Treatment
Comparison
Active Ingredientdehydroepiandrosterone

DHEA (Dehydroepiandrosterone)

otc

DHEA is sold as an over-the-counter dietary supplement in the United States. It is not FDA-approved as a drug for any medical condition. Prescription compounded DHEA formulations are also not FDA-approved.

Cost information

$10–$50/mo (OTC); varies for compounded

Some clinics add DHEA to TRT, but it is not a replacement for testosterone therapy: in a 2020 meta-analysis of randomized trials it raised testosterone in men by an average of only 21.36 ng/dL, and a 2-year NEJM trial in older men found no meaningful gains in muscle strength, body composition or quality of life. Oral DHEA is an over-the-counter supplement, not an FDA-approved treatment for low testosterone. DHEA (dehydroepiandrosterone, also called prasterone) is made by the adrenal glands and levels fall with age, which is why it is marketed for aging and hormone support. The only FDA-approved DHEA product is Intrarosa, a vaginal insert for menopause symptoms. This page covers what the trials show, the known and theoretical risks, drug interactions, and what to ask a TRT clinic that suggests it.

Dosage Format

Typical supplemental doses range from 25–100mg daily, though some TRT protocols may use higher doses under medical supervision. Dosing should be guided by a healthcare provider based on lab results.

Type

Otc

Who to discuss it with

Men and women seeking a supplemental approach to support overall hormone balance, often used as an adjunct rather than a primary TRT medication

Key distinction

DHEA is a naturally occurring hormone produced by the adrenal glands that serves as a precursor to both testosterone and estrogen. It is available over the counter as a supplement, though its effectiveness for raising testosterone levels may be modest compared to prescription TRT options.

Updated · By Treatment Comparison Editorial Team · Sources and scope

Sources: DailyMed (NLM): Intrarosa (prasterone) FDA label · Experimental Gerontology (PubMed): Meta-analysis: DHEA and testosterone levels (2020) · New England Journal of Medicine (PubMed): DHEA or testosterone in older adults, 2-year trial (2006) · Diabetology & Metabolic Syndrome (PubMed): Meta-analysis: DHEA, testosterone and estradiol in postmenopausal women (2025) · Merck Manual Professional Version: Merck Manual: DHEA · Journal of Clinical Endocrinology & Metabolism (PubMed): Endocrine Society guideline on androgen therapy in women (2014) · MedlinePlus (NIH): MedlinePlus testosterone test

DHEA vs prescription testosterone at a glance

From the Intrarosa label, the 2006 NEJM trial, the 2020 meta-analysis and the Merck Manual
Oral DHEA supplementPrescription testosterone
FDA-approved for low testosteroneNoYes, specific products
Prescription neededNoYes, after blood tests
Average testosterone change in men+21.36 ng/dL in pooled trialsDelivers testosterone directly
Also raises estrogenYes, converted to androgens and estrogensSee our testosterone pages
Key cautionsHormone-sensitive cancers, mania, blood thinnersCovered on our testosterone pages

Sources: DailyMed (NLM): Intrarosa (prasterone) FDA label · Experimental Gerontology (PubMed): Meta-analysis: DHEA and testosterone levels (2020) · Merck Manual Professional Version: Merck Manual: DHEA

What the trials show

The largest long-term trial randomized 87 older men with low DHEA-S and low bioavailable testosterone to DHEA, low-dose testosterone or placebo, and 57 older women with low DHEA-S to DHEA or placebo, for 2 years. Both hormones raised their target levels. Neither improved oxygen use, muscle strength or insulin sensitivity, and neither changed body composition in men or women analyzed separately. DHEA was linked to higher bone density at the femoral neck in men and at the wrist in women. The authors concluded neither hormone had physiologically relevant benefits on body composition, physical performance, insulin sensitivity or quality of life.

A 2020 meta-analysis of 42 publications (55 trial arms) found DHEA raised testosterone by 28.02 ng/dL overall: 21.36 ng/dL in men and 30.98 ng/dL in women, with larger rises above 50 mg a day. The authors used subgroup analysis to explore differences between studies, so these are averages across varied trials, not a predicted result for one person.

