Dehydroepiandrosterone (DHEA) and its sulfated form, DHEA-S, are the most abundant circulating steroid hormones in the human body. Produced primarily by the adrenal glands, DHEA acts as a precursor that the body converts into more potent sex hormones like testosterone and estrogen. When DHEA levels become elevated in women, it often signals an overproduction of androgens, which can lead to a range of noticeable physical symptoms. Addressing this imbalance requires identifying the root cause and implementing a comprehensive strategy, ideally in consultation with a healthcare provider for accurate diagnosis and a personalized treatment plan.
Identifying High DHEA Levels
Elevated DHEA is typically diagnosed through a blood test measuring DHEA-S, the more stable and prevalent form of the hormone in circulation. Since DHEA-S levels do not fluctuate significantly throughout the day, a single blood draw is usually sufficient to assess adrenal androgen output. High levels often result in symptoms associated with androgen excess, collectively known as hyperandrogenism. Common physical signs include hirsutism (the growth of coarse, dark hair in a male-like pattern), cystic acne, androgenic alopecia (male-pattern hair thinning), and menstrual irregularities. Identifying the underlying cause is paramount, as elevated DHEA-S can signal Polycystic Ovary Syndrome (PCOS), non-classical Congenital Adrenal Hyperplasia (CAH), or, rarely, an adrenal tumor.
Daily Habits and Dietary Strategies
Targeting lifestyle factors is often the first step in managing high DHEA levels, especially when linked to conditions like PCOS involving insulin resistance. Improving insulin sensitivity helps reduce androgen production, since high insulin levels signal the ovaries and adrenal glands to create more androgens. This is achieved by prioritizing a low-glycemic diet that limits refined sugars and high-glycemic carbohydrates.
Focusing on whole foods, lean proteins, and healthy fats helps stabilize blood sugar and prevents spikes that contribute to hormonal imbalance. Incorporating fiber-rich foods, such as vegetables and flaxseeds, supports hormone metabolism and elimination. Maintaining a healthy body weight through balanced nutrition is also supportive, since excess adipose tissue can contribute to hormonal dysfunction.
Stress management plays a relevant role, as the adrenal glands produce both DHEA and cortisol, the primary stress hormone. Chronic stress can increase the adrenal burden, sometimes leading to DHEA overproduction as a byproduct of the stress response. Techniques such as consistent sleep hygiene, mindfulness meditation, and deep breathing exercises help modulate the body’s stress axis.
Regular physical activity is beneficial because it directly improves insulin sensitivity and helps maintain a healthy weight. However, the type of exercise matters; excessive, high-intensity cardio can sometimes increase cortisol, potentially counteracting efforts to lower DHEA. Instead, consistent, moderate activities like brisk walking, yoga, and resistance training are recommended for their hormone-balancing effects.
Targeted Nutritional and Herbal Support
Certain nutritional compounds and botanicals have shown promise in modulating androgen levels or supporting the metabolic issues driving DHEA elevation. Supplements that improve insulin sensitivity are frequently used, such as Myo-Inositol, often combined with D-chiro-inositol in a 40:1 ratio. This combination supports healthy insulin levels, which can indirectly lead to reduced androgen production. Chromium is another mineral that assists in glucose metabolism and may contribute to better insulin function.
Specific herbal remedies are sometimes used for their anti-androgen properties, though they should always be discussed with a healthcare provider due to potential interactions. Drinking spearmint tea twice daily has demonstrated a mild anti-androgen effect, potentially helping to reduce symptoms like hirsutism. Zinc is an important mineral that can inhibit the enzyme responsible for converting testosterone into its more potent form, dihydrotestosterone (DHT), reducing the overall androgenic effect.
Adaptogenic herbs, such as Ashwagandha or Rhodiola, are sometimes utilized to support the adrenal glands and help the body adapt to stress. Since stress can contribute to DHEA overproduction, supporting adrenal function may help restore balance. These natural approaches are intended to complement medical treatment, not replace it, and quality and dosage can vary widely.
Prescription and Clinical Treatments
When lifestyle measures and targeted nutritional support are insufficient, or when the DHEA elevation is severe, medical intervention is necessary to address the root cause. Treatment is highly dependent on the underlying diagnosis, such as PCOS, CAH, or an adrenal tumor.
Anti-androgen medications, such as spironolactone, are commonly prescribed to manage the symptoms of high DHEA. Spironolactone works primarily by blocking androgen receptors in the skin and hair follicles, which lessens the effects of androgens like acne and excessive hair growth. Dosage is typically individualized and requires regular monitoring by a physician.
Oral contraceptives containing both estrogen and progestin are a frequent treatment, particularly for women with PCOS who also need contraception. These medications work by suppressing the production of ovarian and adrenal androgens. They also increase sex hormone-binding globulin (SHBG), a protein that binds up free androgens in the bloodstream, effectively reducing their biological activity.
In specific cases, such as non-classical Congenital Adrenal Hyperplasia, low doses of glucocorticoids like dexamethasone may be prescribed. This medication suppresses hormone production by the adrenal gland, directly reducing the excessive output of DHEA. If a rare cause like an adrenal tumor is identified, surgical removal is typically the definitive treatment option to quickly normalize hormone levels.