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Longevity Library · Lab reference

Written by Daniel Tagge, MD
Updated October 10, 2026
Reviewed October 12, 2026
37 sources · Measured in µg/dL

System: Metabolism & Metabolomics

DHEA-SDehydroepiandrosterone sulfate · DHEA sulfate

DHEA-S is the sulfated storage form of the adrenal steroid DHEA, a precursor the tissues convert to androgens and estrogens rather than a hormone in its own right; it peaks in the twenties and falls by about 70 percent by the fifties, so every value must be read against age and sex. In older men, the lowest quarter of values kept company with higher mortality (hazard ratio about 1.5 in 2,644 Swedish men aged 69 to 81), with no gradient above that and no consistent signal in women; two years of DHEA that restored youthful levels in 144 older adults changed no measure of body composition, fitness, insulin sensitivity or quality of life; and no study defines an optimal DHEA-S inside the age range.

DHEA-S is the most abundant steroid in the blood and the one that falls most steeply with age. Laboratories print a range for each age band and sex, for example about 72 to 375 µg/dL in men and about 41 to 244 in women aged 45 to 54. Very low values point to adrenal failure or steroid medication, very high values to polycystic ovary syndrome, a supplement or an adrenal tumor, and in between the number mostly reports age. The literature is firm that restoring it with supplements did not change outcomes in older adults, and quiet about what, if anything, a higher natural value inside the range means.

01 · The scale

Where the laboratory range and the evidence sit.

Risk sat at the bottom, in older men, as an association. In 242 men aged 50 to 79 followed 12 years, a DHEA-S below 140 µg/dL went with 3.3 times the cardiovascular death rate; in 2,644 Swedish men aged 69 to 81, the lowest quarter had 1.54 times the all-cause mortality of the rest, with no cancer signal; in 963 men and 1,171 women aged 65 to 76, mortality was highest in the lowest quarter of men and did not differ across the upper three, and women showed nothing consistent; a 2025 meta-analysis of six cohorts found the top third of men had 0.72 times the mortality of the bottom third, with very low certainty, and no association in women. Two years of DHEA that returned 144 older adults to youthful levels changed no measure of body composition, strength, fitness, insulin sensitivity or quality of life, and a Mendelian randomization study found genetically higher DHEA-S associated with a shorter, not longer, lifespan in men.

0100200300400500

  1. Laboratory reference range, men aged 45 to 54 (one US national laboratory; the range is lower at every older age and higher at every younger one)

    72 to 375 µg/dL · LabCorp test 004020

  2. Laboratory reference range, women aged 45 to 54 (same laboratory)

    41 to 244 µg/dL · LabCorp test 004020

  3. Below about 25 with a morning cortisol under 5 µg/dL: adrenal insufficiency was found in 72 percent of those tested at one referral center

    0 to 25 µg/dL · Han 2025

  4. Below about 140 in men aged 50 to 79: 3.3 times the cardiovascular mortality in one 242-man cohort; the lowest quarter carried the risk in older men generally

    25 to 140 µg/dL · Barrett-Connor 1986; Ohlsson 2010; Trivedi 2001

  5. Above the lowest quarter in older men, mortality did not differ by quarter; no cohort finds a gradient inside the age range and no trial has tested one

    140 to 375 µg/dL · Trivedi 2001; Ohlsson 2010; Raeisi-Dehkordi 2025

  6. Above the laboratory upper limit for women aged 45 to 54: polycystic ovary syndrome, a DHEA supplement or an adrenal source are the questions

    244 to 375 µg/dL · Teede 2023; Carmina 2022; Fassnacht 2023

  7. Above the laboratory upper limit for men aged 45 to 54: a supplement, an assay question or an adrenal source; sex steroids and precursors are measured when an adrenal tumor is suspected

    375 and above µg/dL · Fassnacht 2023; Nair 2006

  • Laboratory range
  • Evidence supports
  • Guideline goal or unstudied
  • Higher risk in studies
Scale in µg/dL. Some laboratories report µmol/L; multiply µg/dL by about 0.0271 for µmol/L. Bands show where studies found something, not a recommendation for any one person.

02 · What it is

What DHEA-S measures.

The adrenal cortex has three layers, and the innermost one, the zona reticularis, makes DHEA and its sulfate DHEA-S, while the outer layers make aldosterone and cortisol. DHEA acts mainly by being converted to sex steroids in other tissues. In six people sampled every 20 minutes for 24 hours, DHEA and cortisol rose and fell in episodes together through the whole day, while DHEA-S, because it is both secreted and made by sulfation and has a long half-life, fluctuated much less; that stability is why the sulfate, not DHEA itself, is the test ordered.1,2,3Grade C

No other routinely measured hormone falls with age the way this one does. In a cross-sectional study of 981 men and 481 women aged 11 to 89, DHEA-S peaked at ages 20 to 24 in men (logarithmic mean 3,470 ng/mL, about 347 µg/dL) and 15 to 19 in women (2,470 ng/mL, about 247 µg/dL), then declined steadily to about 67 µg/dL in men and about 45 in women past 70, and was higher in men than women at every age from 20 to 69. In 97 men of the Baltimore Longitudinal Study of Aging sampled over an average of 13 years, 65 (67 percent) declined, 13 showed no change and 19 rose, and the wide differences between men could not be matched to any change in health or circumstances. In a Quebec series, serum DHEA had fallen by 74 percent in men and 70 percent in women between the 20-to-30 and 50-to-60 age groups, with most of the drop taking place before 60 and smaller changes after.4,5,6Grade B

Clinically the number is a readout of the adrenal gland and of the pituitary signal that drives it. A 2025 JAMA review lists an early-morning cortisol, ACTH and DHEA-S as the tests used to diagnose adrenal insufficiency: primary adrenal failure shows a low morning cortisol (below 5 µg/dL), a high ACTH and a low DHEA-S, while pituitary and glucocorticoid-induced forms show a low or intermediate cortisol with a low or low-normal DHEA-S. In 1,135 patients at one referral center who had a cosyntropin stimulation test, 195 (17.2 percent) had adrenal insufficiency; DHEA-S alone discriminated them about as well as a baseline cortisol (area under the curve 0.81 for each), only 1.3 percent of patients with a cortisol of 5 to 9.9 µg/dL and a DHEA-S of 60 µg/dL or more had the disease, and 72.2 percent of those with a cortisol under 5 and a DHEA-S under 25 µg/dL did.7,8Grade B

03 · Origins

Where it came from, and where it sits in the network.

