Normal DHEA-S Levels by Age: What's Typical, and What Isn't
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The short answer
DHEA-S comes almost entirely from the adrenal glands and peaks in the late teens before declining steadily with age in everyone; androstenedione comes from both the adrenals and the ovaries. In PCOS, elevated DHEA-S alone is usually adrenal-source androgen excess — but a level above roughly 700 µg/dL, or a sudden onset, points past PCOS toward a tumour work-up instead.
What is DHEA-S, and why does a PCOS panel test it separately from testosterone?
DHEA-S is produced almost exclusively by the adrenal glands, which makes it the one androgen tested as part of the full PCOS diagnostic work-up that isn’t primarily driven by the ovaries — testosterone and androstenedione both have a meaningful ovarian contribution, but DHEA-S is an adrenal-specific marker used to work out where excess androgen is coming from. In a 2018 study measuring all three androgens together in 1,205 women referred for androgen excess, severe DHEA-S elevation in premenopausal women was predominantly caused by PCOS (80% of cases), while severe elevations of androstenedione and testosterone in the same premenopausal group were more often driven by non-classic congenital adrenal hyperplasia (59% and 43% of severe cases, respectively). That pattern is why a panel includes DHEA-S specifically: an androgen picture dominated by DHEA-S looks different, diagnostically, from one dominated by androstenedione or testosterone, even though all three sit under the umbrella term “elevated androgens.”
Note: in May 2026, PCOS was renamed polyendocrine metabolic ovarian syndrome, or PMOS, by a global consensus of more than 50 organisations. The adrenal-androgen testing described here didn’t change — only the name for the underlying condition did. This article uses PCOS, since that is still what most readers search.
What are normal DHEA-S levels in women, by age?
DHEA-S peaks in the late teens and declines steadily for the rest of life in both sexes — a 1984 study measuring DHEA-S in 481 women aged 11 to 89 found a geometric mean of roughly 247 µg/dL at ages 15–19, falling to roughly 45 µg/dL past age 70, a more than fivefold decline across adulthood. That study was conducted in a general population, not specifically in PCOS, and it establishes the age-related biology rather than a PCOS-specific range.
| Age band | Typical range (µg/dL) | Typical range (µmol/L) |
|---|---|---|
| 18–19 | ~145–395 | ~3.9–10.7 |
| 20–29 | ~65–380 | ~1.8–10.3 |
| 30–39 | ~45–270 | ~1.2–7.3 |
| 40–49 | ~32–240 | ~0.9–6.5 |
| 50 and over | ~20–190 | ~0.5–5.1 |
*These are commonly published laboratory reference intervals, not a single validated study’s percentiles, and they vary by assay. The number that applies to your result is the range printed on your own report, from your own lab.
What is androstenedione, and why get it tested alongside DHEA-S and testosterone?
Androstenedione is the precursor hormone that both the adrenal glands and the ovaries convert into testosterone, which makes it useful precisely because it can catch androgen excess that testosterone alone misses. In a 2014 study of 86 people with PCOS and 43 controls, everyone with an elevated total testosterone also had elevated androstenedione, but 20 of the 86 people with PCOS (23%) had a normal total testosterone alongside a clearly elevated androstenedione — hyperandrogenism that a testosterone-only panel would have missed entirely. That same study found dysglycaemia on an oral glucose tolerance test in 0% of people with both androgens normal, 14% of those with only androstenedione elevated, and 25% of those with both elevated — metabolic risk scaled with the androgen picture rather than jumping only when testosterone itself crossed the line, which is why measuring both catches risk a testosterone-only panel would understate.
| Hormone | Primary source | Typical range (conventional) | Typical range (SI) | Isolated elevation suggests |
|---|---|---|---|---|
| DHEA-S | Adrenal, almost exclusively | ~35–430 µg/dL | ~0.9–11.7 µmol/L | Adrenal-source androgen excess, most often PCOS |
| Androstenedione | Adrenal and ovarian, mixed | ~30–200 ng/dL | ~1.0–7.0 nmol/L | Androgen excess missed by testosterone alone; if severe, non-classic CAH |
| Total testosterone | Ovarian and adrenal, mixed | ~8–60 ng/dL | ~0.3–2.1 nmol/L | Ovarian-source androgen excess; if severe, an androgen-secreting tumour |
*Commonly published laboratory reference intervals, not a single validated study’s percentiles. Assay method changes where these ranges sit, which is why the range printed on your own report — not this table — is the one that applies to your result.
How common is adrenal androgen excess in PCOS, and when does it point elsewhere?
