A blood sample drawn from a vein in your arm
Dehydroepiandrosterone sulfate (DHEAS) is a male sex hormone (androgen) that is present in both men and women. This test measures the level of DHEAS in the blood.
- 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
DHEAS is produced almost exclusively by the adrenal glands, with smaller amounts being produced by a woman's ovaries and a man's testicles.
A DHEAS test is useful in determining whether the adrenal glands are working properly. Adrenal tumors (cancerous and non-cancerous) and enlargement of an adrenal gland (hyperplasia) can lead to an increased level of DHEAS. Rarely, an ovarian tumor may produce DHEAS.
- May not be noticed in adult men
- Can cause early (precocious) puberty in young boys
- Can lead to absence of menstrual periods (amenorrhea) and the development of masculine physical characteristics (virilization) in girls and women, such as excess body and facial hair (hirsutism)
- Can cause a female baby to be born with genitals that are not distinctly male or female in appearance (ambiguous external genitalia)
How is the test used?
- Evaluate whether the adrenal glands are working properly
- Distinguish between DHEAS-secreting conditions that are caused by the adrenal glands from 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, DHEAS levels are often measured, along with other hormones such as FSH, LH, prolactin, estrogen, and testosterone, to help diagnose polycystic ovary syndrome (PCOS) and to help rule out other causes of infertility, lack of menstrual period (amenorrhea), and excess hair on the face and body (hirsutism).
DHEAS 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.
When is it ordered?
DHEAS levels are not routinely measured. A DHEAS test may be ordered, along with other hormone tests, when an excess (or, more rarely, a deficiency) in male hormones (androgens) is suspected and/or when your healthcare 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
- Excess facial or body hair (hirsutism)
- Loss of hair from the top of the head (male pattern baldness)
- Enlargement of the Adam's apple
- Decreased breast size
It may also be ordered when a girl has genitals that are not distinctly male or female in appearance (ambiguous genitalia).
DHEAS may also be measured when young boys show signs of early (precocious) puberty, the development of a deeper voice, pubic hair, muscularity, and an enlarged penis well before the age of normal puberty.
What does the test result mean?
A normal DHEAS level, in addition to other normal male hormone levels, likely indicates that your adrenal glands are functioning normally. Rarely, DHEAS may be normal when an adrenal tumor or cancer is present but is not producing excess hormones.
A high DHEAS blood level may indicate that excess DHEAS production is causing or contributing to your symptoms. However, an increased level of DHEAS 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 DHEAS may indicate:
- Congenital adrenal hyperplasia
- A tumor of the adrenal gland, which may be benign or cancerous
- Polycystic ovary syndrome (PCOS)—about 25% to 50% of women with POCS have elevated DHEAS
- Rarely, an ovarian tumor that produces DHEAS
A low level of DHEAS may be due to:
Does my sample for a DHEAS level have to be drawn at a certain time of day like other hormone tests?
Some hormones are increased in the morning while others rise and fall throughout the day. Some are released intermittently or with increased activity or in response to stress. Some hormones are higher at particular times of the month, and others are relatively stable. Blood sample collection for some hormone tests are timed so that the hormones can be evaluated at their highest or lowest levels. The DHEAS concentration, however, is stable, so your sample may be collected any time of day and it will not affect the result of the test.
Does everyone with elevated DHEAS have symptoms?
Not necessarily. It may be difficult to determine when adult men have an elevated level of DHEAS (since they already have masculine secondary sexual characteristics) and women of some ethnic groups (for example, Asian women) may have elevated levels of testosterone and DHEAS without exhibiting symptoms such as excess hair growth or acne. Also, it should be noted that symptoms and their severity will vary from person to person.
Can the DHEAS test be performed in my healthcare practitioner's office?
Is there anything else I should know?
DHEAS levels are normally high in both male and female newborns. They drop sharply shortly after birth, then rise again during puberty. DHEAS concentrations peak after puberty, and then, like other male and female hormones, the levels tend to decline with age.
People taking DHEA supplements will have elevated blood levels of DHEAS. Certain antidiabetic drugs (such as metformin and troglitazone), prolactin, danazol, calcium channel blockers, and nicotine may also increase DHEAS levels. Drugs/hormones that may show decreased levels include insulin, oral contraceptives, corticosteroids, dopamine, hepatic enzyme inducers (carbamazepine, imipramine, phenytoin), fish oil, and vitamin E. It is important to inform your healthcare provider when taking any of these medications or supplements.