Adrenarche, the childhood switching-on of adrenal DHEA-S production, is nearly a primate monopoly. When DHEA and DHEA-S were measured before and after sexual maturation across rodents, domestic animals and primates in 1978, mature rodents and farm animals ran a DHEA-S under 5 µg/dL; rhesus monkeys held about 357 µg/dL from birth to 3 years with no rise at puberty; and only the chimpanzee showed a human-like pattern, with DHEA-S 3.3-fold higher at ages 7 to 22 than at 0 to 3 and a rise in DHEA apparent at about 5 years, ahead of the gonadal steroids. Later reviews describe the secretion of large quantities of DHEA and DHEA-S as a phenomenon limited to humans and some nonhuman primates, occurring at three life stages (from the fetal zone before birth, from the newly formed zona reticularis at adrenarche, and in ever-decreasing amounts from that layer with aging), and dependent on cells that express the enzyme P450c17 with its partner cytochrome b5 and do not express 3-beta-hydroxysteroid dehydrogenase. The zona reticularis is a novel layer derived from the fetal adrenal and associated with primates generally; the chimpanzee is the closest model for human adrenarche.9,10,11Grade C

Why humans do this is a hypothesis, not a finding. The anthropologist Benjamin Campbell noted that DHEA-S rises from about age 6 into the mid-twenties in parallel with the maturation of the cerebral cortex, that DHEA-S acts at neuron receptor sites and affects mood, and proposed that it supports the extended brain development and long childhood of our species by increasing activity in the amygdala and hippocampus and promoting synapse formation in the cortex, with the timing in chimpanzees possibly similar; he states the full course in apes is not clear. The chemistry behind the sulfate is better understood: after synthesis, hydrophobic steroids are sulfated to speed their transit in the circulation, target cells take the sulfates up through organic anion-transporting polypeptides, and sulfatases inside the cell hydrolyze them back to the unconjugated, usually active, form. On this reading DHEA-S is a circulating reservoir rather than a hormone, and the measured number reports the size of the reservoir, not what any tissue is doing with it.11,12Grade C

In the network, DHEA-S is the largest pool of steroid precursor in the blood and is drawn down locally. Labrie's intracrinology work holds that in women androgens are made from circulating DHEA inside each peripheral tissue by cell-specific enzymes and inactivated in the same cells, that women synthesize roughly half as much androgen as men of the same age, and that in men around age 50 to 60 the testes and the adrenal DHEA pool supply roughly equal amounts of androgen; that is the sense in which a DHEA-S sits on the shelf beside Total testosterone (men) and SHBG. The same pituitary signal, ACTH, drives cortisol from the middle layer and DHEA from the inner one, which is why DHEA and cortisol pulse together and why a DHEA-S falls when the axis is chronically suppressed by steroid medication; yet the inner layer alone wastes with age. In 100 premenopausal and 100 postmenopausal women measured by mass spectrometry, DHEA-S was 2.8-fold higher before menopause than after, the adrenal-specific 11-oxygenated androgens did not fall at all, and the aged glands showed involution of the zona reticularis with blurring of its enzyme boundary, which is the anatomical face of the decline the cohorts chart.6,13,3,14,15Grade C

04 · The laboratory range

What a laboratory calls normal.

Age- and sex-specific; on one US national laboratory's immunoassay about 72 to 375 µg/dL in men and about 41 to 244 in women aged 45 to 54, about 164 to 531 and 110 to 432 at ages 20 to 24, and about 21 to 226 and 14 to 143 past 75.

The printed range is a table, not a number. One US national laboratory's electrochemiluminescence immunoassay prints, in µg/dL, about 164 to 531 for men and 110 to 432 for women aged 20 to 24; about 103 to 416 and 57 to 279 at 35 to 44; about 72 to 375 and 41 to 244 at 45 to 54; about 49 to 344 and 29 to 221 at 55 to 64; and about 21 to 226 and 14 to 143 at 75 and older. A value that is ordinary at 70 is low at 30, and a laboratory that prints a single adult range flattens that difference.16Grade C

Mass-spectrometry reference work agrees on the shape. In 525 volunteers aged 18 to 81 (293 women, 232 men) measured by liquid chromatography-tandem mass spectrometry, DHEA-S was 48 percent higher in men than women, the upper cutoff fell by 40 percent in women and 31 percent in men between ages 22 and 70, and the authors concluded that age-specific intervals, with attention to sex, were needed for it. In 1,423 Australian women aged 18 to 75, DHEA-S in the 595 free of confounding conditions declined steeply with age, more in the earlier decades than the later ones, and natural menopause itself had no independent effect on it in women aged 45 to 54.17,18Grade B

Guidelines treat the number with care for the same reason. The 2023 international polycystic ovary syndrome guideline allows DHEA-S as a second-line androgen when testosterone is not raised, while noting its poorer specificity and greater age-associated decrease, and asks for validated mass-spectrometry assays. The 2023 European adrenal incidentaloma guideline says plainly that age-adjusted DHEA-S reference values are not well established. The reference range is a distribution of people of a given age, not a map of risk, and nothing in it marks a healthier half.19,14Grade A

05 · The evidence

What the studies support.

The idea that DHEA-S predicts longevity began in Rancho Bernardo. Among 242 men aged 50 to 79 followed 12 years, a baseline DHEA-S below 140 µg/dL carried an age-adjusted relative risk of 3.3 for cardiovascular death and 3.2 for ischemic heart disease death in men with no history of heart disease, and each 100 µg/dL more DHEA-S went with 36 percent lower all-cause and 48 percent lower cardiovascular mortality after adjustment for blood pressure, cholesterol, obesity, glucose and smoking. The authors noted that a single measurement limited their conclusions. The cohort was small and the finding has been chased ever since.20Grade C

The best single cohort is MrOS Sweden: 2,644 men aged 69 to 81, DHEA and DHEA-S measured by mass spectrometry, 328 deaths over a mean 4.5 years. Men in the lowest quarter of DHEA-S had 1.54 times the all-cause mortality of the other three quarters after adjustment for cardiovascular risk factors (95 percent confidence interval 1.21 to 1.96), 1.61 times the cardiovascular mortality and 1.67 times the ischemic heart disease mortality, and no excess cancer mortality; the association held after adjustment for C-reactive protein, estradiol and testosterone, and was stronger in men under the median age of 75.4 (hazard ratio for cardiovascular death 2.64) than above it (1.30). The comparison is bottom quarter against the rest; the paper does not report a gradient within the upper three quarters.21Grade B

