DHEA and pregnenolone are both hormones that are available as a food supplement in some countries but only available on prescription in others. DHEA and pregnenolone are made in the adrenal glands, ovaries, testes, and in the gut and brain, from cholesterol. Pregnenolone is produced first, and is then converted into DHEA as necessary. Taking pregnenolone supplements therefore has a similar effect to taking DHEA supplements.
What does DHEA do?
DHEA (dehydroepiandrosterone, or androstenolone) is often described as the master sex hormone as it acts as a building block for producing other steroid hormones including oestrogen, progesterone, testosterone as well as cortisol. For many years, this was thought to the sole function of DHEA, but it’s now known that cells contain specific DHEA receptors. DHEA has effects within the brain to regulate mood, protects brain cells from the degenerative changes, and is believed to help regulate cell ageing throughout the body.
Natural production of DHEA
You start producing DHEA at puberty in large amounts, and blood levels are at their peak in your early twenties. DHEA levels are slightly higher in men than women, and levels decline with age in both sexes. At the age of 20, you produce around 30mg DHEA per day but this slowly falls to less than 6 mg per day by the age of 50.
DHEA levels rise during sex to reach levels that are three to five times higher than before. Exercise also increases DHEA levels temporarily but only if physical activity is consistent and sustained. You need to exercise vigorously for 30 minutes a day for one month before significant increases in DHEA levels occur.
After DHEA is released from the adrenal glands, it is modified in the liver by the addition of a sulphate molecule, so most DHEA circulates in the form of DHEA-sulphate (DHEA-s). DHEA-s is generally considered to be less active than DHEA, but it is usually this level which is measured and used to reflect your DHEA status.
DHEA (and the related hormone, pregnenolone, see below) are made in the body from cholesterol. If you are taking a cholesterol lowering medication (usually a statin) then this may suppress DHEA production.
Benefits of a higher DHEA level
Having a high DHEA level is linked with a higher sex drive, and falling levels of DHEA partly account for reduced sex drive with increasing age. The main medical use of DHEA is to replenish levels when sex drive dwindles in middle age.
The age-related reduction in DHEA levels appears to contribute to the increased risk of a number of age-related conditions such as diabetes, obesity, elevated cholesterol levels, heart disease, arthritis and autoimmune diseases. Some evidence suggests that replenishing DHEA levels helps to:
- Regulate immune function to reduce the severity of infections and auto-immune disorders
- Improve physical and emotional well-being
- Decrease body fat percentage
- Regulate sugar control
- Lift mood and improve depression
- Increase energy levels
- Reduce the adverse effects of stress
- Enhance memory and mental clarity
- Reduce the risk of coronary heart disease in both men and women
- Reduce the risk of osteoporosis
- Reduce the risk of dementia
- Reduce the risk of erectile dysfunction in males
Some claim that DHEA may extend life span and hail it as the fountain of youth, although as yet there is no robust evidence to support this.
DHEA and sex drive
DHEA increases sex drive by increasing circulating levels of androgens (the masculinising hormones, androstenedione, testosterone and dihydrotestosterone) in both sexes. As DHEA levels do not fall dramatically at the menopause it is thought to help sustain female sex drive as levels of oestrogen fall. Research findings regarding DHEA and sex drive are conflicting, however.
In one study men and women aged 40 to 70 years took 50 mg DHEA nightly for 3 months. This was found to double levels of androgens in women, but only produced a small rise in androstenedione in men. Treatment was associated with a marked increase in perceived physical and psychological well-being for both men (67%) and women (84%) but the volunteers reported no change in libido.
In a small study, 5 postmenopausal women aged 60 to 70, used a 10% DHEA cream applied to the inner thighs, every morning, for one year. The dose was adjusted according to blood results to sustain similar DHEA levels to those found in women aged 20 and 30. After one year, 80% of the women reported increased well-being and 80% reported a marked increase in sex drive. There was also a significant improvement in vaginal dryness. While there was no change in total body weight, there was a 10% reduction in body fat which was replaced by lean muscle. Their bone density increased. Some of the women developed mild acne as a side effect of raised levels of androgen hormones, but there were no serious side effects.
Overall, the results of 23 clinical trials, involving 1,188 postmenopausal women, found that taking DHEA did not significantly improve libido or sexual function. However, this conclusion was reached with ‘low confidence’ due to the risk of bias and inconsistency across the studies.
DHEA is available in a variety of formulations: pills, capsules, sublingual tablets, cream form, tablets, liquid and spray. When oral DHEA is taken with food as twice as much is absorbed when digested with meals than when taken on an empty stomach, so check the information that comes with your pack to see whether or not your formulation should be taken with food.
While DHEA is freely available in some countries, it is beneficial is to consult a medical doctor who will measure your levels of DHEA/DHEAS (through either a blood or saliva test) to see if you need supplementation and, if so, determine the right dose.
DHEA requirements vary from person to person. It is important not to take too much – smaller doses may be as effective and safer. When taking DHEA for low sex drive, it is usual to start with a low daily dose of 5 to 10 mg and to increase if this is ineffective, up to a dose range of 25 to 50 mg a day. Some physicians recommend smaller doses of 2 to 8 mg DHEA, taken every other day or, if taken daily, to stop them for a week or two after every month of treatment.
The aim is to achieve normal youthful levels without side effects.