Roughly 20–30% of people with PCOS show excess adrenal androgen production on DHEA-S, according to a 2015 review of the mechanism behind adrenal androgens in PCOS, and in the 1,205-woman study above, PCOS accounted for the large majority of severe DHEA-S elevations seen in premenopausal women referred for androgen testing — but that same study also found that essentially all severe androstenedione and DHEA-S excess in postmenopausal women traced back to adrenal tumours rather than PCOS, since PCOS as a cause of new androgen excess becomes far less likely once ovarian function has stopped. Non-classic congenital adrenal hyperplasia is the other adrenal-androgen mimic worth ruling out in premenopausal women, distinguished from PCOS by an elevated 17-OH progesterone rather than by DHEA-S itself. The practical rule: DHEA-S elevation in a premenopausal person with a PCOS-typical history is usually PCOS; the same finding after menopause, or alongside a testosterone or androstenedione level far outside range, is not.
Do any supplements lower DHEA-S in PCOS?
No supplement has controlled-trial evidence showing it reliably lowers DHEA-S in PCOS, and claims to the contrary online are not backed by the kind of trial data this site requires before repeating a number. The medical options that address adrenal androgen symptoms work differently from what “lowering DHEA-S” implies: spironolactone blocks the androgen receptor rather than reducing the hormone itself, and combined hormonal contraceptives suppress LH-driven ovarian androgen output more effectively than they suppress ACTH-driven adrenal output, which is why DHEA-S often changes less than testosterone does on the same treatment. If a DHEA-S result is the specific concern, that is worth naming directly to a clinician rather than defaulting to a supplement marketed for “adrenal support,” a term with no consistent clinical definition.
Who this doesn’t help
This won’t tell you whether your own DHEA-S or androstenedione result is normal — that comparison has to be made against the range printed on your own report, not the tables above. It also won’t settle a diagnosis by itself: DHEA-S and androstenedione are not part of the Rotterdam criteria in the way testosterone is, so an elevated result on either supports the biochemical-hyperandrogenism leg but doesn’t replace assessing ovulation and ultrasound or AMH findings, and a normal result on both doesn’t rule PCOS out. And it won’t substitute for imaging when either value is severely elevated or rose suddenly — that combination needs a tumour work-up regardless of how the rest of the PCOS picture looks.
Common questions
What are normal DHEA-S levels in women by age?
DHEA-S peaks in the late teens at a geometric mean of roughly 247 µg/dL and declines steadily to roughly 45 µg/dL by age 70 and beyond, a more than fivefold drop across adulthood, per a study following 481 women aged 11 to 89.What is androstenedione, and why is it tested with DHEA-S and testosterone?
Androstenedione is a precursor both the adrenal glands and ovaries convert to testosterone. In one study, 23% of people with PCOS had a normal total testosterone but a clearly elevated androstenedione — hyperandrogenism a testosterone-only panel would have missed.How common is adrenal androgen excess in PCOS?
Roughly a quarter to a third of people with PCOS show an elevated DHEA-S. In women referred for androgen testing, PCOS accounted for the large majority of severe DHEA-S elevation seen before menopause.Do any supplements lower DHEA-S in PCOS?
No supplement has controlled-trial evidence for reliably lowering DHEA-S in PCOS. Medical options like spironolactone block the androgen receptor rather than lowering the hormone, and combined hormonal contraceptives affect ovarian androgens more than adrenal ones.What DHEA-S level suggests a tumour rather than PCOS?
A DHEA-S above roughly 700 µg/dL, or any androgen elevation that developed suddenly over weeks rather than gradually since adolescence, should prompt imaging for an adrenal tumour rather than a PCOS diagnosis.Can DHEA-S be elevated without PCOS?
Yes. Non-classic congenital adrenal hyperplasia and, less commonly, adrenal tumours can both elevate DHEA-S. Non-classic CAH is distinguished from PCOS by an elevated 17-OH progesterone, and severe elevation after menopause points toward a tumour rather than PCOS.
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Sources
- 1.Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023.
- 2.Orentreich N, Brind JL, Rizer RL, Vogelman JH. Age Changes and Sex Differences in Serum Dehydroepiandrosterone Sulfate Concentrations Throughout Adulthood. J Clin Endocrinol Metab. 1984.
- 3.Elhassan YS, Idkowiak J, Smith K, et al. Causes, Patterns, and Severity of Androgen Excess in 1205 Consecutively Recruited Women. J Clin Endocrinol Metab. 2018.
- 4.O'Reilly MW, Taylor AE, Crabtree NJ, et al. Hyperandrogenemia Predicts Metabolic Phenotype in Polycystic Ovary Syndrome: The Utility of Serum Androstenedione. J Clin Endocrinol Metab. 2014.
- 5.Martin KA, Anderson RR, Chang RJ, et al. Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018.
- 6.Goodarzi MO, Carmina E, Azziz R. DHEA, DHEAS and PCOS. J Steroid Biochem Mol Biol. 2015.
- 7.Teede HJ, Khomami MB, Morman R, et al. Polyendocrine Metabolic Ovarian Syndrome, the New Name for Polycystic Ovary Syndrome: A Multistep Global Consensus Process. Lancet. 2026.