Other cohorts find the same shape or nothing. Among 963 men and 1,171 women aged 65 to 76 in Cambridgeshire followed to 296 deaths, all-cause and cardiovascular mortality were highest in the lowest DHEA-S quarter of men and did not differ significantly across the upper three quarters (adjusted relative risks 1.00, 0.66, 0.70 and 0.73 by rising quarter), while in women the quarters ran 1.00, 0.71, 0.97 and 1.14, with the highest rates in the highest quarter; the authors concluded there was no consistent relationship in older men and women. In 950 Americans aged 65 and older with DHEA-S measured three to six times, the level itself did not predict death (hazard ratio 0.97 per standard deviation) but a steep decline (1.75) and extreme variability (1.89) did, and people with both patterns died at 141 against 48 per 1,000 person-years; the authors read the trajectory, not the level, as the biological signal.22,23Grade B

Pooled, the association survives in men and not in women, with wide uncertainty. A 2020 meta-analysis of six prospective studies with 6,744 older people found the lowest DHEA-S category carried 1.46 times the all-cause mortality (1.25 to 1.70) and 1.49 times the cardiovascular mortality of the reference, significant in men (1.41) and not in women (1.72, interval crossing 1). A 2025 systematic review of sex hormones and mortality in 359,047 participants across 53 publications found the top third of DHEA-S in men had 0.72 times the all-cause mortality of the bottom third (0.57 to 0.91, six studies, heterogeneity 74 percent, certainty of evidence rated very low), no association in women (0.84, three studies) or in combined cohorts (0.90), and no association with cardiovascular death in men (0.76, five studies) or women (0.83, four studies). A low DHEA-S in an older man marks something; whether the hormone does anything is not shown by these designs.24,25Grade B

Genetics points the other way. A 2025 two-sample Mendelian randomization study used sex-specific genetic predictors of DHEA-S from 4,327 men and 3,501 women and tested them against parental lifespan in 415,311 fathers and 412,937 mothers of UK Biobank participants. Genetically higher DHEA-S was unrelated to lifespan in women (0.04 years per logged µmol/L, interval minus 0.50 to 0.58) and associated with a shorter lifespan in men (minus 1.15 years, minus 1.72 to minus 0.58), with higher systolic and diastolic blood pressure in men and possibly lower apolipoprotein B. The exposure sample is small and the method has its own assumptions, but it is the one design that is not confounded by the frailty that lowers DHEA-S, and it does not support the idea that more is better.26Grade C

The definitive supplementation trial was Nair's at the Mayo Clinic: 87 men aged 60 and older with low DHEA-S and bioavailable testosterone and 57 women with low DHEA-S, randomized to DHEA, testosterone (men only) or placebo for two years. DHEA raised DHEA-S by a median of 3.4 µg/mL (about 340 µg/dL) in men and 3.8 µg/mL (about 380) in women, to the levels of young adults. It had no significant effect on body composition, did not change peak oxygen consumption, muscle strength or insulin sensitivity, raised femoral neck bone density in men and ultradistal radius density in women by small amounts, and did not improve quality of life; the authors concluded that DHEA has no physiologically relevant benefit in elderly people. Restoring the number did not restore anything the number was supposed to mark.27Grade B

The other trials are smaller and point the same way. In the French DHEAge study, 280 healthy people aged 60 to 79 took 50 mg of DHEA or placebo daily for a year; DHEA-S returned to a young concentration, testosterone and estradiol rose a little, bone turnover improved only in women over 70, libido scores rose in those older women and skin hydration and thickness improved mainly in women, with no harmful accumulation; the authors wrote that it does not create supermen or superwomen. Across 23 randomized trials in 1,188 postmenopausal women with normal adrenal function, DHEA did not significantly improve libido or sexual function (standardized mean difference 0.35, interval minus 0.02 to 0.73) and did not change lipids, glucose, weight or bone density, with low confidence in the evidence. The Cochrane review of DHEA for cognition in healthy older people found three adequate trials, none showing benefit, and one showing worse visual memory recall after a stressor on DHEA; its authors concluded that what little controlled evidence exists does not support a benefit.28,29,30Grade B

The one group in whom DHEA has a measurable, if small, effect is women whose adrenal glands have failed. Across 10 randomized trials of women with primary or secondary adrenal insufficiency, DHEA improved health-related quality of life by an effect size of 0.21 (0.08 to 0.33) and depression slightly, with no significant effect on anxiety or sexual well-being; the authors called the improvement small and perhaps trivial and the evidence insufficient for routine use. An endocrinology review of the same era put it this way: there is convincing evidence for benefit in adrenal insufficiency, and in healthy elderly people the randomized trials do not justify DHEA, with no major benefit reported and the effect on sex-steroid-dependent tumor growth still to be considered. That is a treatment decision for a physician who knows the person's adrenal diagnosis, not a page.31,2Grade B

06 · What moves it

The levers with evidence behind them.

What is listed here has been tested. The size of each effect, and the size of the study, are in the sentence, so a small effect reads as a small effect.

  • Age

    lowers it steadily from the mid-twenties, by about 70 percent by the fifties

    The single largest determinant of a DHEA-S is the birth date on the requisition. Peak values in the early twenties fall to about a fifth by age 70 in the cross-sectional data, most of the loss happens between the twenties and the fifties, and in 950 people aged 65 and older the average further decline was about 0.013 µg/mL a year, about 1.3 µg/dL. Within a decade of age the differences between people are large, heritable and unexplained: in 97 men followed 13 years, nothing in their health or circumstances accounted for who ran high and who ran low.4,6,23,5Grade B

  • Smoking

    raises it modestly

    In 1,241 randomly sampled middle-aged US men, cigarette smokers had a DHEA-S 13 percent higher than nonsmokers, with DHEA 18 percent, androstenedione 33 percent and cortisol 5 percent higher, independent of age and body mass index. The adrenal steroids in those men were more influenced by smoking, age and weight than by anything in the diet. A higher DHEA-S in a smoker is not a point in the smoker's favor; it is a stimulated adrenal gland.32Grade C