The body converts some DHEA into a metabolite, 7-keto-DHEA, which is more potent than DHEA. The importance of 7-keto DHEA is that it cannot be converted into sex hormones and therefore does not have an androgenic or oestrogenic action in the body.
Some supplements contain just 7-Keto-DHEA without the parent DHEA. This will provide many of the anti-ageing effects of DHEA but will not have a direct effect to increase sex drive, although it may possibly have a secondary effect as a result of promoting general feelings of well-being.
If you are interested in the reputed longevity/immune enhancing and memory boosting benefits of DHEA, then 7-Keto-DHEA is probably the best choice. If you are interested in the prosexual benefits however, 7-Keto-DHEA is not the best option.
Side effects of DHEA
DHEA increases the level of androgen hormones, and cortisol. If used appropriately, in low doses, under medical supervision, side effects are less likely.
Excess DHEA can have masculinizing effects in women with the development of facial hair and a deeper voice (which is irreversible). This is only usually seen in doses greater than 25 mg a day and is most common at doses above 90mg per day. Some doctors feel women should not take DHEA at all. Others feel it is acceptable to take it over the age of 40 as long as androgen levels are being measured regularly.
Possible side effects of taking too much DHEA include:
- Acne and other skin rashes
- Unwanted facial hair growth in women
- Mood changes such as irritability or hyperactivity
- Increased heart rate and palpitations
- Tiredness, fatigue and lack of energy
Transient hepatitis and increased pressure in the eyes have also been reported.
As 30% of women with polycystic ovary syndrome (PCOS) have raised levels of DHEA-s, it’s possible that PCOS-like symptoms could result from taking DHEA supplements before the menopause.
As some DHEA is converted into oestrogen, there is a possibility of breast enlargement in men taking high doses long-term.
Although reports of serious problems are infrequent, the long-term safety of using DHEA regularly for many years is unknown. Effects on risk of cancers for example – especially those of the prostate gland, thyroid, breast and ovaries – are not yet fully understood. Some doctors therefore advise those with a family history of hormone sensitive cancers not to take DHEA.
Some scientists question whether taking DHEA supplements shuts down your body’s own mechanisms for producing natural DHEA. It certainly reduces the production of luteinising hormone (LH) in the pituitary gland for example, and prolonged use may result in lowered levels of testosterone. The long-term effects are simply unknown.
DHEA should therefore not generally be taken under the age of 40 (unless there is a proven deficiency) as treatment may interfere with long term natural production of the hormone.
As with most supplements, DHEA should not be taken during pregnancy, while breastfeeding.
NB DHEA is classed as an anabolic androgen and is prohibited in competitive sport.
DHEA from wild yam
Some supplements labelled DHEA actually contain diosgenin, a steroid found in the Mexican wild yam. While diosgenin can be converted to DHEA in the laboratory, this reaction cannot occur in the body. A study measuring DHEA and DHEA-s levels in those taking natural wild yam supplements found no change in levels of these hormones.
What does pregnenolone do?
If DHEA is the mother of all sex hormones, then pregnenolone may be described as the grandmother, as pregnenolone is produced first and converted into DHEA as necessary. Pregnenolone is also converted directly into progesterone so it is more progestogenic than DHEA.
Pregnenolone is mainly found in the adrenal glands and brain, but is also present in other tissues such as the liver and skin. Like DHEA, natural levels of pregnenolone peak in the late twenties to early thirties and then start to decline. By the age of 75, a person produces 60% less pregnenolone than in their thirties.
Like DHEA, pregnenolone supplements are said to have a variety of beneficial effects, including:
- Increasing a low sex drive
- Promoting general feelings of well-being and banishing fatigue
- Reducing the effects of ageing
- Improving visual and auditory perception
- Enhancing memory, mental acuity, alertness and awareness
- Lifting a low mood
- Improving the quality of sleep
- Regulating immune function
- Reducing the adverse effects of stress
- Reducing the risks of osteoporosis and adult-onset diabetes
- Helping to reduce the symptoms of arthritis, pre-menstrual syndrome, menopause and stress
Since pregnenolone and DHEA work in harmony, some physicians prescribe small amounts of each together. Some claim that this minimises the anabolic and oestrogenic effects of DHEA, although little research is available to confirm this.
It does seem, however, that pregnenolone is less likely to have a masculinising effect in women than DHEA as it is less likely to increase testosterone levels.
Pregnenolone is best used only under medical supervision so that blood levels can be assessed and an appropriate dose suggested. Most physicians recommend starting with a low dose of 5mg to 10mg, which may be increased to 20mg or 30 mg (occasionally 50mg) if there is no obvious effect. Once benefit is obtained, a lower maintenance dose of 2 mg to 5 mg per day often suffices and prevents accumulation. Regular breaks in treatment – so called hormone holidays – are also recommended. When oral hormones are taken with food, twice as much is absorbed when digested with meals as when taken on an empty stomach.
Like DHEA, the long-term safety of taking pregnenolone hormone is not yet known. Pregnenolone supplements are not usually necessary in those aged under 40 unless blood tests confirm a clinical deficiency.
The possible unwanted side effects are similar to those of DHEA.
Pregnenolone should not be used during pregnancy, when breast-feeding or if oestrogen-sensitive conditions are present except under the advice of a medical practitioner.
NB Pregnenolone is classed as an anabolic androgen and should not be used by those taking part in competitive sports.