UNLOCK /Hormones · Jul 02, 2026 · 22 min read

Is Supplementing DHEA Helpful For Gaining Muscle?

Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal glands that is available over the counter in the US. It is still a WADA-banned substance, but does it actually increase muscle mass, lowr fat mass, or significantly increase strength?

Exploratory DN Meta-Analysis on DHEA Supplementation and Strength. I believe this is the first ever.

TL;DW - There might be a little, maybe something there on the body composition side. Any signal is likely coming from older individuals, and there is unlikely to be a benefit in young healthy subjects. There has not been a published meta-analysis on strength. It will very likely be null.

Below is a scorched-earth deep dive into what can and can't affect DHEA and what supplementing what else DHEA may and may not move the needle on:

Briefly, there are some very serious medical conditions that can bottom out DHEA-S. High allostatic load and fatty liver also seem to reduce it and these are inherently intertwined, as many of the allostatic load calculators subtly capture metabolic health. DHEA-S also appears to decrease with age. Sleep deprivation, fragmentation, and OSA don't seem to do much and sleep extension doesn't seem to increase it. Also, with limited data, DHEA-S doesn't appear to be a reliable marker of overtraining syndrome. Regular physical activity in older adults and mindfulness-based stress reduction may somewhat increase it.

Clinical Evidence Reference

DHEA-S / Modulators

A consolidated map of what raises, lowers, and fails to move circulating DHEA-S — and what supplementing it actually accomplishes. Magnitudes from RCTs, meta-analyses, and Mendelian randomization where available. Sex stratifies many findings dramatically.

What Lowers DHEA-S in Men

↓ Suppressors

Severe (>30%)

Moderate (10–30%)

Mild (<10%)

Severe — Near-elimination or major suppression

Oral corticosteroids (severe asthmatics, U-BIOPRED)

DHEA-S <5% of healthy controls · Yasinska 2023

−95%

Adrenal insufficiency / Addison's disease

Near-total absence of adrenal androgen synthesis · Gurnell 2008 RCT n=44 men

~zero

Chronic opioid useM-data

Daniell 2002: 29% of opioid-treated men below detection vs 1% controls; ACTH normal · Rubinstein 2017 fentanyl OR 25.7

~−70%

Major depressive disorderM

228 vs 307 µg/dL controls · Arinami 2021 n=58 men

−26%

Septic shock / critical illness

1.2 vs 4.2 µmol/L; nonsurvivors 0.4 · cortisol↑/DHEA-S↓ dissociation · Beishuizen 2002

−71%

Multiple trauma

2.4 vs 4.2 µmol/L; CIRCI marker · Beishuizen 2002, Bentley 2019

−43%

Moderate — Clinically meaningful

High allostatic load (cumulative chronic stress)

DHEAS is 1 of 9 reliable allostatic load biomarkers across 67,126 people · McCrory 2023 IPD meta. 60% of studies show lower DHEAS as a primary AL mediator linked to metabolic syndrome · Osei 2022 SR

AL marker

NAFLD / hepatic fibrosisM-data

Stage F0 1.03 → F4 0.35 µg/mL · Charlton 2008

−66%

Inhaled high-dose budesonide (800 µg/d)

12-week treatment in mild asthma · Kannisto 2004

−18%

Inflammatory arthritis (RA, SpA)

28% below lower extreme of healthy range · Dessein 2001

~−25%

Pulmonary fibrosis

Pooled SMD −0.72 · Chen 2024 meta-analysis

SMD −0.72

Mild — Smaller or context-dependent

Aging (per 5 years)

Linear decline · Jimenez 2018, Boston Puerto Rican Health Study

−12.4 µg/dL

Soy isoflavones (66 mg/d, 3 mo)M

Serum DHEAS decreased P<0.01 (n=200 men, RCT). Mechanism: CYP17 17,20-lyase inhibition by genistein 20%, daidzein 58% (in vitro) · Swart 2019

P<0.01

Inhaled budesonide (200 µg/d, 2 wk)

Transient; recovered by 12 weeks · Kannisto 2004

−8%

T2DM, CKD (associations)

Likely partly inflammation-mediated · Brahimaj 2017 (Rotterdam)

variable

What Doesn't Reliably Lower It

≈ Resilient

Pattern. Across these stressors, testosterone, T3, IGF-1, and cortisol move first. DHEA-S behaves more like a chronic-illness/severe-undernutrition marker than an acute stress or single-variable insult marker. The smoking paradox (DHEA-S rises with cigarette use in men) is consistent with nicotine-mediated CYP17 17α-hydroxylase upregulation, not improved health.

