Table of ContentsView AllTable of ContentsWhat Is DHT?DHT FunctionDHT vs. TestosteroneEffect of High LevelsEffect of Low LevelsLowering DHTSide Effects of DHT Blockers
Table of ContentsView All
View All
Table of Contents
What Is DHT?
DHT Function
DHT vs. Testosterone
Effect of High Levels
Effect of Low Levels
Lowering DHT
Side Effects of DHT Blockers
Dihydrotestosterone(DHT) is an androgen that promotes the growth of facial hair, body hair, and pubic hair during puberty in those assigned male at birth. It also plays a role in the growth of the penis, scrotum, and prostate.
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These effects are similar to those oftestosterone. DHT hormone is formed from testosterone and is a precursor of other steroid hormones.
This article reviews the known effects of dihydrotestosterone, as well as some that are still under investigation.
Dihydrotestosterone (DHT) is a primary androgen hormone that is derived from testosterone. DHT is present starting in utero. Its role changes as males progress through developmental stages with various impacts on physiology during childhood, puberty, and throughout adult life.
What Does DHT Do for the Body?
DHT directs the development of the external genitalia, including the penis and scrotum, and theprostate gland. During puberty, DHT plays an important role in the growth of facial and body hair, increased muscle mass, and deepening of the voice.
Impact on Sexual Development
DHT has several effects on sexual development and sexual function, including:
In particular, DHT plays an important role in the development of male external genitalia. At puberty, DHT is critical forpenile growth. It works in combination with testosterone to increase the size of the male external genitalia.
This does not mean that taking testosterone or DHT will increase your penis size. Adult males who have completed puberty no longer have androgen receptors in their penile tissue.
Impact on Sexual Function
The role of DHT in male sexual function is still somewhat controversial. Much of the data is indirect, coming from studies of 5-alpha reductase inhibitors rather than studies of DHT levels directly.
That said, a number of studies have shown an increase inerectile dysfunctionin males taking 5-alpha reductase inhibitors to decrease their DHT levels.These medications have also been shown to decrease libido and sex drive. As such, it is generally held that DHT plays an important role in male sexual desire and function.
Although drugs that reduce DHT also cause problems for male sexual function, it is not necessarily true that DHT treatment would improve sexual function. Higher levels may not always be better.
DHT levels interact with the levels of steroids in the blood, and increasing DHT can decrease other hormones, such as estrogen. It’s possible this could negatively affect male sexual function.
Impact on Fertility
The effects of DHT onmale fertilityare not yet clear. The enzymes that produce DHT are present in the prostate, the penis, and the scrotum. However, they are not present in the testes. This suggests thatspermatogenesisdoes not require DHT.
However, some data suggest that 5-alpha reductase inhibitors can affect sperm production, at least temporarily.Use of these drugs has been associated with decreased sperm count and lowered semen volume in some studies. It has also been associated with reduced sperm motility.
Fortunately, these effects seem to be reversible when treatment is discontinued. Furthermore, other studies have not seen changes in sperm parameters with low-dose finasteride, so further research is still needed.
DHT and testosterone are both classified as androgens. In the body, the enzyme 5-alpha reductase converts testosterone to DHT.
DHT is estimated to be around five times more powerful than testosterone.DHT is primarily created in the organs where it is used, such as the prostate.
Testosterone and DHT both bind to the same receptors. However, DHT does so more efficiently.
Most DHT and testosterone in the body are bound to proteins, such as albumin and sex hormone-binding globulin in the blood. With DHT, less than 1% of the hormone in the blood is circulating freely.This is slightly lower than the amount of free versus bound testosterone.
Albumin can bind a large amount of testosterone or other sex hormones but binds those hormones weakly. Sex hormone-binding globulin, in contrast, binds less hormone but does so more strongly.
When DHT Is Too High
The significance of DHT differs in various organs. High levels of DHT are problematic in some areas of the body, but necessary in others.
As a broad overview, an overproduction of DHT is known to cause a number of undesirable health effects in males includingenlargement of the prostateandmale pattern baldness.
It can also causehirsutism(excess hair growth) and female pattern baldness.
Male Pattern Baldness
Androgens are important for the hair-growth patterns associated with puberty. However, not all hair follicles react to androgens in the same way.
In particular, an excess of DHT has been associated with both beard growth and male pattern baldness. This is why anti-DHT medications can be used to improve hair growth on the scalp in males who are experiencing male pattern baldness.
Prostate Disease
DHT is commonly associated withbenign prostatic hyperplasia(BPH). BPH can cause symptoms such as difficulty urinating, needing to urinate more frequently, and other urinary issues.
