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What is DHEA?

Dehydroepiandrosterone (DHEA) is a hormone that assists women with the production of testosterone. Watch Dr. Gleicher explain the history of DHEA and its application in fertility treatment.

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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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