Acute sleep deprivation (24–48 h)M-data

Testosterone −24%, cortisol +21%, DHEA-S spared · Lamon 2021, Åkerstedt 1980

~null

Selective slow-wave sleep suppression

Testosterone & 17-OHP fall; DHEA itself unchanged · Ukraintseva 2018

~null

Excessive sleep (>9 h)

Lowers testosterone, not DHEA-S · Ruge 2019, n=2,095

~null

Cigarette smoking — paradoxically raisesM

+13–38% vs nonsmokers · Salvini 1992 (n=543), Field 1994 (n=1,241), Key 2011

↑ +13–38%

Overtraining syndrome (basal DHEA-S)

Basal hormones mostly normal; OTS marker is blunted ACTH/GH stim response · Cadegiani 2017 SR, EROS-BASAL 2019

basal normal

Obstructive sleep apnea (basal DHEA-S)

Not in established OSA biomarker panel; CPAP no clear effect · Fiedorczuk 2022 umbrella review

~null

Insulin therapy in newly Dx T2DM (paradox)M

DHEA-S falls but T rises as DHEA→T conversion increases · Hu 2022

↓ DHEA-S, ↑ T

What Raises Endogenous DHEA-S

↑ Interventions

Robust — Replicated

Oral DHEA supplementation (50 mg/d)

Restores levels to young-adult range · Arlt 1998 PK · Jankowski 2019 men: +269 µg/dL

3–4×

Regular physical activity (older men)

Most reliable behavioral intervention · de Nys 2022 meta of 22 RCTs

moderate ↑

Provisional

Treating opioid use (tapering)M-data

Partial recovery as opioid dose decreases · Kallman 2024

recovery

MBSR / mindfulness (8 wk)

+0.70 µmol/L vs waitlist · Jørgensen 2021

+~26 µg/dL

What does not reliably raise DHEA-S. Sleep extension in normal sleepers (Arnal 2016 RCT, 6 nights of 10 h TIB), HIV stress-management interventions (35-RCT meta-analysis: no effect), and some adaptogenic supplements (ashwagandha & massage chair RCTs paradoxically reduced DHEA-S — interpreted as HPA normalization).

DHEA Supplementation in Men

⚖ Outcomes

★ The Headline

Almost everything fails in healthy elderly men. Corona 2013 SR/MA (25 RCTs, n=1,353): null on lipids, glycemia, bone, sexual function, QoL. Even the apparent fat-mass reduction (SMD −0.35) disappeared after adjusting for downstream T/E2 conversion. Nair 2006 NEJM (n=87, 2 yr) confirms: no physiologically relevant benefit on body composition, performance, insulin sensitivity, or QoL. Mechanistic reason: men's testes already produce ~100× more testosterone than DHEA→T conversion can add.

✓ Possibly Helpful

Femoral neck BMD in Addison's disease Reversed loss · Gurnell 2008 RCT n=44 Addison's men, 12 mo

Lean mass in Addison's disease Total +0.02 kg, truncal +0.017 kg · Gurnell 2008 (P<0.05)

Endothelial function in hypercholesterolemic men FMD 3.9% → 8.4% · Kawano 2003 n=24 (single trial, not replicated)

Pubertal development in central AI youth Pubic hair Tanner stage advanced · Binder 2009 (mostly girls)

~ Mixed / Modest

Insulin sensitivity (elderly only) Villareal 2004: AUC ↓ 1119 µU/mL · Corona 2013: null in elderly men meta

Visceral fat (elderly, short-term) −13 cm² at 6 mo · Villareal 2004 · not durable at 2 yr

Fat mass in elderly men SMD −0.35 in meta · BUT effect disappears after T/E2 adjustment · Corona 2013

Estradiol (modest rise) +4.8 pg/mL pooled · Jankowski 2019

IGF-1 in men Modest +6.3 ng/mL · Xie 2020 meta: men null overall

✗ Doesn't Improve

Testosterone in men No meaningful peripheral conversion · Brown 1999, Wallace 1999, Nair 2006

Strength / lean mass (healthy men) No effect at 12 wk or 2 yr · Wallace 1999, Nair NEJM

Resistance-training adaptations (young men) Identical to placebo · Brown 1999

VO₂peak / aerobic performance No change · Nair 2006

Bone mineral density (men) No benefit at any site · Mühlen 2008, Lin 2019, Jankowski 2019 pooled