Sources: Experimental Gerontology (PubMed): Meta-analysis: DHEA and testosterone levels (2020) · New England Journal of Medicine (PubMed): DHEA or testosterone in older adults, 2-year trial (2006)

Questions to ask a clinic that suggests DHEA

  • What symptom or lab result is DHEA meant to address, and how will we know if it works?
  • Which labs will you repeat, and when (testosterone, estradiol, DHEA-S, lipids)?
  • Does it interact with anything I take, such as blood thinners, antidepressants or tamoxifen?
  • Is it a store-bought supplement or a compounded prescription, and what does it cost each month?

Sources: Merck Manual Professional Version: Merck Manual: DHEA · MedlinePlus (NIH): MedlinePlus testosterone test

Where to Get DHEA (Dehydroepiandrosterone)

We could not confirm on either clinic's public pages that DHEA is part of their protocols. Ask during the consultation whether they prescribe it, why, and which labs they will repeat.

1

Marek Health

Marek Health's site could not be loaded for this review, so we could not confirm whether it uses DHEA or what it costs. Ask during the consultation.

Not verified

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2

Defy Medical

Defy's TRT page says supplemental medications are prescribed to support a TRT protocol, based on blood testing and a virtual consult, with no subscriptions or contracts. It does not name DHEA or list prices.

Not listed publicly

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How DHEA (Dehydroepiandrosterone) Works

DHEA is an inactive steroid on its own. Tissues convert it into active androgens, such as testosterone, and into estrogens, as the Intrarosa label describes. That is why a DHEA supplement can raise both testosterone and estrogen, and why the effect differs from person to person. In the 2020 meta-analysis, the average testosterone rise was larger in women (30.98 ng/dL) than in men (21.36 ng/dL), larger at doses above 50 mg a day (57.96 ng/dL) than at 50 mg or less (19.43 ng/dL), and larger in trials of 12 weeks or less than in longer ones. Prescription testosterone, by contrast, supplies the hormone itself rather than relying on the body to convert a precursor.

Side Effects

Common

  • • Acne
  • • Unwanted facial or body hair in women
  • • Breast tissue growth (gynecomastia) in men
  • • Headache
  • • Mood changes
  • • Vaginal discharge with the Intrarosa insert (5.71% vs 3.66% on placebo in 12-week trials)

Serious risks and warning signs

  • • Possible stimulation of hormone-sensitive cancers (prostate, breast, liver), listed by the Merck Manual as a theoretical risk
  • • May lower HDL cholesterol and raise triglycerides
  • • Case reports of mania, including in people taking antidepressants, and one reported seizure
  • • More bleeding risk with blood thinners (anticoagulants)
  • • May counteract tamoxifen, aromatase inhibitors and fulvestrant
  • • Long-term safety data are limited; the Merck Manual describes adverse effects as unclear

Eligibility to Discuss With a Clinician

No prescription is needed to buy oral DHEA supplements, but low testosterone is diagnosed with morning blood tests (MedlinePlus notes samples are drawn between 7 and 10 a.m.) plus symptoms, not by trying a supplement. People with prostate or breast cancer, PCOS, or a history of mania should talk to a clinician first, as should anyone taking blood thinners, antidepressants, tamoxifen, aromatase inhibitors or fulvestrant. For women, the Endocrine Society's 2014 guideline advises against routine DHEA use because data on its effectiveness and safety are limited. Competitive athletes should know DHEA is banned by many sports organizations as a prohormone.

Explore Testosterone (TRT)Guides »

Related Medications

Testosterone Cypionate (Injectable)EnclomipheneTestosterone Cream/Gel

Provider Reviews

Explore providers in the testosterone (trt) category. This does not mean every provider offers DHEA (Dehydroepiandrosterone); check the exact product with the provider.

Related Articles

  • Understanding TRT: What to Know Before Starting Testosterone TherapyRead »
  • TRT Eligibility: Who Qualifies for Testosterone Replacement Therapy?Read »
  • TRT Side Effects and Monitoring: What to Expect on Testosterone TherapyRead »

Frequently Asked Questions

Sources and editorial notes

FDA status, dosing and mechanism come from the Intrarosa (prasterone) label on DailyMed; outcome numbers come from the abstracts of the 2006 NEJM trial and the 2020 and 2025 meta-analyses; risks and interactions come from the Merck Manual, all opened October 26, 2026. Defy Medical's TRT page was checked the same day; Marek Health's site would not load, so no provider prices or DHEA protocols are shown. No clinician review is claimed.

Content updated . Source checking is editorial work; it is not a clinical review.