  • Body fat

    lowers it modestly in men; runs higher with weight in women

    In 957 men and women from the Study of Health in Pomerania measured by mass spectrometry, body mass index and leptin were inversely associated with DHEA-S, androstenedione and testosterone in men and positively associated with all the sex hormones in women. The effect is small next to age, and the direction differs by sex, so weight does not move this number the way it moves testosterone or SHBG.33Grade C

  • Calorie restriction

    did not change it in the one human comparison

    In 24 men who had practiced calorie restriction with adequate nutrition for an average of 7.4 years, with body fat of about 8.7 percent against 23.2 percent in sedentary men eating a Western diet, total testosterone and the free androgen index were lower and SHBG higher than in both endurance runners and controls, while DHEA-S did not differ between the three groups. Whatever a lean, restricted life does to the gonadal axis, it left the adrenal precursor alone in this sample.34Grade C

  • Glucocorticoid medication and other suppression of the pituitary-adrenal axis

    lowers it, and can leave it low for a time after the medicine stops

    Steroid medicines in more than physiological doses suppress the pituitary signal that drives the adrenal cortex, and DHEA-S falls with it: the JAMA review lists a low or low-normal DHEA-S as typical of glucocorticoid-induced adrenal insufficiency, the European incidentaloma guideline notes that DHEA-S is decreased when the hypothalamic-pituitary-adrenal axis is chronically suppressed, and in the Mayo diagnostic series recent glucocorticoid use lowered the test's discriminating power (area under the curve 0.72 against 0.83). Opioids and other medicines that suppress ACTH act the same way. None of these should be stopped over a DHEA-S result; the number is a conversation with the prescriber.7,14,8Grade B

  • DHEA supplements

    raise it to youthful levels, and make the measurement a report on the dose

    Over-the-counter DHEA restores a young person's DHEA-S within weeks: 50 mg a day reestablished a young concentration in 280 people aged 60 to 79, and two years of DHEA raised the level by a median of about 340 µg/dL in men and 380 in women in the Mayo trial. After that the number no longer reports the adrenal gland. Anyone taking DHEA, including compounded or so-called bioidentical preparations, should say so before a DHEA-S is interpreted, and nothing on this page about natural levels applies to them.28,27Grade B

07 · Reading it well

Caveats, and what belongs with a physician.

The range depends on age and sex, and the method. The laboratory table above drops by roughly two thirds between the early twenties and old age, men run about half again higher than women on mass spectrometry, and a laboratory that prints a single adult range, or an immunoassay compared with a mass-spectrometry value, can move a result across a cutoff without the person changing. The polycystic ovary syndrome guideline asks for validated mass-spectrometry assays when DHEA-S is used for a diagnosis.16,17,19Grade B

One value is close to the person's level, which is unusual for a hormone. In 38 men sampled weekly for 10 weeks in the European Biological Variation Study, within-person variation of DHEA-S was 9 percent, against 22 percent for luteinizing hormone, with high individuality across the hormones studied; in four men sampled weekly, the coefficient of variation was 19 percent with no monthly, seasonal or annual rhythm; and in 783 middle-aged twin men, salivary DHEA-S was highest on waking and fell only slightly through the day, with heritability of 0.37 to 0.46. The hour of the draw matters little, a repeat usually agrees, and most of the difference between two people of the same age is inherited or unexplained rather than earned.35,4,36Grade B

In a woman, a high value is an adrenal androgen question before it is anything else. Among 648 hyperandrogenic women with polycystic ovary syndrome aged 20 to 29, DHEA-S was raised in 33 percent, more often in the nonclassic phenotypes, and the authors note that adrenal androgens fall by about 40 percent from the twenties to the thirties, so the age of the woman decides what counts as raised. The 2023 international guideline places DHEA-S second to testosterone in the workup because of its poorer specificity and steeper age decline.37,19Grade B

A very high value in anyone can come from an adrenal tumor. The European guideline on adrenal incidentalomas suggests measuring sex steroids and steroid precursors, which it lists as DHEA-S, androstenedione, 17-hydroxyprogesterone, 11-deoxycortisol and testosterone in women, in patients with clinical or imaging features suggestive of adrenocortical carcinoma, and asks that rapid virilization be addressed by measuring testosterone and the androgen precursors DHEA-S and androstenedione. A low value on the same imaging has its own meaning: some panelists use a low age-adjusted DHEA-S as a marker of mild autonomous cortisol secretion, because the axis is suppressed, while noting that age-adjusted reference values are not well established.14Grade A

A low value is a readout of the pituitary-adrenal axis, not a deficiency to be filled. Adrenal insufficiency presents with fatigue in 50 to 95 percent, nausea and vomiting in 20 to 62 percent, and loss of appetite and weight in 43 to 73 percent of patients, is rare in its primary and pituitary forms (fewer than 279 per million) and common in its glucocorticoid-induced form, and is diagnosed by a morning cortisol and ACTH with the DHEA-S beside them, confirmed where needed by a cosyntropin stimulation test. A low DHEA-S in a tired person is a reason to measure cortisol, not a reason to buy DHEA.7,8Grade B

The number is not the diagnosis, and the cohorts are not a target. The mortality associations come from men mostly past 65 and compare the lowest quarter with the rest; they say nothing about a 45-year-old in the middle of the age range, and the women's data are null or inverted. Nothing on this page applies to children, in whom DHEA-S is the marker of adrenarche and its timing, or to anyone taking DHEA, testosterone or a glucocorticoid, whose value reflects the medicine.22,21,9Grade B

See a physician

  • A DHEA-S well above the laboratory limit for your age and sex, particularly in a woman with new or rapidly progressing facial or body hair, acne, scalp hair thinning, a deepening voice or irregular or absent periods, which is the pattern that needs testosterone, androstenedione and an adrenal evaluation.
  • A DHEA-S above the age range in anyone with an adrenal mass found on a scan, or a very high value with no supplement to explain it, where the European guideline asks for sex steroids and precursors to be measured because an adrenocortical tumor is one of the causes.
  • A very low value, below about 25 µg/dL, together with fatigue, nausea, loss of appetite or weight, salt craving, lightheadedness on standing or low blood pressure, especially within months of stopping a steroid medicine (tablets, injections, high-dose inhalers or creams), which calls for an early-morning cortisol and ACTH.
  • A low value in a woman already diagnosed with adrenal insufficiency, for whom DHEA is a treatment the trials have studied with small effects on quality of life, and which is her endocrinologist's call.
  • Anyone taking DHEA, pregnenolone or a compounded hormone preparation, or considering one, who should hear before starting that the two-year trial in older adults found no benefit, that the hormone converts to testosterone and estrogen, and that its effect on hormone-sensitive tumors has not been settled.
  • A child with pubic or underarm hair, adult body odor or acne before about age 8, in whom DHEA-S is the marker of early adrenarche and belongs with a pediatrician.