Cognitive function No benefit · Nair 2006, Kritz-Silverstein 2008 DAWN n=110 men

Quality of life / well-being No SF-36 or life-satisfaction effect · Nair 2006, Kritz-Silverstein 2008

Sexual function in healthy elderly No IIEF benefit · Corona 2013 meta of 25 RCTs

Subjective distress under acute stress 12-day DHEA (50→75 mg/d) raised salivary DHEA(S) and DHEA/cortisol ratio in military survival training but no improvement in subjective distress · Taylor 2012 RCT n=48 men

Fatigue (even in Addison's) No benefit · Gurnell 2008 n=106 RCT

Lipids (TC, LDL, TG, HDL in men) All null · Qin 2020 SR/MA · HDL drop is female-only finding

Glycemic control (overall) No FPG, insulin, or HOMA-IR effect · Wang 2020 meta

Mortality / cardiovascular events No RCT evidence · no adequately powered hard-endpoint trial

⚠ Cautions

WADA prohibited at all times Anti-doping concern for any competitive athlete

Acne / androgenic skin effects Dose-dependent androgenic side effect; Cochrane review found acne OR 3.77 vs placebo · Scheffers 2015 (mostly female data; risk plausibly lower in men but documented)

No clear benefit-to-cost case in healthy men Two large rigorous trials (Corona 2013 meta, Nair 2006 NEJM) both null

Marketing-driven well-being claims Original Morales 1994 67% well-being claim (subjective open Q) never replicated

Pre-existing prostate cancer Caution in androgen-sensitive disease; no DHEA RCTs in this population

What Lowers DHEA-S in Women

↓ Suppressors

Severe (>30%)

Moderate (10–30%)

Mild (<10%)

Severe — Near-elimination or major suppression

Adrenal insufficiency / Addison's disease

Near-total absence of adrenal androgen synthesis; women lose major sex-steroid precursor source

~zero

Sheehan syndrome / hypopituitarismF

ACTH-deficient adrenal androgen pathway; affects FSFI · Mandal 2022 RCT n=28

~zero

Oral corticosteroids (high-dose, chronic)

DHEA-S <5% of healthy controls in severe asthma · Yasinska 2023

−95%

Chronic caregiver stress (AD spousal caregivers, mostly women)

Cortisol unchanged; selective DHEA-S drop · Moriguchi Jeckel 2010

−32%

Septic shock / critical illness

1.2 vs 4.2 µmol/L; nonsurvivors 0.4 · cortisol↑/DHEA-S↓ dissociation · Beishuizen 2002

−71%

Moderate — Clinically meaningful

High allostatic load (cumulative chronic stress)

AL marker

Anorexia nervosa (severe undernutrition)F-data

Pooled MD −24.9 µg/dL; total DHEA paradoxically elevated → sulfotransferase impairment · Lin 2022 meta of 15 studies

~−10–15%

Heavy alcohol useF-strongest

Female data strongest; falls further in early abstinence · Weinland 2022

~−30%

Inhaled high-dose budesonide (800 µg/d)

12-week treatment in mild asthma · Kannisto 2004

−18%

Inflammatory arthritis (RA, SpA)

28% below lower extreme of healthy range · Dessein 2001

~−25%

Opioid use (chronic)

Reversible with tapering · Itodo 2022, Kallman 2024

significant

Mild — Smaller or context-dependent

Aging (per 5 years)

Linear decline; women already start lower than men · Jimenez 2018

−12.4 µg/dL

Menopause itselfF

Compounds age-related decline; loss of ovarian DHEA contribution

gradual ↓

Soy isoflavones (66 mg/d, 6 mo, postmenopausal)F

Serum DHEAS decreased P<0.01 (n=200 postmenopausal women, RCT). CYP17 17,20-lyase inhibition by genistein 20%, daidzein 58% (in vitro). Androstenedione also decreased in women (P<0.01) · Swart 2019

P<0.01

T2DM, CKD, NAFLD (associations)

Likely partly mediated by inflammation · Zhang 2022

variable

What Doesn't Reliably Lower It

≈ Resilient

Pattern. DHEA-S is more chronic-illness/severe-undernutrition marker than acute stressor marker. Testosterone, IGF-1, and cortisol move first.

