An adrenal hormone that declines steeply with age and converts into testosterone and estrogen. Best-supported for older women: vaginal DHEA improves genital comfort and sexual health, while oral doses modestly support bone, mood, and desire where levels are genuinely low. Men gain little. Effects are best guided by measured hormone levels, not age. (Full Review)
| Marker | Target | Why |
|---|---|---|
| DHEA-S (serum) | Mid-to-upper range for a healthy 30-year-old, sex-specific | Confirms deficiency and tracks restoration |
| Total & Free Testosterone | Mid-youthful physiologic range, sex-specific | Detects androgenic overshoot, the main side-effect driver |
| Estradiol | Age- and sex-appropriate physiologic range | Detects excess estrogen conversion via aromatase |
| SHBG | Within reference range | Interprets true free-hormone exposure |
| PSA (men ≥40) | < 4 ng/mL and stable year-over-year | Prostate safety surveillance |
| HDL Cholesterol | > 50 mg/dL (women), > 40 mg/dL (men) | Detects the androgen-mediated HDL drop, mainly in women |
| Fasting Insulin & Glucose (or HbA1c) | Fasting insulin < 8 µIU/mL; HbA1c < 5.4% | Tracks the metabolic/insulin-sensitivity effect |
| IGF-1 | Age-appropriate mid-range | Contextualizes growth-signaling effects |
Cadence: Baseline before starting; recheck at 6–12 weeks or after any dose change, then every 6–12 months once stable; annual lipid and prostate surveillance.