This page is education, not individual medical advice, and reading it creates no physician-patient relationship.

08 · Open questions

What the literature does not settle.

  • No randomized trial has taken healthy adults in midlife whose DHEA-S sits in the lower half of their age range, raised it to the upper half and measured any outcome; the Mayo trial enrolled older adults with low values, restored youthful levels for two years and found nothing, so any optimal zone inside the age range is a judgment, not a tested goal.
  • The cohorts and the genetics disagree: low DHEA-S keeps company with mortality in older men, while genetically higher DHEA-S went with a shorter lifespan and higher blood pressure in men. Whether a low value is a cause, a marker of frailty and suppressed adrenal function, or both at different ages is unresolved.
  • Why the association appears in men and not in women, and why one women's cohort put the highest mortality in the highest quarter, has no settled explanation; ovarian and adrenal androgen sources, estrogen use and smaller study sizes are all candidates.
  • Whether the trajectory matters more than the level, as the Cardiovascular Health Study suggested, has not been tested prospectively, and no one knows what a steep individual decline or extreme variability is marking.
  • The adrenarche hypothesis, that DHEA-S supports the extended maturation of the human brain, is a proposal from comparative biology and remains untested in any design that could establish it.
  • In older women the adrenal 11-oxygenated androgens do not fall with age while DHEA-S does, and they correlate better with androgen action; which measurement should stand for adrenal androgen status after menopause is an open laboratory question.
  • Why between-person variation inside a decade of age is so wide and so heritable, and whether the set point carries information about aging that the age-adjusted percentile does not, is unknown.

10

Questions

11 · Sources

37 sources, read in full.

Numbered in the order they appear. Each line says what this page relies on from the paper; the link opens the record at PubMed or the publisher.

  1. 1.

    Rainey WE, Carr BR, Sasano H, Suzuki T, Mason JI. Dissecting human adrenal androgen production. Trends in Endocrinology and Metabolism. 2002. PMID 12128283. DOI 10.1016/s1043-2760(02)00609-4.

    Review · Within the adult adrenal, the zona glomerulosa produces aldosterone, the zona fasciculata cortisol and the zona reticularis both DHEA and DHEA-S; cytochrome b5, DHEA sulfotransferase and 3-beta-hydroxysteroid dehydrogenase regulate DHEA(S) production.

  2. 2.

    Arlt W. Dehydroepiandrosterone and ageing. Best Practice and Research: Clinical Endocrinology and Metabolism. 2004. PMID 15261843. DOI 10.1016/j.beem.2004.02.006.

    Review · DHEA is the major zona reticularis steroid and, unlike cortisol and aldosterone, declines with aging; it acts mainly by conversion to sex steroids; convincing benefit in adrenal insufficiency, while in healthy elderly people randomized trials do not justify its use and tumor-growth effects need consideration.

  3. 3.

    Rosenfeld RS, Rosenberg BJ, Fukushima DK, Hellman L. 24-Hour secretory pattern of dehydroisoandrosterone and dehydroisoandrosterone sulfate. Journal of Clinical Endocrinology and Metabolism. 1975. PMID 123927. DOI 10.1210/jcem-40-5-850.

    Laboratory method study · With 20-minute sampling over 24 hours in six subjects, DHEA and cortisol were episodic and synchronous through the day, while DHEA-S, because of its origin by secretion and sulfation and its long half-life, fluctuated less and was less synchronous.

  4. 4.

    Orentreich N, Brind JL, Rizer RL, Vogelman JH. Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood. Journal of Clinical Endocrinology and Metabolism. 1984. PMID 6235241. DOI 10.1210/jcem-59-3-551.

    Cross-sectional study · In 981 men and 481 women aged 11 to 89, DHEA-S peaked at 20 to 24 in men (log mean 3,470 ng/mL) and 15 to 19 in women (2,470 ng/mL), declined steadily to 670 and 450 ng/mL past 70, and was higher in men from 20 to 69; weekly sampling in four men showed a 19 percent coefficient of variation and no monthly, seasonal or annual rhythm.

  5. 5.

    Orentreich N, Brind JL, Vogelman JH, Andres R, Baldwin H. Long-term longitudinal measurements of plasma dehydroepiandrosterone sulfate in normal men. Journal of Clinical Endocrinology and Metabolism. 1992. PMID 1400863. DOI 10.1210/jcem.75.4.1400863.

    Prospective cohort · In 97 Baltimore Longitudinal Study of Aging men sampled over an average 13 years, DHEA-S declined in 65 (67 percent), was unchanged in 13 and rose in 19; the wide between-person variability could not be correlated with health or life circumstances.

  6. 6.

    Labrie F, Bélanger A, Cusan L, Gomez JL, Candas B. Marked decline in serum concentrations of adrenal C19 sex steroid precursors and conjugated androgen metabolites during aging. Journal of Clinical Endocrinology and Metabolism. 1997. PMID 9253307. DOI 10.1210/jcem.82.8.4160.

    Cross-sectional study · Serum DHEA fell 74 percent in men and 70 percent in women from the 20-to-30 peak to the 50-to-60 group, with most of the decline before 60; in women most androgens derive from peripheral conversion of DHEA and DHEA-S, and in men at 50 to 60 the testes and DHEA(S) contribute roughly equally.

  7. 7.

    Vaidya A, Findling J, Bancos I. Adrenal Insufficiency in Adults: A Review. JAMA. 2025. PMID 40522647. DOI 10.1001/jama.2025.5485.

    Review · Early-morning cortisol, ACTH and DHEA-S diagnose adrenal insufficiency; primary disease shows cortisol under 5 µg/dL, high ACTH and low DHEA-S, secondary and glucocorticoid-induced forms low or low-normal DHEA-S; symptoms include fatigue in 50 to 95 percent; primary and secondary forms affect fewer than 279 per million.

  8. 8.

