DHEA-S: The Overlooked Hormone That Could Explain Your Fatigue, Hormonal Imbalance, or Fertility Struggles
- levilla3
- Apr 17
- 2 min read
When it comes to hormones, we often hear about estrogen, progesterone, and testosterone. But another player deserves attention—DHEA-S, or dehydroepiandrosterone sulfate.
What Is DHEA-S?
DHEA-S is the sulfated, more stable form of DHEA (dehydroepiandrosterone)—a hormone produced primarily by your adrenal glands and, to a lesser extent, by the ovaries and testes. DHEA itself is a precursor, meaning your body can convert it into estrogen, testosterone, and other sex hormones as needed.
DHEA-S acts like a reservoir in the body. Because it's bound to a sulfate group, it stays in circulation longer, making it a reliable marker for assessing long-term adrenal androgen production.
How Is DHEA-S Made?
The process begins in the adrenal cortex, where cholesterol is converted into pregnenolone, which then follows one of several hormone pathways. When routed through the androgenic pathway, pregnenolone converts to DHEA, and from there, DHEA is sulfated (via the enzyme SULT2A1) to become DHEA-S.
Most of the DHEA in circulation is in the sulfated form—around 80–90%—which is why it's often measured in blood tests to assess androgen levels and adrenal function (1).
Why Is DHEA-S Important?
DHEA-S plays a role in:
Adrenal function and stress response
Sex hormone balance (especially estrogen and testosterone)
Mood and cognitive function
Immune regulation
Bone density and aging
Because DHEA-S levels naturally decline with age (peaking in the mid-20s), it's often discussed in the context of healthy aging and vitality (2).
Symptoms of Low DHEA-S
Deficiency may be due to adrenal insufficiency, chronic stress, aging, or certain autoimmune or pituitary disorders.
Common symptoms include:
Chronic fatigue
Low libido
Depressed mood or anxiety
Decreased muscle mass
Hormonal imbalance (e.g., irregular cycles, low estrogen/testosterone)
Weakened immune response
Symptoms of High DHEA-S
Elevated levels are often associated with excess androgen production, most commonly in polycystic ovary syndrome (PCOS) or, in rare cases, adrenal tumors.
Symptoms of excess may include:
Acne
Oily skin
Hair thinning or excess hair growth (hirsutism)
Irregular periods
Fertility challenges
Aggression or mood swings
When Should You Test DHEA-S?
DHEA-S is a valuable lab to consider if you are experiencing:
Signs of adrenal dysfunction
Symptoms of androgen imbalance (too high or too low)
Suspected PCOS or fertility issues
Chronic stress, burnout, or suspected HPA axis dysfunction
Unexplained fatigue or low mood
Because DHEA-S has a longer half-life than DHEA, it provides a more stable snapshot of hormone production and is generally preferred for testing (3).
Final Thoughts
Work with a qualified provider who can assess your full hormone picture and help you understand whether supplementation or lifestyle changes are appropriate. Whether you're navigating fertility issues, hormonal symptoms, or chronic fatigue, testing DHEA-S can be an important step in uncovering the root cause.
References
Labrie F. DHEA and the intracrine formation of androgens and estrogens in peripheral target tissues: its role during aging. Steroids. 1998 Jun;63(5-6):322–8. PubMed ID: 9699700
Morales AJ et al. Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. J Clin Endocrinol Metab. 1994;78(6):1360–7. PubMed ID: 8200927
Arlt W. Dehydroepiandrosterone and ageing. Best Pract Res Clin Endocrinol Metab. 2004;18(3):363–80. PubMed ID: 15157838