DHT stimulates the growth of epithelial and stromal cells in the prostate. DHT works in combination with estrogen to promote prostate enlargement.
The estrogens that are more common in older males increase the number of hormone receptors in the prostate. With more hormone receptors, DHT leads to prostate growth.
DHT-induced prostate growth can sometimes be treated with drugs that reduce DHT concentrations such as finasteride, a 5-alpha-reductase inhibitor.
What Is an Enlarged Prostate?
Hirsutism
An overproduction of DHT can cause females to experienceextra facial and body hair growth.
Although it may seem confusing, blocking DHT can reduce unwanted hair growth for females. This is often done with the same drugs used to increase hair growth among balding males.
The same drugs have opposite effects because hair follicles in each area of the body respond differently to different types of hormones.
Androgen Insensitivity
When DHT Is Too Low
In babies, when DHT is too low, it affects the development of male sex characteristics. Low DHT may cause delays in the onset of puberty for males and females, as well as reduced pubic and body hair.
In addition, low DHT in males may cause:
How Is DHT Reduced?
Finasteride (Proscar, Propecia) and dutasteride (Avodart) are examples of FDA-approved medications that lower DHT levels.
Certain foods and nutrients are purported to lower DHT levels, such as:
What Are the Side Effects of DHT Blockers?
Documented risks of taking DHT blockers include:
Summary
Dihydrotestosterone (DHT) is a male hormone that plays a role in the development of male sex organs and male characteristics such as facial and body hair.
In babies, when DHT is too low, it affects the development of male sex characteristics. In adults, high DHT levels can contribute to undesirable health effects like enlarged prostate and male pattern baldness.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Medline Plus.SRD5A2 gene.Hirshburg JM, Kelsey PA, Therrien CA, Gavino AC, Reichenberg JS.Adverse Effects and Safety of 5-alpha Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review. J Clin Aesthet Dermatol. 2016 Jul;9(7):56-62. PMID: 27672412Drobnis EZ, Nangia AK, Drobnis EZ, Nangia AK.5α-Reductase inhibitors (5ARIs) and male reproduction.Impacts of Medications on Male Fertility. 2017:59-61.Elsaie ML.Hormonal treatment of acne vulgaris: an update.Clin Cosmet Investig Dermatol. 2016;9:241-8. doi:10.2147/CCID.S114830Laurent M, Antonio L, Sinnesael M, et al.Androgens and estrogens in skeletal sexual dimorphism.Asian J Androl. 2014;16(2):213-22. doi:10.4103/1008-682X.122356Health Matters.Dihydrotestosterone - female.Harvard Medical School.Testosterone, prostate cancer, and balding - Is there a link?Medline Plus.Androgen insensitivity syndrome.Adil A, Godwin M.The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. J Am Acad Dermatol. 2017 Jul;77(1):136-141.e5. doi: 10.1016/j.jaad.2017.02.054Patel DP, Swink SM, Castelo-Soccio L.A Review of the Use of Biotin for Hair Loss. Skin Appendage Disord. 2017 Aug;3(3):166-169. doi: 10.1159/000462981Cho YH, Lee SY, Jeong DW, Choi EJ, Kim YJ, Lee JG, Yi YH, Cha HS.Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med. 2014;2014:549721. doi: 10.1155/2014/549721Ashique S, Sandhu NK, Haque SN, Koley K.A Systemic Review on Topical Marketed Formulations, Natural Products, and Oral Supplements to Prevent Androgenic Alopecia: A Review. Nat Prod Bioprospect. 2020 Dec;10(6):345-365. doi: 10.1007/s13659-020-00267-9Fischer TW, Herczeg-Lisztes E, Funk W, Zillikens D, Bíró T, Paus R.Differential effects of caffeine on hair shaft elongation, matrix and outer root sheath keratinocyte proliferation, and transforming growth factor-β2/insulin-like growth factor-1-mediated regulation of the hair cycle in male and female human hair follicles in vitro. Br J Dermatol. 2014 Nov;171(5):1031-43. doi: 10.1111/bjd.13114Ekman P.A risk-benefit assessment of treatment with finasteride in benign prostatic hyperplasia. Drug Saf. 1998 Mar;18(3):161-70. doi: 10.2165/00002018-199818030-00002Additional ReadingMarchetti PM, Barth JH.Clinical biochemistry of dihydrotestosterone.Ann Clin Biochem. 2013;50(Pt 2):95-107. doi:10.1258/acb.2012.012159Swerdloff RS, Dudley RE, Page ST, Wang C, Salameh WA. Dihydrotestosterone:Biochemistry, physiology, and clinical implications of elevated blood levels.Endocr Rev. 2017;38(3):220-254. doi:10.1210/er.2016-1067
