Confirm the result with repeat testing and review DHEA-S, total/free testosterone, androstenedione, LH, FSH, prolactin, TSH, 17-hydroxyprogesterone, and cortisol if indicated
Stop any DHEA supplements, “adrenal support” products, or androgenic supplements unless prescribed
Review all medications and hormones with a clinician
Evaluate for polycystic ovary syndrome
Evaluate for congenital adrenal hyperplasia
Evaluate for adrenal or ovarian tumors if levels are markedly elevated or symptoms are rapid/severe
Treat the underlying cause rather than the DHEA level itself
Use combined oral contraceptives if appropriate to reduce androgen symptoms
Use anti-androgens such as spironolactone if appropriate and prescribed
Manage insulin resistance with weight loss, exercise, and metformin if indicated
Address stress, sleep, and overall metabolic health
Refer to an endocrinologist or gynecologist for persistent or unexplained elevation
Seek urgent evaluation for rapid virilization, severe abdominal pain, or very high DHEA-S levels