Acute sleep deprivation (24–48 h)

Testosterone falls; DHEA-S spared · Lamon 2021

~null

Habitual sleep duration (in adequate sleepers)

No association with PSQI, TST, WASO, SE · Mochón-Benguigui 2022

no relation

Short-term LEA (4–14 d, <30 kcal/kg FFM/d)

Leptin −53%, insulin −38%, T & T3 fall; DHEA-S not reliably affected · Koehler 2016

~null

Normal-weight hypothalamic amenorrheaF

LEA without weight loss; DHEAS normal · Miller 2007, n=217

normal

PCOS (DHEAS itself often elevated, not lowered)F

Adrenal androgen excess in subset of PCOS phenotype

normal/↑

What Raises Endogenous DHEA-S

↑ Interventions

Robust — Replicated

Oral DHEA supplementation (50 mg/d)

Restores levels to young-adult range · Arlt 1998 PK · multiple RCTs · women +231 µg/dL pooled

3–4×

Regular physical activity (older women)

Most reliable behavioral intervention · de Nys 2022 meta of 22 RCTs

moderate ↑

Provisional

Vaginal DHEA (prasterone 6.5 mg)F

Local intracrine action; serum DHEA-S rises modestly but stays in normal postmenopausal range · Barton 2018

local +

MBSR / mindfulness (8 wk)

+0.70 µmol/L vs waitlist · Jørgensen 2021; not replicated in cancer pts

+~26 µg/dL

DHEA Supplementation in Women

⚖ Outcomes

★ Strongest Indication

Vaginal DHEA (prasterone, 6.5 mg, Intrarosa) for postmenopausal vulvovaginal atrophy. FDA-approved 2016. Lemos 2026 SR/MA (n=1,611): dryness MD −0.23, dyspareunia MD −0.40. Labrie 2015 n=482: all 6 FSFI domains improved, total +41.3% over placebo (P=0.0006). Acts via local conversion; serum estradiol stays in normal postmenopausal range.

✓ Reliably Improves

Vaginal symptoms (dryness, dyspareunia) Vaginal route only · FDA-approved · Lemos 2026 SR/MA

FSFI sexual function in postmenopausal VVA All 6 domains, +41% over placebo · Labrie 2015 n=482

Lumbar spine BMD +1.0% over 12 mo · Jankowski 2019 pooled n=295 · MR-causal Quester 2022

Hip / trochanter BMD SMD 0.5 in women only · Lin 2019 SR/MA

Forearm fracture risk OR 0.70 per SD genetic DHEAS · Quester 2022 MR

Testosterone +24.3 ng/dL postmenopausal · He 2025 meta (21 studies)

Estradiol +7.9 pg/mL postmenopausal · He 2025

IGF-1 +16–25 ng/mL · Xie 2020 (women-only effect)

FSFI in Sheehan / central AI Severe androgen-deficiency context · Mandal 2022, Binder 2009

~ Mixed / Modest

QoL / mood in adrenal insufficiency Effect size 0.21 — "small and perhaps trivial" · Alkatib 2009 SR/MA, 10 RCTs

Body composition Lean +0.45 kg, fat −0.85% · Wang 2020 meta · modest

Insulin sensitivity (AI patients) Real effect in hypoadrenal · Dhatariya 2005 clamp study

Visceral fat (elderly) −13 cm² at 6 mo; not durable at 2 yr · Villareal 2004

IVF surrogates (poor responders) AFC, AMH, oocyte yield improve · live birth does not (see right)

AN bone (only with OCP combination) DiVasta 2012; harmful in adolescents w/ open physes

✗ Doesn't Improve

Cognition (postmenopausal) Sultana 2023 SR (4 RCTs): no benefit · Kritz-Silverstein 2008 DAWN n=225

Well-being / QoL in healthy older women Kritz-Silverstein 2008: no SF-36 or life-satisfaction benefit

Postmenopausal libido (oral, normal adrenals) Panjari 2009 n=93 null · Elraiyah 2014 SR P=0.06 (NS) · Cochrane SMD 0.31 only

IVF live birth rate Wang Z 2022 BJOG RCT n=821: 8.8% vs 9.0% (P=0.91) · Endo Society does not recommend

Hot flashes / vasomotor symptoms No consistent effect · Wierman 2022 review

⚠ Adverse / Caution

HDL-C decrease −5.1 mg/dL in women (worse than men) · Qin 2020 meta · Dhatariya 2005, Nordmark 2005

Androgenic side effects Acne OR 3.77 vs placebo · Scheffers 2015 Cochrane · hirsutism, voice change

Hormone-sensitive cancer concerns Vaginal DHEA acceptable in BC on AI (Mensión 2022); systemic DHEA cautioned

Adolescent AN with open physes Potentially harmful to BMD · Lin 2022 SR

Supraphysiologic levels at >50 mg Older women particularly susceptible · Gurnell 2008

REFERENCES FOR DHEA FOREST PLOTS:

1. Wang, F., et al., The effects of dehydroepiandrosterone (DHEA) supplementation on body composition and blood pressure: a meta-analysis of randomized clinical trials. Steroids, 2020. 163: p. 108710.

