What is a normal DHEA level for women? The short answer: It depends on age. Because DHEA has been known to improve ovarian health and sexual well-being, many women wonder what level of DHEA they should aim for in their blood test results. However, trying to optimize DHEA levels is not the best way to approach this question. Following testosterone levels is what reproductive endocrinologists recommend, for two reasons. Let's take a look as to why.
Normal DHEA levels by age
DHEA is a familiar hormone to many women on the TTC journey: In a dietary supplement form, DHEA has been used in fertility centers worldwide to improve the ovarian environment of women with low ovarian reserve to facilitate healthy egg development. Others may know DHEA as an “anti-aging supplement,” as it has been marketed – with various levels of scientific evidence to support the claims – as an agent to reduce the risk of age-related conditions like cardiovascular disease and cognitive decline. DHEA is also known to help maintain sexual well-being among premenopausal and postmenopausal women.
How much DHEA our bodies have changes naturally with age. DHEA levels are low at birth, and rise slowly toward puberty. Then, they rise rapidly to peak at around ages 20-24. From this peak, DHEA levels decline at a rate of about 2-3% a year. Men and women experience the decline of DHEA levels differently: In men, the speed of decline slows down as they age. Women, in contrast, experience a steep initial decline, followed by a plateau. Regardless, women start seeing a steeper decline of DHEA in their mid- to late-30s.
What decline of DHEA means for female fertility and sexual well-being
In parallel with the steeper decline in serum DHEA levels, many women in their mid- to late-30s start experiencing a decline in reproductive and sexual health. This may lead you to think that the decline in DHEA itself is to blame for things like egg quality issues or lower sex drive after age 35 or so, but not so fast: What matters isn’t how much DHEA is circulating in the blood. Rather, it’s how much testosterone is present.
Testosterone, while called a “male” hormone, also plays important roles in female bodies. A healthy level of testosterone is essential for women to develop healthy eggs with full developmental potential and experience sexual wellness to the fullest. Like DHEA, testosterone levels also decline with age – and a part of the reason is the decline in DHEA, which is converted in the body into testosterone and other hormones.
In short, DHEA supplementation has the goal of raising testosterone levels - and that's one reason reproductive endocrinologists with expertise in DHEA monitor their patients' testosterone levels, in addition to DHEA levels.
Normal testosterone levels by age
What is a normal testosterone level, then? The answer is surprisingly complicated. First, what’s considered a normal testosterone level for women changes with age – and this normal testosterone level follows a similar curve to that of DHEA. Furthermore, each laboratory has its own “reference range” for blood test results, including testosterone, because different analytical tools and technologies labs use can make a significant difference in how much is detected in the blood.
Monitoring DHEA and testosterone levels
This is why fertility experts who incorporate DHEA into fertility treatment protocols and monitor their patients’ progress via serum testosterone levels look at their levels in relative terms, rather than in absolute numbers. Center for Human Reproduction, the IVF center that introduced DHEA supplementation for fertility purposes, for example, aims for the upper one-third of each reporting lab’s normal range while their patients are supplementing with DHEA.
Another reason reproductive endocrinologists with knowledge of DHEA don’t monitor their patients on DHEA using DHEA levels in the blood? It’s the fact that DHEA is an intermediate step in the conversion process. Because our bodies use DHEA to produce testosterone and other hormones, the level of DHEA fluctuates much more than testosterone. Right after taking a DHEA supplement, the DHEA level rises quickly, then as the body uses it up to produce other hormones, the DHEA level in the blood plummets. This fluctuation makes DHEA a poor indicator to follow, in order to understand what’s really going on.
What does this mean for me?
- For fertility and sexual well-being, keep your eye on serum testosterone levels, not DHEA levels.
- Consider adding 25 mg of DHEA to your daily prenatal vitamins routine if you are 35 and up.
- If you are 40 and up, the general recommendation is to take 75 mg of DHEA per day to support ovarian function, along with your prenatal vitamins.
- If you are pre-menopausal, 75 mg of DHEA may help with sexual health.
- Ask your doctor about how they can help you monitor your progress and adjust the DHEA dosage, based on your testosterone levels.
We always recommend speaking to your healthcare team before starting on any dietary supplements, but this is especially true for DHEA. Though it’s available as an over-the-counter supplement in the United States, it is a hormone, after all – and DHEA does have some contraindications (as listed here). So, discuss it with your doctor – and if you or your team have any questions, please reach out to us via LiveChat. We are here for you.