    Han AJ, Suresh M, Gruber LM, Algeciras-Schimnich A, Achenbach SJ, Atkinson EJ, Bancos I. Performance of Dehydroepiandrosterone Sulfate and Baseline Cortisol in Assessing Adrenal Insufficiency. Journal of Clinical Endocrinology and Metabolism. 2025. PMID 39657727. DOI 10.1210/clinem/dgae855.

    Prospective cohort · Among 1,135 patients with cosyntropin testing, 195 (17.2 percent) had adrenal insufficiency; DHEA-S and baseline cortisol each had an area under the curve of 0.81; 1.3 percent with cortisol 5 to 9.9 µg/dL and DHEA-S of 60 or more had the disease, 72.2 percent with cortisol under 5 and DHEA-S under 25 did; recent glucocorticoid use lowered DHEA-S performance (0.72 versus 0.83).

  9. 9.

    Cutler GB Jr, Glenn M, Bush M, Hodgen GD, Graham CE, Loriaux DL. Adrenarche: a survey of rodents, domestic animals, and primates. Endocrinology. 1978. PMID 155005. DOI 10.1210/endo-103-6-2112.

    Laboratory method study · Mature rodents and domestic animals had DHEA-S under 5 µg/dL; rhesus monkeys aged 0 to 3 ran 357 µg/dL without a pubertal rise; chimpanzees showed 3.3-fold higher DHEA-S at 7 to 22 years than at 0 to 3, with the DHEA rise apparent at 5 years ahead of gonadal steroids; only the chimpanzee showed an adrenarche comparable to man.

  10. 10.

    Conley AJ, Pattison JC, Bird IM. Variations in adrenal androgen production among (nonhuman) primates. Seminars in Reproductive Medicine. 2004. PMID 15635499. DOI 10.1055/s-2004-861548.

    Review · Secretion of DHEA and DHEA-S is apparently unique to humans and nonhuman primates, occurring from the fetal zone, at adrenarche with the zona reticularis, and in declining amounts with aging; synthesis requires P450c17, its reductase and cytochrome b5 without 3-beta-HSD; DHEA-S is a reliable index of adrenal androgen secretion rate; chimpanzees are the best model for human adrenarche.

  11. 11.

    Campbell B. Adrenarche and the evolution of human life history. American Journal of Human Biology. 2006. PMID 16917887. DOI 10.1002/ajhb.20528.

    Review · The zona reticularis is a novel layer derived from the fetal adrenal and associated with primates; DHEA-S rises from about age 6 to the mid-20s in parallel with cortical maturation; the author proposes DHEA-S supports extended human brain maturation via amygdala, hippocampus and cortical synaptogenesis, and notes chimpanzee timing may be similar.

  12. 12.

    Mueller JW, Gilligan LC, Idkowiak J, Arlt W, Foster PA. The Regulation of Steroid Action by Sulfation and Desulfation. Endocrine Reviews. 2015. PMID 26213785. DOI 10.1210/er.2015-1036.

    Review · After biosynthesis, hydrophobic steroids are sulfated to expedite circulatory transit; target cells take up sulfated steroids through organic anion-transporting polypeptides and sulfatases hydrolyze them to their unconjugated, usually active, forms; dysregulation is linked to steroid-dependent cancers and polycystic ovary syndrome.

  13. 13.

    Labrie F, Martel C, Bélanger A, Pelletier G. Androgens in women are essentially made from DHEA in each peripheral tissue according to intracrinology. Journal of Steroid Biochemistry and Molecular Biology. 2017. PMID 28153489. DOI 10.1016/j.jsbmb.2016.12.007.

    Review · In women, intracellular androgens are made from circulating DHEA of mainly adrenal origin inside each peripheral tissue and inactivated in the same cells; women synthesize approximately 50 percent as much androgen as men of the same age; DHEA secretion has fallen by an average of 60 percent by menopause.

  14. 14.

    Fassnacht M, Tsagarakis S, Terzolo M, Tabarin A, Sahdev A, Newell-Price J, et al.. European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors. European Journal of Endocrinology. 2023. PMID 37318239. DOI 10.1093/ejendo/lvad066.

    Guideline · Suggests measuring sex steroids and precursors (DHEA-S, androstenedione, 17-hydroxyprogesterone, 11-deoxycortisol, testosterone in women) when features suggest adrenocortical carcinoma; rapid virilization calls for testosterone, DHEA(S) and androstenedione; DHEA-S is decreased when the HPA axis is chronically suppressed, and age-adjusted DHEA-S reference values are not well established.

  15. 15.

    Nanba AT, Rege J, Ren J, Auchus RJ, Rainey WE, Turcu AF. 11-Oxygenated C19 Steroids Do Not Decline With Age in Women. Journal of Clinical Endocrinology and Metabolism. 2019. PMID 30753518. DOI 10.1210/jc.2018-02527.

    Cross-sectional study · In 100 premenopausal and 100 postmenopausal women measured by LC-MS/MS, DHEA-S was 2.8-fold higher before menopause, while 11-oxygenated androgens did not decrease with age; aged adrenals showed involution of the zona reticularis with blurring of its enzyme zonation.

  16. 16.

    Labcorp. Dehydroepiandrosterone (DHEA) Sulfate, test 004020: reference interval by age and sex. Labcorp test menu. 2026.

    Laboratory method study · Electrochemiluminescence immunoassay reference intervals in µg/dL by age band: men 164.3 to 530.5 and women 110.0 to 431.7 at 20 to 24; 102.6 to 416.3 and 57.3 to 279.2 at 35 to 44; 71.6 to 375.4 and 41.2 to 243.7 at 45 to 54; 48.9 to 344.2 and 29.4 to 220.5 at 55 to 64; 20.8 to 226.4 and 13.9 to 142.8 at 75 and older.

  17. 17.

    Eisenhofer G, Peitzsch M, Kaden D, Langton K, Pamporaki C, Masjkur J, et al.. Reference intervals for plasma concentrations of adrenal steroids measured by LC-MS/MS: Impact of gender, age, oral contraceptives, body mass index and blood pressure status. Clinica Chimica Acta. 2017. PMID 28479316. DOI 10.1016/j.cca.2017.05.002.

    Laboratory method study · In 525 volunteers aged 18 to 81 (293 women, 232 men), DHEA-S was 48 percent higher in men than women, its upper cutoff fell 40 percent in women and 31 percent in men between ages 22 and 70, and age- and sex-specific reference intervals were judged necessary.

