Hello, I'm Dr. Gleicher and I'm the Medical Director and Chief Scientist at CHR.
One of the questions we hear almost every day is, "What is DHEA?"
Now DHEA stands for dehydroepiandrosterone
and it is a hormone that we all are producing in our bodies,
indeed it is what we call a "mild male hormone."
What does that mean? It means that it doesn't do very much
physiologically. And the reason that this male hormone has no really great function in
our bodies
is that it's affinity to the androgen receptor (to the cell receptor that
translates the hormone's function into activities in our body), that affinity, is very low for
DHEA. It is, for example, very high for testosterone,
and therefore testosterone is the most important male hormone in our bodies. So,
DHEA
does not have a lot of function. Yet,
why do we talk so much about it? The reason is simple. Our body makes
testosterone, the most important male hormone, from
DHEA. In other words, DHEA is the
substrate from which our body makes testosterone and testosterone is
extremely important in our bodies not only in men, but also in women. As we learned
starting about 12 years ago,
good testosterone levels are really crucially important for
normal
follicular maturation in ovaries. In the old days,
15-20 years ago, we used to believe that male hormones were bad for
follicle maturation and ovulation, in general for female fertility.
That mistaken belief came from our knowledge
that women with so-called polycystic ovary syndrome, or PCOS,
usually have high androgen levels
(high male hormones) and often do not ovulate.
That
association made us believe for the longest time that
high androgen levels are something "bad" that really harms
ovarian function. And it is, indeed, true that
too high
androgen levels are bad.
But too low
androgen levels are also bad because if
testosterone levels (particularly
testosterone levels) are too low,
the normal progression of follicle maturation
slows down and
in worst cases completely stops. And
those few follicles that still make it through the process usually produce relatively poor quality eggs. And
since eggs make up 95% of embryos, the embryo quality also suffers and
therefore pregnancy chances are low.
So, when we prescribe
DHEA to our infertility patients,
it is not so much to raise DHEA levels in their blood
(even though that's what's happening too), but it is really to raise
testosterone levels in their blood. It is the testosterone hormone
that is usually low in these patients and that needs to be raised in order to make the ovaries produce
more and
better eggs. I
hope you now know what
DHEA is all about. Thank you.
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