2. Brown, G.A., et al., Effect of oral DHEA on serum testosterone and adaptations to resistance training in young men. J Appl Physiol (1985), 1999. 87(6): p. 2274–83.

3. Dayal, M., et al., Supplementation with DHEA: effect on muscle size, strength, quality of life, and lipids. J Womens Health (Larchmt), 2005. 14(5): p. 391–400.

4. Dhatariya, K.K., et al., Dehydroepiandrosterone replacement therapy in hypoadrenal women: protein anabolism and skeletal muscle function. Mayo Clin Proc, 2008. 83(11): p. 1218–25.

5. Igwebuike, A., et al., Lack of dehydroepiandrosterone effect on a combined endurance and resistance exercise program in postmenopausal women. J Clin Endocrinol Metab, 2008. 93(2): p. 534–8.

6. Kenny, A.M., et al., Dehydroepiandrosterone combined with exercise improves muscle strength and physical function in frail older women. J Am Geriatr Soc, 2010. 58(9): p. 1707–14.

7. Morales, A.J., et al., The effect of six months treatment with a 100 mg daily dose of dehydroepiandrosterone (DHEA) on circulating sex steroids, body composition and muscle strength in age-advanced men and women. Clin Endocrinol (Oxf), 1998. 49(4): p. 421–32.

8. Muller, M., et al., Effects of dehydroepiandrosterone and atamestane supplementation on frailty in elderly men. J Clin Endocrinol Metab, 2006. 91(10): p. 3988–91.

9. Nair, K.S., et al., DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med, 2006. 355(16): p. 1647–59.

10. Pénisson-Besnier, I., et al., Dehydroepiandrosterone for myotonic dystrophy type 1. Neurology, 2008. 71(6): p. 407–12.

11. Percheron, G., et al., Effect of 1-year oral administration of dehydroepiandrosterone to 60- to 80-year-old individuals on muscle function and cross-sectional area: a double-blind placebo-controlled trial. Arch Intern Med, 2003. 163(6): p. 720–7.

12. Villareal, D.T. and J.O. Holloszy, DHEA enhances effects of weight training on muscle mass and strength in elderly women and men. Am J Physiol Endocrinol Metab, 2006. 291(5): p. E1003–8.

13. Wallace, M.B., et al., Effects of dehydroepiandrosterone vs androstenedione supplementation in men. Med Sci Sports Exerc, 1999. 31(12): p. 1788–92.

14. Weiss, E.P., D.T. Villareal, and J.O. Holloszy, Effect of DHEA replacement therapy on muscle strength and size in sedentary older adults. Med Sci Sports Exerc, 2010. 42(5 Suppl): Abstract 590 (presented at ACSM Annual Meeting, June 2, 2010, Baltimore, MD).

REFERENCES FOR DHEA TABLE:

1. Yasinska, V., et al., Low levels of endogenous anabolic androgenic steroids in females with severe asthma taking corticosteroids. ERJ Open Res, 2023. 9(5): p. 00269-2023.

2. Gurnell, E.M., et al., Long-term DHEA replacement in primary adrenal insufficiency: a randomized, controlled trial. J Clin Endocrinol Metab, 2008. 93(2): p. 400–9.

3. Daniell, H.W., Hypogonadism in men consuming sustained-action oral opioids. J Pain, 2002. 3(5): p. 377–84.

4. Rubinstein, A.L., et al., Association between commonly prescribed opioids and androgen deficiency in men: a retrospective cohort analysis. Pain Med, 2017. 18(4): p. 637–44.

5. Beishuizen, A., et al., Decreased levels of dehydroepiandrosterone sulphate in severe critical illness: a sign of exhausted adrenal reserve?. Crit Care, 2002. 6(5): p. 434–8.

6. Bentley, C., et al., Dehydroepiandrosterone: a potential therapeutic agent in the treatment and rehabilitation of the traumatically injured patient. Burns Trauma, 2019. 7: p. 26.

