can change, potentially increasing the relative influence of androgens. While total DHT levels in postmenopausal women are lower than in premenopausal women, this relative change in hormone ratios can have noticeable effects.