About the Test
Purpose of the test
The test for DHEA-S is ordered along with tests for testosterone and several other male hormones (androgens) to:
- Evaluate whether the adrenal glands are working properly
- Distinguish between DHEA-S-secreting conditions caused by the adrenal glands and those that originate in the testicles — or rarely, in the ovaries (ovarian tumors)
- Help diagnose tumors in the outer layer (cortex) of the adrenal gland (adrenocortical tumors) and adrenal cancers
- Help diagnose congenital adrenal hyperplasia and enlargement of the adrenal glands (hyperplasia) in adults
In women, DHEA-S levels are often measured, along with other hormones such as FSH, LH, prolactin, estrogen, and testosterone, to help diagnose polycystic ovary syndrome (PCOS) and rule out other causes of infertility, lack of menstrual period (amenorrhea), and excess hair on the face and body (hirsutism).
DHEA-S levels may be ordered with other hormones to investigate and diagnose the cause of the development of masculine physical characteristics (virilization) in young girls and early (precocious) puberty in young boys.
What does the test measure?
DHEA-S is a male sex hormone (androgen) present in both men and women. This test measures the level of DHEA-S in the blood.
DHEA-S:
- Plays a role in developing male secondary sexual characteristics at puberty
- Can be converted by the body into more potent androgens, such as testosterone and androstenedione
- Can be converted into the female hormone estrogen
DHEA-S is produced almost exclusively by the adrenal glands, with smaller amounts being produced by a woman’s ovaries and a man’s testicles.
A DHEA-S test is useful in determining whether the adrenal glands are working properly. Adrenal tumors (cancerous and non-cancerous) and hyperplasia can lead to an increased level of DHEA-S. Rarely, an ovarian tumor may produce DHEA-S.
Excess DHEA-S may:
- Not be noticed in adult men
- Cause precocious puberty in young boys
- Lead to amenorrhea and the development of virilization in girls and women, such as hirsutism
- Cause a female baby to be born with genitals that are not distinctly male or female in appearance (ambiguous external genitalia)
When should I get this test?
DHEA-S levels are not routinely measured. A DHEA-S test may be ordered, along with other hormone tests, when an excess (or, more rarely, a deficiency) in androgens is suspected and/or your health care practitioner wants to evaluate your adrenal gland function.
It may be measured when a woman has signs and symptoms such as no menstrual periods and infertility and when a girl or woman has symptoms related to developing masculine physical characteristics. These can vary in severity and may include:
- A deeper voice
- Hirsutism
- Loss of hair from the top of the head (male pattern baldness)
- Muscularity
- Acne
- Enlargement of the Adam’s apple
- Decreased breast size
It may also be ordered when a girl has ambiguous genitalia.
DHEA-S may also be measured when young boys show signs of precocious puberty, the development of a deeper voice, pubic hair, muscularity, and an enlarged penis well before the age of normal puberty.
Finding a DHEA-S Test
How can I get a DHEA-S test?
DHEA-S testing is usually performed at a doctor’s office or another medical setting like a hospital or lab. Tests for this are normally ordered by a doctor but may be available without orders from your doctor at a walk-in lab.
Can I take the test at home?
No, the DHEA-S test is not currently available as an at-home test.
How much does the test cost?
The cost of a DHEA-S test will vary depending on factors such as where the test is done and whether you have health insurance. When ordered by a doctor, insurance typically covers the test, although you may have to pay a copay or deductible. Your doctor’s office, lab, and health plan can provide information about any out-of-pocket costs that may be your responsibility.
Taking a DHEA-S Test
The DHEA-S test usually requires a blood sample, which is usually taken from your arm in a doctor’s office, health clinic, hospital, or lab.
Before the test
Usually, no special preparation is required for a DHEA-S test.
During the test
A blood sample is taken from a vein in your arm. The person taking the sample may tie a band around your upper arm and will clean the area where the needle will be inserted into your skin. A small amount of blood is drawn into a tube. You may feel a slight sting when the needle enters your skin.
The process of taking a blood sample usually takes less than three minutes.
After the test
At a doctor’s office or lab, you will be asked to apply gentle pressure to the site with a bandage or a piece of gauze after the needle is withdrawn. This will help stop bleeding and may prevent bruising. Next, the site will be bandaged. You may resume your normal activities following the test.
A blood draw is a very low-risk procedure. You may have slight bruising at the site where the blood sample was taken.
DHEA-S Test Results
Receiving test results
The doctor who ordered your DHEA-S test may share the results with you, or you may be able to access them through an online patient portal. DHEA-S results are usually available within a few business days.
Interpreting test results
A normal DHEA-S level, in addition to other normal male hormone levels, likely indicates that your adrenal glands are functioning normally. Rarely, DHEA-S may be normal when an adrenal tumor or cancer is present but is not producing excess hormones.
A high DHEA-S blood level may indicate that excess DHEA-S production is causing or contributing to your symptoms. However, an increased level of DHEA-S is not diagnostic of a specific condition. It usually indicates the need for further testing to pinpoint the cause of the hormone imbalance. An elevated DHEA-S may indicate:
- Congenital adrenal hyperplasia
- A tumor of the adrenal gland, which may be benign or cancerous
- PCOS — about 25% to 50% of women with PCOS have elevated DHEA-S
- Rarely, an ovarian tumor that produces DHEA-S
A low level of DHEA-S may be due to:
- Adrenal insufficiency or Addison’s disease
- Adrenal dysfunction
- Hypopituitarism, a condition that causes low levels of the pituitary hormones that regulate the production of adrenal hormones
Sources
Abdel-Rahman MY, Hurd WW. Androgen Excess. In: Lucidi RS, ed. Medscape. Updated February 7, 2022. Accessed January 5, 2023. http://emedicine.medscape.com/article/273153-overview
A.D.A.M. Medical Encyclopedia. Congenital Adrenal Hyperplasia. Updated November 11, 2021. Accessed January 5, 2023. http://www.nlm.nih.gov/medlineplus/ency/article/000411.htm.
A.D.A.M. Medical Encyclopedia. DHEA-Sulfate Test. January 9, 2022. Accessed January 5, 2023. http://www.nlm.nih.gov/medlineplus/ency/article/003717.htm.
A.D.A.M. Medical Encyclopedia. Ovarian Overproduction of Androgens. Updated April 19, 2022. Accessed January 5, 2023. http://www.nlm.nih.gov/medlineplus/ency/article/001165.htm.
ARUP Consult. Polycystic Ovarian Syndrome – PCOS. Updated February 2022. Accessed January 5, 2023. http://www.arupconsult.com/Topics/PCOS.html?client_ID=LTD#tabs=0
Elhomsy G. and Griffing GT. Dehydroepiandrosterone (DHEA) Sulfate. In: Staros EB, ed. Medscape. Updated September 25, 2020. Accessed January 5, 2023. http://emedicine.medscape.com/article/2088893-overview#showall
Kaplowitz PB. Precocious Puberty. In: Hoffman RP, ed. Medscape. Updated January 24, 2022. Accessed January 5, 2023. http://emedicine.medscape.com/article/924002-overview
Kovacs P. Elevated DHEAS Levels in Women with PCOS. Medscape. Published June 24, 2004. Accessed January 5, 2023. https://www.medscape.com/viewarticle/481129
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