7. Corona, G., et al., Dehydroepiandrosterone supplementation in elderly men: a meta-analysis study of placebo-controlled trials. J Clin Endocrinol Metab, 2013. 98(9): p. 3615–26.

8. Nair, K.S., et al., DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med, 2006. 355(16): p. 1647–59.

9. Charlton, M., et al., Low circulating levels of dehydroepiandrosterone in histologically advanced nonalcoholic fatty liver disease. Hepatology, 2008. 47(2): p. 484–92.

10. Kannisto, S., et al., Serum dehydroepiandrosterone sulfate concentration as an indicator of adrenocortical suppression during inhaled steroid therapy in adult asthmatic patients. Eur J Endocrinol, 2004. 150(5): p. 687–90.

11. Dessein, P.H., et al., Hyposecretion of the adrenal androgen dehydroepiandrosterone sulfate and its relation to clinical variables in inflammatory arthritis. Arthritis Res, 2001. 3(3): p. 183–8.

12. Arlt, W., et al., Oral dehydroepiandrosterone for adrenal androgen replacement: pharmacokinetics and peripheral conversion to androgens and estrogens in young healthy females after dexamethasone suppression. J Clin Endocrinol Metab, 1998. 83(6): p. 1928–34.

13. Jankowski, C.M., et al., Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition: a pooled analysis of four clinical trials. Clin Endocrinol (Oxf), 2019. 90(2): p. 293–300.

14. von Mühlen, D., et al., Effect of dehydroepiandrosterone supplementation on bone mineral density, bone markers, and body composition in older adults: the DAWN trial. Osteoporos Int, 2008. 19(5): p. 699–707.

15. Lin, H., et al., A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA supplementation of bone mineral density in healthy adults. Gynecol Endocrinol, 2019. 35(11): p. 924–31.

16. Quester, J., et al., Endogenous DHEAS is causally linked with lumbar spine bone mineral density and forearm fractures in women. J Clin Endocrinol Metab, 2022. 107(5): p. e2080–6.

17. He, S., et al., Impact of DHEA supplementation on testosterone and estradiol levels in postmenopausal women: a meta-analysis of randomized controlled trials assessing dose and duration effects. Diabetol Metab Syndr, 2025. 17(1): p. 258.

18. Jørgensen, M.A., et al., Effect of Mindfulness-Based Stress Reduction on dehydroepiandrosterone-sulfate in adults with self-reported stress. A randomized trial. Clin Transl Sci, 2021. 14(6): p. 2360–9.

19. Wang, F., et al., The effects of dehydroepiandrosterone (DHEA) supplementation on body composition and blood pressure: a meta-analysis of randomized clinical trials. Steroids, 2020. 163: p. 108710.

20. Dhatariya, K., et al., Effect of dehydroepiandrosterone replacement on insulin sensitivity and lipids in hypoadrenal women. Diabetes, 2005. 54(3): p. 765–9.

21. Brown, G.A., et al., Effect of oral DHEA on serum testosterone and adaptations to resistance training in young men. J Appl Physiol (1985), 1999. 87(6): p. 2274–83.

22. Wallace, M.B., et al., Effects of dehydroepiandrosterone vs androstenedione supplementation in men. Med Sci Sports Exerc, 1999. 31(12): p. 1788–92.

23. Labrie, F., et al., Effect of intravaginal prasterone on sexual dysfunction in postmenopausal women with vulvovaginal atrophy. J Sex Med, 2015. 12(12): p. 2401–12.

24. Lemos, M.J., et al., Intravaginal dehydroepiandrosterone for the treatment of vulvovaginal atrophy: a systematic review and meta-analysis. Menopause, 2026.

25. Panjari, M., et al., A randomized trial of oral DHEA treatment for sexual function, well-being, and menopausal symptoms in postmenopausal women with low libido. J Sex Med, 2009. 6(9): p. 2579–90.

26. Elraiyah, T., 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. J Clin Endocrinol Metab, 2014. 99(10): p. 3536–42.

27. Wierman, M.E., et al., Should dehydroepiandrosterone be administered to women?. J Clin Endocrinol Metab, 2022. 107(6): p. 1679–85.

28. Scheffers, C.S., et al., Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database Syst Rev, 2015. 1(1): p. CD011066.

