Is DHEA Scientifically Proven to Boost Testosterone? Urologist Explains

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Low testosterone is a growing concern for many men, especially as they age. Nearly 40% of men over the age of 40 experience symptoms related to low testosterone, including fatigue, erectile dysfunction, decreased sex drive, loss of muscle mass, mood changes, and even cognitive issues like brain fog. Beyond quality of life, low testosterone also raises the risk of metabolic problems such as diabetes, high cholesterol, and cardiovascular disease.

Many men seek natural or over-the-counter supplements to boost their testosterone levels, often without consulting a physician. However, with the supplement industry booming—selling nearly $9 billion worth of products in the US alone in 2018—it's crucial to understand what actually works and what might pose risks. Here, we’ll explore three popular testosterone boosters: androstenedione, androstenediol, and dehydroepiandrosterone (DHEA), examining the science behind their effectiveness and safety.

Understanding Testosterone Boosters: What Are They?

Androstenedione, androstenediol, and DHEA are all classified as prohormones. This means they are precursors in the body’s hormone synthesis pathway, particularly related to cholesterol metabolism, and can convert into testosterone or other hormones. These supplements have been widely available over the counter at various points in time, although regulatory changes have tightened access to some.

Androstenedione: Does It Deliver?

Androstenedione is an endogenous androgen produced through the cholesterol pathway, initially synthesized from pregnanolone and progesterone. It is converted into testosterone by the enzyme 17 beta-hydroxy steroid dehydrogenase and can also convert into estrone and estradiol, forms of estrogen.

In studies where men took 300 mg of androstenedione daily for one month, there was a notable 34% increase in total testosterone levels. However, when supplementation extended to 12 weeks, testosterone levels returned to baseline, showing no sustained increase. Meanwhile, estradiol levels rose, which can lead to unwanted side effects such as gynecomastia (breast enlargement) and adverse changes in cholesterol profiles.

Importantly, despite the initial testosterone boost, there were no improvements in lean body mass, muscle fibre growth, or reduction in fat mass—typical markers expected if testosterone truly increased muscle-building effects. Additionally, lipid profiles worsened, with an increase in LDL (bad cholesterol) and apolipoprotein B, raising concerns about cardiovascular risk.

Androstenediol: A Closer Look

Androstenediol is another cholesterol pathway product, converted from DHEA and further down the line into testosterone. Interestingly, research suggests that when people take androstenediol supplements, their androstenedione and free testosterone levels rise, but total serum testosterone does not change significantly.

While an increase in free testosterone sounds promising—since this is the biologically active form available for the body to use—the rise in estrogen (estradiol) levels again poses potential risks. Similar to androstenedione, androstenediol supplementation led to decreased HDL (good cholesterol) and increased LDL, raising concerns about cardiovascular health.

Furthermore, no benefits were observed regarding lean body mass or fat loss, indicating that the hormonal changes did not translate into the expected anabolic or muscle-building effects.

DHEA: What Does the Evidence Say?

DHEA is a well-studied precursor hormone that remains available over the counter. Supplementation with DHEA reliably increases serum DHEA levels, as expected. However, multiple high-quality studies, including double-blinded, placebo-controlled randomized controlled trials, have shown that DHEA supplementation does not significantly increase total serum testosterone levels or improve lean body mass, strength, bone mineral density, or sexual function outcomes such as erectile function.

Unlike androstenedione and androstenediol, DHEA supplementation did not adversely affect lipid profiles, which is a positive finding. However, because it can increase estradiol levels, monitoring is advised if you choose to try DHEA.

Bottom Line: Are These Testosterone Boosters Worth It?

While androstenedione, androstenediol, and DHEA are all involved in the hormone synthesis pathway and can influence testosterone precursors, the evidence shows they do not reliably or sustainably increase total testosterone levels or produce the desired anabolic effects like increased muscle mass or reduced fat.

Moreover, androstenedione and androstenediol may elevate estrogen levels and negatively impact cholesterol profiles, potentially increasing cardiovascular risk. DHEA appears safer in terms of lipid effects but still lacks strong evidence for boosting testosterone or improving related health outcomes.

Given these findings, I generally do not recommend these supplements as effective testosterone boosters. The complex biochemical pathways these prohormones follow mean they can convert into multiple hormones, sometimes causing unintended side effects rather than the intended testosterone increase.

What’s Next?

This overview is just the beginning of my series exploring testosterone boosters. In upcoming articles, I will review other popular supplements like fenugreek (Trigonella foenum-graecum), as well as revisit herbs like tongkat ali and ashwagandha, which are frequently included in testosterone-boosting products.

If you’re interested in natural ways to support your testosterone and overall health, stay informed and consult with your healthcare provider before starting any new supplement. Remember, managing low testosterone effectively often requires a comprehensive approach that includes medical evaluation and lifestyle changes.