A blood sample drawn from a vein in your arm
None, although women should talk to their health practitioner about the timing of the test; your healthcare provider may want to have the sample collected a week before or after your menstrual period.
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.
It is useful as a marker for adrenal gland function. Adrenal tumors (cancerous and non-cancerous) and adrenal hyperplasia can lead to the overproduction 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 sample collected for testing?
A blood sample is obtained by inserting a needle into a vein in the arm.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed. Women should talk to their health practitioner about the timing of the test. The healthcare provider may want to have the sample collected a week before or after a woman's menstrual period.
How is it used?
- Evaluate adrenal gland function
- Distinguish 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 adult-onset adrenal hyperplasia
In women, concentrations of DHEAS 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 presence of excess facial and body hair (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, whenever excess (or, more rarely, deficient) androgen production is suspected and/or when a health practitioner wants to evaluate a person's adrenal gland function.
- A deeper voice
- Excess facial or body hair (hirsutism)
- Male pattern baldness
- Enlargement of the Adam's apple
- Decreased breast size
It may also be ordered when a young girl shows signs of virilization or when a female infant has external genitalia that are not distinctly male or female in appearance (ambiguous genitalia).
DHEAS 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.
What does the test result mean?
A normal DHEAS level, in addition to other normal male hormone (androgen) levels, likely indicates that the adrenal gland is functioning normally. Rarely, DHEAS may be normal when an adrenal tumor or cancer is present but is not secreting hormones.
A high DHEAS blood level may indicate that excess DHEAS production is causing or contributing to the person's 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 an adrenocortical tumor, Cushing disease, adrenal cancer, or adrenal hyperplasia, or rarely a DHEAS-producing ovarian tumor.
DHEAS may be elevated with polycystic ovary syndrome (PCOS) but may also be normal as this disorder is usually related to ovarian androgen production (primarily testosterone).
A low level of DHEAS may be due to adrenal insufficiency, adrenal dysfunction, Addison disease, or hypopituitarism, a condition that causes low levels of the pituitary hormones that regulate the production and secretion of adrenal hormones.
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 products.
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 the symptoms present and their severity will vary from person to person.
Can the DHEAS test be performed in my doctor's office?
Should everyone have a DHEAS test?
Testing is typically only performed when a person has symptoms that suggest excess or inadequate production of DHEAS. Most people will not need to have this test performed.
On This Site
Elsewhere On The Web
Hormone Health Network: An Introduction to the Endocrine System
Hormone Health Network: Adrenal Disorders
Hormone Health Network: Precocious Puberty
American Cancer Society: Adrenal Cancer
National Cancer Institute: Adrenocortical Carcinoma
National Endocrine and Metabolic Diseases Information Service: Adrenal Insufficiency and Addison's Disease
National Endocrine and Metabolic Diseases Information Service: Polycystic Ovary Syndrome (PCOS): Overview