  18. 18.

    Davison SL, Bell R, Donath S, Montalto JG, Davis SR. Androgen levels in adult females: changes with age, menopause, and oophorectomy. Journal of Clinical Endocrinology and Metabolism. 2005. PMID 15827095. DOI 10.1210/jc.2005-0212.

    Cross-sectional study · In 1,423 community women aged 18 to 75 (reference group 595), DHEA-S declined steeply with age, more in the earlier decades, and menopausal status had no independent effect on androgen levels in women aged 45 to 54.

  19. 19.

    Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT, et al.; International PCOS Network. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Journal of Clinical Endocrinology and Metabolism. 2023. PMID 37580314. DOI 10.1210/clinem/dgad463.

    Guideline · If testosterone or free testosterone is not elevated, androstenedione and DHEA-S could be considered, noting their poorer specificity and the greater age-associated decrease in DHEA-S; laboratories should use validated LC-MS/MS assays for testosterone and, if needed, for androstenedione and DHEA-S.

  20. 20.

    Barrett-Connor E, Khaw KT, Yen SS. A prospective study of dehydroepiandrosterone sulfate, mortality, and cardiovascular disease. New England Journal of Medicine. 1986. PMID 2946952. DOI 10.1056/NEJM198612113152405.

    Prospective cohort · In 242 men aged 50 to 79 followed 12 years, DHEA-S below 140 µg/dL carried an age-adjusted relative risk of 3.3 for cardiovascular and 3.2 for ischemic heart disease death in men without prior heart disease; each 100 µg/dL more went with 36 percent lower all-cause and 48 percent lower cardiovascular mortality; a single determination limited the conclusions.

  21. 21.

    Ohlsson C, Labrie F, Barrett-Connor E, Karlsson MK, Ljunggren O, Vandenput L, Mellström D, Tivesten A. Low serum levels of dehydroepiandrosterone sulfate predict all-cause and cardiovascular mortality in elderly Swedish men. Journal of Clinical Endocrinology and Metabolism. 2010. PMID 20610590. DOI 10.1210/jc.2010-0760.

    Prospective cohort · In 2,644 men aged 69 to 81 (MrOS Sweden) with 328 deaths over a mean 4.5 years, the lowest DHEA-S quartile predicted all-cause (HR 1.54, 1.21 to 1.96), cardiovascular (1.61) and ischemic heart disease death (1.67) but not cancer, with a stronger association below the median age of 75.4 (HR 2.64 for cardiovascular death).

  22. 22.

    Trivedi DP, Khaw KT. Dehydroepiandrosterone sulfate and mortality in elderly men and women. Journal of Clinical Endocrinology and Metabolism. 2001. PMID 11549645. DOI 10.1210/jcem.86.9.7838.

    Prospective cohort · In 963 men and 1,171 women aged 65 to 76 with 296 deaths, mortality was highest in the lowest DHEA-S quartile of men and did not differ across the upper three (adjusted relative risks 1.00, 0.66, 0.70, 0.73); in women the quartiles ran 1.00, 0.71, 0.97, 1.14 with the highest rates in the highest quartile; no consistent relationship overall.

  23. 23.

    Cappola AR, O'Meara ES, Guo W, Bartz TM, Fried LP, Newman AB. Trajectories of dehydroepiandrosterone sulfate predict mortality in older adults: the cardiovascular health study. Journals of Gerontology Series A. 2009. PMID 19713299. DOI 10.1093/gerona/glp129.

    Prospective cohort · In 950 adults aged 65 and older with three to six DHEA-S measurements, the average decline was 0.013 µg/mL a year; steep decline (HR 1.75) and extreme variability (1.89) predicted death while baseline level did not (0.97 per SD); both patterns together gave 141 versus 48 deaths per 1,000 person-years.

  24. 24.

    Li R, E L, Zha N. Circulating dehydroepiandrosterone sulfate level and cardiovascular or all-cause mortality in the elderly population: a meta-analysis. Annals of Palliative Medicine. 2020. PMID 32921089. DOI 10.21037/apm-20-441.

    Systematic review and meta-analysis · Across six prospective studies of 6,744 older people, the lowest DHEA-S level carried pooled relative risks of 1.46 (1.25 to 1.70) for all-cause and 1.49 (1.11 to 1.99) for cardiovascular mortality; significant in men (1.41) but not women (1.72, 0.99 to 2.99).

  25. 25.

    Raeisi-Dehkordi H, Amiri M, Beigrezaei S, Quezada-Pinedo HG, Khatami F, Alijla F, et al.. Endogenous Sex Steroid Hormones, Sex Hormone-Binding Globulin, and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Journal of Clinical Endocrinology and Metabolism. 2025. PMID 40333346. DOI 10.1210/clinem/dgaf262.

    Systematic review and meta-analysis · Across 53 publications with 359,047 participants, the top versus bottom third of DHEA-S in men had HR 0.72 (0.57 to 0.91, six studies, I² 74 percent, very low certainty) for all-cause mortality, with no association in women (0.84, three studies), in combined cohorts (0.90), or with cardiovascular death in men (0.76) or women (0.83).

  26. 26.

    Schooling CM, Zhao JV. Dehydroepiandrosterone sulfate on lifespan in men and women using Mendelian randomization. Nutrition, Metabolism and Cardiovascular Diseases. 2025. PMID 40450423. DOI 10.1016/j.numecd.2025.104128.

    Mendelian randomization · Using sex-specific DHEA-S genetics from 4,327 men and 3,501 women against parental attained age in 415,311 fathers and 412,937 mothers, DHEA-S was unrelated to lifespan in women (0.04 years per logged µmol/L) and associated with shorter lifespan in men (minus 1.15 years, minus 1.72 to minus 0.58), with higher blood pressure in men and possibly lower ApoB.

  27. 27.

    Nair KS, Rizza RA, O'Brien P, Dhatariya K, Short KR, Nehra A, et al.. DHEA in elderly women and DHEA or testosterone in elderly men. New England Journal of Medicine. 2006. PMID 17050889. DOI 10.1056/NEJMoa054629.

    Randomized trial · In a two-year placebo-controlled trial of 87 elderly men with low DHEA-S and bioavailable testosterone and 57 elderly women with low DHEA-S, DHEA raised DHEA-S by a median 3.4 µg/mL in men and 3.8 in women and had no significant effect on body composition, peak oxygen uptake, strength, insulin sensitivity or quality of life, with small bone density gains at one site in each sex.