29. Kritz-Silverstein, D., et al., Effects of dehydroepiandrosterone supplementation on cognitive function and quality of life: the DHEA and Well-Ness (DAWN) trial. J Am Geriatr Soc, 2008. 56(7): p. 1292–8.

30. DiVasta, A.D., et al., The effect of gonadal and adrenal steroid therapy on skeletal health in adolescents and young women with anorexia nervosa. Metabolism, 2012. 61(7): p. 1010–20.

31. Lin, J., et al., Dehydroepiandrosterone status and efficacy of dehydroepiandrosterone supplementation for bone health in anorexia nervosa: a systematic review and meta-analysis. Int J Eat Disord, 2022. 55(6): p. 733–46.

32. Cadegiani, F.A., et al., Hormonal aspects of overtraining syndrome: a systematic review. BMC Sports Sci Med Rehabil, 2017. 9: p. 14.

33. Cadegiani, F.A., et al., Basal hormones and biochemical markers as predictors of overtraining syndrome in male athletes: the EROS-BASAL study. J Athl Train, 2019. 54(8): p. 906–14.

34. Villareal, D.T., et al., Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial. JAMA, 2004. 292(18): p. 2243–8.

35. Alkatib, A.A., et al., A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency. J Clin Endocrinol Metab, 2009. 94(10): p. 3676–81.

36. Kallman, T.F., et al., The effects of opioid tapering on select endocrine measures in men and women with head and neck cancer — a longitudinal 12-month study. Pain Rep, 2024. 9(5): p. e1183.

37. De Nys, L., et al., The effects of physical activity on cortisol and sleep: a systematic review and meta-analysis. Psychoneuroendocrinology, 2022. 143: p. 105843.

38. Morales, A.J., et al., Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. J Clin Endocrinol Metab, 1994. 78(6): p. 1360–7.

39. Arinami, H., et al., Role of insulin-like growth factor 1, sex and corticosteroid hormones in male major depressive disorder. BMC Psychiatry, 2021. 21(1): p. 157.

40. Itodo, O.A., et al., Early changes in androgen levels in individuals with spinal cord injury: a longitudinal SwiSCI study. J Clin Med, 2022. 11(21): p. 6559.

41. Hu, Y., et al., Short-time intensive insulin therapy upregulates 3 beta- and 17 beta-hydroxysteroid dehydrogenase levels in men with newly diagnosed T2DM. Front Endocrinol (Lausanne), 2022. 13: p. 894743.

42. Chen, Y., et al., Meta-analysis of the association between sex hormones and pulmonary fibrosis. Postgrad Med, 2024. 136(5): p. 567–76.

43. Sultana, F., et al., Effect of dehydroepiandrosterone therapy on cognitive performance among postmenopausal women: a systematic review of randomized clinical trial data. Menopause, 2023. 30(11): p. 1167–73.

44. Mensión, E., et al., Safety of prasterone in breast cancer survivors treated with aromatase inhibitors: the VIBRA pilot study. Climacteric, 2022. 25(5): p. 476–82.

45. Mandal, S., et al., DHEA on sexual function in Sheehan Syndrome: a randomized double-blind placebo-controlled crossover trial. J Clin Endocrinol Metab, 2022. 107(8): p. e3395–402.

46. Weinland, C., et al., Sulphated dehydroepiandrosterone serum levels are reduced in women with alcohol use disorder and correlate negatively with craving: a sex-separated cross-sectional and longitudinal study. Addict Biol, 2022. 27(2): p. e13135.

47. McCrory, C., et al., Towards a consensus definition of allostatic load: a multi-cohort, multi-system, multi-biomarker individual participant data (IPD) meta-analysis. Psychoneuroendocrinology, 2023. 153: p. 106117.

48. Taylor, M.K., et al., Effects of dehydroepiandrosterone supplementation during stressful military training: a randomized, controlled, double-blind field study. Stress, 2012. 15(1): p. 85–96.

49. Salvini, S., et al., Effects of age, smoking and vitamins on plasma DHEAS levels: a cross-sectional study in men. J Clin Endocrinol Metab, 1992. 74(1): p. 139–43.

50. Swart, A.C., et al., The effect of soy isoflavones on steroid metabolism. Front Endocrinol (Lausanne), 2019. 10: p. 229.

51. Barton, D.L., et al., Evaluating the efficacy of vaginal dehydroepiandosterone for vaginal symptoms in postmenopausal cancer survivors: NCCTG N10C1 (Alliance). Support Care Cancer, 2018. 26(2): p. 643–50.

