Although present in both men and women, DHEA levels are higher in men throughout life. DHEA is produced in the adrenal gland, and according to Quackwatch.com (2004) "no one knows exactly what it does in the body." DHEA is easily converted into testosterone and estrogen. A Mayo Clinic study (Nair et al, 2006) published today in the New England Journal of Medicine examined the effects of the sex steroid Dehydroepiandrosterone (DHEA) in elderly men and women. Despite health-food store and internet claims that DHEA is the "fountain of youth," Nair et al largely confirmed results of the French "DHEAge" study (2000) which showed that the only consistent effect of DHEA administration was to raise DHEA levels.

In terms of gender-specific responses to DHEA administration, results have been inconsistent enough that it is difficult to draw conclusions. The DHEAge study showed some increase in female (but not male) libido. Nair et al. reported bone mineral density increased in both men and women, but these were site-specific and different between the sexes. As Paul M. Stewart (2006) puts it in his editorial about Nair et al's study, BMD changes "have been small, specific to site and sex, and not reproducible between studies." Nair et al also found a slight decrease in HDL ("good" cholesterol) for men and women taken together, but no other lipid changes. Kudielka et al (1998) showed that DHEA treatment seemed to affect adrenal stress hormone levels in elderly women under social stress tests, but not in men. Kudielka et al's study did not show any reduction of subjective stress, however. Gurnell and Chatterjee's review (2001) suggested that DHEA's seeming effectiveness in women might be attributable to raising androgen levels above what would normally be expected in women, although (being pro-DHEA) they were quick to point out that the body hair and lipid level side effects had not been demonstrated as being present.

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My relationship to OTC hormones is largely influenced by my participation in the transsexual community. It seems like the question arises again and again in the female-to-male online forums: "will taking DHEA give me masculinizing effects?" Testosterone itself is schedule III controlled substance (like ketamine or codeine), with heavily restricted access and legal implications for unauthorized possession, which DrugPolicy.org says are rapidly increasing due to media attention. Therefore, a lot of transsexuals frustrated with the red tape attempt to jump-start their transition with "dietary supplements" -- an expensive and ineffective habit. I am somewhat heartened to see that most of the DHEA studies show no ill effect from the administration of DHEA, but I worry about what long-term effects may be looming in the future. However, this concern is probably biased, since the Mayo Clinic points out that long-term effects of the plain-old-testosterone therapy I take myself are largely unknown.