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Medline Plus.SRD5A2 gene.Hirshburg JM, Kelsey PA, Therrien CA, Gavino AC, Reichenberg JS.Adverse Effects and Safety of 5-alpha Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review. J Clin Aesthet Dermatol. 2016 Jul;9(7):56-62. PMID: 27672412Drobnis EZ, Nangia AK, Drobnis EZ, Nangia AK.5α-Reductase inhibitors (5ARIs) and male reproduction.Impacts of Medications on Male Fertility. 2017:59-61.Elsaie ML.Hormonal treatment of acne vulgaris: an update.Clin Cosmet Investig Dermatol. 2016;9:241-8. doi:10.2147/CCID.S114830Laurent M, Antonio L, Sinnesael M, et al.Androgens and estrogens in skeletal sexual dimorphism.Asian J Androl. 2014;16(2):213-22. doi:10.4103/1008-682X.122356Health Matters.Dihydrotestosterone - female.Harvard Medical School.Testosterone, prostate cancer, and balding - Is there a link?Medline Plus.Androgen insensitivity syndrome.Adil A, Godwin M.The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. J Am Acad Dermatol. 2017 Jul;77(1):136-141.e5. doi: 10.1016/j.jaad.2017.02.054Patel DP, Swink SM, Castelo-Soccio L.A Review of the Use of Biotin for Hair Loss. Skin Appendage Disord. 2017 Aug;3(3):166-169. doi: 10.1159/000462981Cho YH, Lee SY, Jeong DW, Choi EJ, Kim YJ, Lee JG, Yi YH, Cha HS.Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med. 2014;2014:549721. doi: 10.1155/2014/549721Ashique S, Sandhu NK, Haque SN, Koley K.A Systemic Review on Topical Marketed Formulations, Natural Products, and Oral Supplements to Prevent Androgenic Alopecia: A Review. Nat Prod Bioprospect. 2020 Dec;10(6):345-365. doi: 10.1007/s13659-020-00267-9Fischer TW, Herczeg-Lisztes E, Funk W, Zillikens D, Bíró T, Paus R.Differential effects of caffeine on hair shaft elongation, matrix and outer root sheath keratinocyte proliferation, and transforming growth factor-β2/insulin-like growth factor-1-mediated regulation of the hair cycle in male and female human hair follicles in vitro. Br J Dermatol. 2014 Nov;171(5):1031-43. doi: 10.1111/bjd.13114Ekman P.A risk-benefit assessment of treatment with finasteride in benign prostatic hyperplasia. Drug Saf. 1998 Mar;18(3):161-70. doi: 10.2165/00002018-199818030-00002Additional ReadingMarchetti PM, Barth JH.Clinical biochemistry of dihydrotestosterone.Ann Clin Biochem. 2013;50(Pt 2):95-107. doi:10.1258/acb.2012.012159Swerdloff RS, Dudley RE, Page ST, Wang C, Salameh WA. Dihydrotestosterone:Biochemistry, physiology, and clinical implications of elevated blood levels.Endocr Rev. 2017;38(3):220-254. doi:10.1210/er.2016-1067
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Medline Plus.SRD5A2 gene.Hirshburg JM, Kelsey PA, Therrien CA, Gavino AC, Reichenberg JS.Adverse Effects and Safety of 5-alpha Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review. J Clin Aesthet Dermatol. 2016 Jul;9(7):56-62. PMID: 27672412Drobnis EZ, Nangia AK, Drobnis EZ, Nangia AK.5α-Reductase inhibitors (5ARIs) and male reproduction.Impacts of Medications on Male Fertility. 2017:59-61.Elsaie ML.Hormonal treatment of acne vulgaris: an update.Clin Cosmet Investig Dermatol. 2016;9:241-8. doi:10.2147/CCID.S114830Laurent M, Antonio L, Sinnesael M, et al.Androgens and estrogens in skeletal sexual dimorphism.Asian J Androl. 2014;16(2):213-22. doi:10.4103/1008-682X.122356Health Matters.Dihydrotestosterone - female.Harvard Medical School.Testosterone, prostate cancer, and balding - Is there a link?Medline Plus.Androgen insensitivity syndrome.Adil A, Godwin M.The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. J Am Acad Dermatol. 2017 Jul;77(1):136-141.e5. doi: 10.1016/j.jaad.2017.02.054Patel DP, Swink SM, Castelo-Soccio L.A Review of the Use of Biotin for Hair Loss. Skin Appendage Disord. 2017 Aug;3(3):166-169. doi: 10.1159/000462981Cho YH, Lee SY, Jeong DW, Choi EJ, Kim YJ, Lee JG, Yi YH, Cha HS.Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med. 2014;2014:549721. doi: 10.1155/2014/549721Ashique S, Sandhu NK, Haque SN, Koley K.A Systemic Review on Topical Marketed Formulations, Natural Products, and Oral Supplements to Prevent Androgenic Alopecia: A Review. Nat Prod Bioprospect. 2020 Dec;10(6):345-365. doi: 10.1007/s13659-020-00267-9Fischer TW, Herczeg-Lisztes E, Funk W, Zillikens D, Bíró T, Paus R.Differential effects of caffeine on hair shaft elongation, matrix and outer root sheath keratinocyte proliferation, and transforming growth factor-β2/insulin-like growth factor-1-mediated regulation of the hair cycle in male and female human hair follicles in vitro. Br J Dermatol. 2014 Nov;171(5):1031-43. doi: 10.1111/bjd.13114Ekman P.A risk-benefit assessment of treatment with finasteride in benign prostatic hyperplasia. Drug Saf. 1998 Mar;18(3):161-70. doi: 10.2165/00002018-199818030-00002
Medline Plus.SRD5A2 gene.
