DHEA Before
You Dose
The androgen panel every woman should run before starting DHEA — and what to do with the results.
"Your androgen environment is not a background variable. It is the terrain in which every follicle either thrives or stalls."
| Marker | Why It Matters | Priority |
|---|---|---|
| DHEA-S | Your baseline adrenal androgen production. Low DHEA-S is the primary justification for supplementing. | Essential |
| Total Testosterone | Elevated total T in context of PCOS or adrenal dysfunction makes DHEA potentially problematic. | Essential |
| Free Testosterone | The bioavailable fraction — often more clinically meaningful than total T, especially in androgen excess. | Essential |
| SHBG | Low SHBG = more free androgens circulating. Context for interpreting total T and estrogen status. | Essential |
| Androstenedione | Upstream androgen. Elevated levels signal the androgen pathway is already overactive before DHEA is added. | Important |
| Fasting Insulin | Hyperinsulinaemia drives androgen excess independently of PCOS diagnosis. Do not skip this. | Essential |
| Fasting Glucose | Pairs with fasting insulin for metabolic picture. Elevated glucose compounds androgen sensitivity. | Essential |
| LH / FSH Ratio | If PCOS traits are present (acne, irregular cycles, oily skin), LH:FSH ratio adds diagnostic weight. LH-dominant pattern is a contra-indication flag. | If PCOS traits |
DHEA May Be Appropriate If…
- DHEA-S is genuinely low (bottom quartile of functional range)
- Total and free testosterone within or below range
- SHBG normal or high
- Fasting insulin normal (≤7–8 mIU/L functionally)
- No PCOS symptoms present
- DOR confirmed with low AMH or low AFC
Reconsider or Avoid DHEA If…
- Total or free testosterone already elevated
- High AMH (PCOS spectrum picture)
- Fasting insulin elevated (>7–8 mIU/L)
- Low SHBG with high free androgen index
- Androstenedione elevated
- Acne, oily skin, facial hair, hair shedding present
- LH:FSH ratio >2:1
Stop DHEA Immediately If You Notice These Signs
These are not detox symptoms. They are your androgen system signalling overload. If any of the following appear within weeks of starting DHEA, stop and retest your androgen panel.
If DHEA Is Appropriate for You
Most fertility research uses 25–75mg/day, with IVF-specific studies often using 75mg split across the day. Micronised DHEA has better oral bioavailability than standard formulations. Run labs 8–12 weeks after initiating to confirm your levels haven't pushed into excess — and always work with a practitioner who can contextualise the results against your full clinical picture. Higher is not better. The goal is adequacy, not supraphysiological.
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blood panel mapped out?
Inside The Fertility Circle, we build your functional testing picture — not just DHEA, but the complete hormonal, metabolic, and nutrient terrain that determines your actual fertility baseline.
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