52. Moriguchi Jeckel, C.M., et al., Neuroendocrine and immunological correlates of chronic stress in 'strictly healthy' populations. Neuroimmunomodulation, 2010. 17(1): p. 9–18.

53. Binder, G., et al., Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: a double-blind, randomized, placebo-controlled phase III trial. J Clin Endocrinol Metab, 2009. 94(4): p. 1182–90.

54. Miller, K.K., et al., Androgens in women with anorexia nervosa and normal-weight women with hypothalamic amenorrhea. J Clin Endocrinol Metab, 2007. 92(4): p. 1334–9.

55. Kawano, H., et al., Dehydroepiandrosterone supplementation improves endothelial function and insulin sensitivity in men. J Clin Endocrinol Metab, 2003. 88(7): p. 3190–5.

56. Field, A.E., et al., 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. J Clin Endocrinol Metab, 1994. 79(5): p. 1310–6.

57. Key, T.J., et al., Circulating sex hormones and breast cancer risk factors in postmenopausal women: reanalysis of 13 studies. Br J Cancer, 2011. 105(5): p. 709–22.

58. Koehler, K., et al., Low energy availability in exercising men is associated with reduced leptin and insulin but not with changes in other metabolic hormones. J Sports Sci, 2016. 34(20): p. 1921–9.

59. Fiedorczuk, P., et al., Potential diagnostic and monitoring biomarkers of obstructive sleep apnea — umbrella review of meta-analyses. J Clin Med, 2022. 12(1): p. 60.

60. Ruge, M., et al., Cross-sectional analysis of sleep hours and quality with sex hormones in men. Endocr Connect, 2019. 8(2): p. 141–9.

61. Ukraintseva, Y.V., et al., Slow-wave sleep and androgens: selective slow-wave sleep suppression affects testosterone and 17α-hydroxyprogesterone secretion. Sleep Med, 2018. 48: p. 117–26.

62. Brahimaj, A., et al., Serum dehydroepiandrosterone levels are associated with lower risk of type 2 diabetes: the Rotterdam Study. Diabetologia, 2017. 60(1): p. 98–106.

63. Zhang, X., et al., Low serum dehydroepiandrosterone is associated with diabetic kidney disease in men with type 2 diabetes mellitus. Front Endocrinol (Lausanne), 2022. 13: p. 915494.

64. Osei, F., et al., Association of primary allostatic load mediators and metabolic syndrome (MetS): a systematic review. Front Endocrinol (Lausanne), 2022. 13: p. 946740.

65. Qin, Y., et al., Effects of dehydroepiandrosterone (DHEA) supplementation on the lipid profile: a systematic review and dose-response meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis, 2020. 30(9): p. 1465–75.

66. Xie, M., et al., Impact of dehydroepiandrosterone (DHEA) supplementation on serum levels of insulin-like growth factor 1 (IGF-1): a dose-response meta-analysis of randomized controlled trials. Exp Gerontol, 2020. 136: p. 110949.

67. Nordmark, G., et al., Effects of dehydroepiandrosterone supplement on health-related quality of life in glucocorticoid treated female patients with systemic lupus erythematosus. Autoimmunity, 2005. 38(7): p. 531–40.

68. Jiménez, M.C., et al., Cardiovascular risk factors and dehydroepiandrosterone sulfate among Latinos in the Boston Puerto Rican Health Study. J Endocr Soc, 2018. 3(1): p. 291–303.

69. Arnal, P.J., et al., Effect of sleep extension on the subsequent testosterone, cortisol and prolactin responses to total sleep deprivation and recovery. J Neuroendocrinol, 2016. 28(2): p. 12346.

70. Lamon, S., et al., The effect of acute sleep deprivation on skeletal muscle protein synthesis and the hormonal environment. Physiol Rep, 2021. 9(1): p. e14660.

71. Wang, Z., et al., Effect of dehydroepiandrosterone administration before in vitro fertilization on the live birth rate in poor ovarian responders according to the Bologna criteria: a randomised controlled trial. BJOG, 2022. 129(7): p. 1030–8.

72. Mochón-Benguigui, S., et al., Sleep and anabolic/catabolic hormonal profile in sedentary middle-aged adults: the FIT-AGEING study. Int J Mol Sci, 2022. 23(23): p. 14709.

73. Akerstedt, T., et al., Adrenocortical and gonadal steroids during sleep deprivation. Sleep, 1980. 3(1): p. 23–30.