Hirshburg JM, Kelsey PA, Therrien CA, Gavino AC, Reichenberg JS.Adverse Effects and Safety of 5-alpha Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review. J Clin Aesthet Dermatol. 2016 Jul;9(7):56-62. PMID: 27672412
Drobnis EZ, Nangia AK, Drobnis EZ, Nangia AK.5α-Reductase inhibitors (5ARIs) and male reproduction.Impacts of Medications on Male Fertility. 2017:59-61.
Elsaie ML.Hormonal treatment of acne vulgaris: an update.Clin Cosmet Investig Dermatol. 2016;9:241-8. doi:10.2147/CCID.S114830
Laurent M, Antonio L, Sinnesael M, et al.Androgens and estrogens in skeletal sexual dimorphism.Asian J Androl. 2014;16(2):213-22. doi:10.4103/1008-682X.122356
Health Matters.Dihydrotestosterone - female.
Harvard Medical School.Testosterone, prostate cancer, and balding - Is there a link?
Medline Plus.Androgen insensitivity syndrome.
Adil A, Godwin M.The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. J Am Acad Dermatol. 2017 Jul;77(1):136-141.e5. doi: 10.1016/j.jaad.2017.02.054
Patel DP, Swink SM, Castelo-Soccio L.A Review of the Use of Biotin for Hair Loss. Skin Appendage Disord. 2017 Aug;3(3):166-169. doi: 10.1159/000462981
Cho YH, Lee SY, Jeong DW, Choi EJ, Kim YJ, Lee JG, Yi YH, Cha HS.Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med. 2014;2014:549721. doi: 10.1155/2014/549721
Ashique S, Sandhu NK, Haque SN, Koley K.A Systemic Review on Topical Marketed Formulations, Natural Products, and Oral Supplements to Prevent Androgenic Alopecia: A Review. Nat Prod Bioprospect. 2020 Dec;10(6):345-365. doi: 10.1007/s13659-020-00267-9
Fischer TW, Herczeg-Lisztes E, Funk W, Zillikens D, Bíró T, Paus R.Differential effects of caffeine on hair shaft elongation, matrix and outer root sheath keratinocyte proliferation, and transforming growth factor-β2/insulin-like growth factor-1-mediated regulation of the hair cycle in male and female human hair follicles in vitro. Br J Dermatol. 2014 Nov;171(5):1031-43. doi: 10.1111/bjd.13114
Ekman P.A risk-benefit assessment of treatment with finasteride in benign prostatic hyperplasia. Drug Saf. 1998 Mar;18(3):161-70. doi: 10.2165/00002018-199818030-00002
Marchetti PM, Barth JH.Clinical biochemistry of dihydrotestosterone.Ann Clin Biochem. 2013;50(Pt 2):95-107. doi:10.1258/acb.2012.012159Swerdloff RS, Dudley RE, Page ST, Wang C, Salameh WA. Dihydrotestosterone:Biochemistry, physiology, and clinical implications of elevated blood levels.Endocr Rev. 2017;38(3):220-254. doi:10.1210/er.2016-1067
Marchetti PM, Barth JH.Clinical biochemistry of dihydrotestosterone.Ann Clin Biochem. 2013;50(Pt 2):95-107. doi:10.1258/acb.2012.012159
Swerdloff RS, Dudley RE, Page ST, Wang C, Salameh WA. Dihydrotestosterone:Biochemistry, physiology, and clinical implications of elevated blood levels.Endocr Rev. 2017;38(3):220-254. doi:10.1210/er.2016-1067
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