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Dehydroepiandrosterone sulfate is an endogenous steroid hormone produced primarily by the adrenal cortex and is the 3β-sulfate ester form and major circulating metabolite of dehydroepiandrosterone (DHEA)[1][7]. DHEA-S is hormonally inert but acts as a neurosteroid and neurotrophin, influencing several neurotransmitter systems. It is a positive allosteric modulator of the NMDA receptor, a negative allosteric modulator of GABA_A and glycine receptors, a weak agonist of the sigma-1 receptor, and binds to TrkA and p75^NTR^ (neurotrophin receptors) with high affinity[1]. DHEA-S can inhibit TRPV1 and TRPC5 channels and P2X receptors[1]. Clinically, prasterone sodium sulfate (the sodium salt form of DHEA-S) is approved in Japan for cervical ripening and dilation during childbirth[1]. DHEA supplementation or DHEA-S testing is used in evaluating adrenal function, androgen excess, disorders of sexual development, and early/late puberty[5][9]. DHEA-S may be used off-label or investigationally for conditions such as systemic lupus erythematosus (SLE), adrenal insufficiency, depression, osteoporosis, and sexual dysfunction, but efficacy and long-term safety remain inadequately established[2][3][4][6][8][10].
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