  28. 28.

    Baulieu EE, Thomas G, Legrain S, Lahlou N, Roger M, Debuire B, et al.. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study to a sociobiomedical issue. Proceedings of the National Academy of Sciences of the United States of America. 2000. PMID 10760294. DOI 10.1073/pnas.97.8.4279.

    Randomized trial · In 280 healthy people aged 60 to 79 given 50 mg DHEA or placebo daily for a year, DHEA-S returned to a young concentration with a small rise in testosterone and estradiol; bone turnover improved only in women over 70, libido rose in those women and skin hydration and thickness improved mainly in women; no harmful accumulation; it does not create supermen or superwomen.

  29. 29.

    Elraiyah T, Sonbol MB, Wang Z, Khairalseed T, Asi N, Undavalli C, et al.. Clinical review: The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis. Journal of Clinical Endocrinology and Metabolism. 2014. PMID 25279571. DOI 10.1210/jc.2014-2261.

    Systematic review and meta-analysis · Across 23 randomized trials of 1,188 postmenopausal women with normal adrenal function, DHEA did not significantly improve libido or sexual function (SMD 0.35, minus 0.02 to 0.73) and had no significant effect on serious adverse events, lipids, glucose, weight, BMI or bone density; low confidence evidence.

  30. 30.

    Grimley Evans J, Malouf R, Huppert F, van Niekerk JK. Dehydroepiandrosterone (DHEA) supplementation for cognitive function in healthy elderly people. Cochrane Database of Systematic Reviews. 2006. PMID 17054283. DOI 10.1002/14651858.CD006221.

    Systematic review and meta-analysis · Three adequate parallel-group trials: no significant effect of DHEA on cognition at 3 months in perimenopausal women, no effect in 46 men aged 62 to 76, and in 75 volunteers aged 59 to 81 a significant impairment in visual memory recall after a stressor on DHEA; the evidence does not support a cognitive benefit.

  31. 31.

    Alkatib AA, Cosma M, Elamin MB, Erickson D, Swiglo BA, Erwin PJ, Montori VM. A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency. Journal of Clinical Endocrinology and Metabolism. 2009. PMID 19773400. DOI 10.1210/jc.2009-0672.

    Systematic review and meta-analysis · Across 10 trials in women with primary or secondary adrenal insufficiency, DHEA improved health-related quality of life by an effect size of 0.21 (0.08 to 0.33) and depression slightly, with no significant effect on anxiety or sexual well-being; small and perhaps trivial, insufficient for routine use.

  32. 32.

    Field AE, Colditz GA, Willett WC, Longcope C, McKinlay JB. The relation of smoking, age, relative weight, and dietary intake to serum adrenal steroids, sex hormones, and sex hormone-binding globulin in middle-aged men. Journal of Clinical Endocrinology and Metabolism. 1994. PMID 7962322. DOI 10.1210/jcem.79.5.7962322.

    Cross-sectional study · In 1,241 randomly sampled middle-aged US men, smokers had DHEA 18 percent, DHEA-S 13 percent, cortisol 5 percent and androstenedione 33 percent higher than nonsmokers, independent of body mass index and age; age was negatively associated with DHEA and DHEA-S.

  33. 33.

    Seyfart T, Friedrich N, Kische H, Bülow R, Wallaschofski H, Völzke H, et al.. Association of sex hormones with physical, laboratory, and imaging markers of anthropometry in men and women from the general population. PLoS One. 2018. PMID 29324787. DOI 10.1371/journal.pone.0189042.

    Cross-sectional study · In 957 men and women of the Study of Health in Pomerania with LC-MS sex hormones, BMI and leptin were inversely associated with testosterone, androstenedione and DHEA-S in men and positively associated with all sex hormones in women.

  34. 34.

    Cangemi R, Friedmann AJ, Holloszy JO, Fontana L. Long-term effects of calorie restriction on serum sex-hormone concentrations in men. Aging Cell. 2010. PMID 20096034. DOI 10.1111/j.1474-9726.2010.00553.x.

    Cross-sectional study · In 24 men practicing calorie restriction for an average 7.4 years (body fat 8.7 percent) against 24 endurance runners and 24 sedentary controls (23.2 percent), testosterone and free androgen index were lower and SHBG higher with calorie restriction, while DHEA-S did not differ between the three groups.

  35. 35.

    Itkonen O, Jonker N, Aarsand AK, Sandberg S, Diaz-Garzon J, Fernandez-Calle P, et al.. The European biological variation study (EuBIVAS): Biological variation data for testosterone, follicle stimulating hormone, prolactin, luteinizing hormone and dehydroepiandrosterone sulfate in men. Clinica Chimica Acta. 2024. PMID 38341016. DOI 10.1016/j.cca.2024.117806.

    Laboratory method study · In 38 men sampled weekly over 10 weeks, within-subject biological variation was 9 percent for DHEA-S, 10 percent for testosterone and 22 percent for LH, with indices of individuality from 0.14 to 0.66 indicating high individuality.

  36. 36.

    Prom-Wormley EC, York TP, Jacobson KC, Eaves LJ, Mendoza SP, Hellhammer D, et al.. Genetic and environmental effects on diurnal dehydroepiandrosterone sulfate concentrations in middle-aged men. Psychoneuroendocrinology. 2011. PMID 21570195. DOI 10.1016/j.psyneuen.2011.03.018.

    Cross-sectional study · In 783 middle-aged men of the Vietnam Era Twin Study of Aging, salivary DHEA-S was highest at awakening and decreased slightly through the day, with heritability estimates of 0.37 to 0.46 at the later time points.

  37. 37.

    Carmina E, Longo RA. Increased Prevalence of Elevated DHEAS in PCOS Women with Non-Classic (B or C) Phenotypes: A Retrospective Analysis in Patients Aged 20 to 29 Years. Cells. 2022. PMID 36291122. DOI 10.3390/cells11203255.

    Cross-sectional study · Among 648 hyperandrogenic women with PCOS aged 20 to 29, serum DHEA-S was increased in 33 percent, more often in nonclassic phenotypes, and was associated with higher testosterone and androstenedione; adrenal androgens fall by 40 percent from the twenties to the thirties.

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