DHT (Dihydrotestosterone) is an androgen or sex hormone that plays a crucial role in developing male characteristics in those individuals assigned males at birth. 

DHT is considered to be around 5 times more powerful than another androgen—testosterone.

DHT helps develop male reproductive organs like the penis, scrotum, and prostate.

The role of this hormone changes according to the individual’s age, from the fetus to adulthood.

But, DHT doesn’t affect the individuals assigned females at birth, apart from the development of body and pubic hair.

Understanding the role of DHT in the human body shows the intricate processes involved in sexual development and how to maintain hormone balance for overall health and well-being.

In this article, you can learn about the hormone DHT, its role, and the effects its absence or abundance can cause.

How is DHT formed?

damaged relaxed hair
Damaged follicles hair

5-alpha-reduction is the process by which Dihydrotestosterone, or DHT, is made.

The Testosterone is converted to DHT in specific body tissues, such as the prostate gland, hair follicles, and skin.

The critical component in the process is an enzyme called 5-alpha-reductase.

There are two types of 5-alpha-reductase enzymes: type 1 and type 2. These enzymes convert Testosterone into DHT, produced in the testes and adrenal glands.

When Testosterone reaches the target tissues, it interacts with the 5-alpha-reductase enzyme. 

The enzyme changes the chemical structure of Testosterone by removing a specific molecular group, and DHT is formed.

The development of various male characteristics and physiological processes influenced by DHT depends on this conversion process.

It’s important to remember that while DHT is made from Testosterone, it can also be made in some tissues using different metabolic pathways.

 But, 5-alpha-reductase enzymes convert Testosterone into most DHT in the body.

What is the function of DHT?

Dihydrotestosterone is essential for developing and functioning in people assigned to males at birth. Its effects vary as they go through various stages of life.

Prenatal or before birth

During prenatal development, DHT is essential for forming male genitals such as the penis, scrotum, and prostate.

According to a study, around the 60th day of prenatal development, the cells in the testes—Leydig cells produce Testosterone with the help of a hormone called placental human chorionic gonadotropin.

Then in the 16th week, another hormone called luteinizing hormone (LH) starts producing Testosterone.

This Testosterone is converted to DHT, helping develop male reproductive organs.
To help move down the scrotum, DHT works with another hormone called INSL3 (insulin-like factor 3).

Without enough DHT, these parts may not form properly, leading to unclear male genitalia. 

Hormones produced by the testes and placenta control the levels of other hormones, such as follicle-stimulating hormones, luteinizing hormones, and many more.

These hormones ensure the right development happens.

Childhood or after birth

After a baby is born, there is a shift in hormone levels for both boys and girls. In boys, this hormone shift increases Testosterone, increasing Dihydrotestosterone (DHT) levels.

A stage known as adrenarche begins in both boys and girls around the age of six. The zona reticularis, a specific region of the adrenal gland, begins to develop during adrenarche.

The newly formed zone produces and releases androgens, including Testosterone. 

The increase in Testosterone contributes to the development of various glands in the body, such as the sebaceous glands.

The sebaceous glands are responsible for oily skin, and the apocrine glands that form the body odor. Additionally, minor acne may appear during this stage.

Fact:
By age 10, enough Testosterone in the body is converted into DHT. This increased level of DHT in the body leads to the growth of pubic hair.

Puberty

During puberty, the luteinizing hormone, released from the pituitary gland, produces Testosterone from the testes.

This Testosterone is then converted to DHT in specific tissues.

In puberty, DHT develops the penis, scrotum, and hair on the face, body, and genitals.

DHT levels are ten times greater in the blood than testosterone. It has a more prominent effect because it is produced in specific tissues.

Tissues such as the prostate gland, hair follicles, and skin.

Adult

Male-Pattern-Baldness
A man with Pattern Baldness

In adults, DHT doesn’t impact the body’s normal functioning. But, it has two effects as people age. 

One is prostate enlargement, and the other is Male Pattern Baldness.

Prostate enlargement can cause urinary problems, and male pattern hair loss leads to thinning or loss of hair on the scalp.

Effects of low DHT level

Some conditions or problems happen when DHT levels are low. Some of them are:

5-alpha-reductase deficiency

5-alpha-reductase deficiency happens when the body doesn’t produce enough DHT enzymes. This deficiency occurs due to a specific gene mutation.

In males, this causes the genitals to don’t develop fully, and their prostate gland is small or absent. 

In serious cases, they may have external genitalia resembling a female’s.

Testosterone and another hormone called AMH are produced, which helps develop certain organs.

But, the testes don’t come down properly because of the lack of DHT. They also have less facial hair, and pubic hair grows like females. Additionally, the prostate doesn’t develop normally.

Female development is not affected by this deficiency, although there may be less body hair and a slight decrease in pubic hair.

DHT and low testosterone

When your body doesn’t produce enough Testosterone, it can lead to male hypogonadism.

In male hypogonadism, the body does not produce enough Testosterone. 

This can happen in two ways: from birth or later in life.

Low testosterone levels mean your body will also have lower levels of DHT. This can cause various problems depending on your age.

Effects of high DHT level

Certain health conditions can happen when the levels are high, such as

Benign Prostatic Hyperplasia (BPH)

It is a condition where the prostate gland, located in men, grows more than usual.

In BPH, the increased production of DHT leads to prostate enlargement. 

More than half of men over 50 have BPH. This leads to problems like difficulty urinating and sexual dysfunction.

You can manage BPH with medication or surgery, if necessary. Men need to get regular prostate exams to check for any changes in the size or function of the gland.

Prostate cancer

This cancer affects the prostate gland in men. 

A study shows that the increase in DHT levels happens because of changes in genes that control the production of DHT.

These changes in the genes lead to uncontrolled cell growth and death of the cell.

Another factor is mutations in the androgen receptor, which interacts with DHT.

Warning:
Prostate Cancer is a potentially life-threatening disease that can develop without noticeable symptoms in its early stages. Be vigilant and aware of the warning signs, such as frequent urination, difficulty starting or stopping urine flow, and blood in the urine or semen.

Male Androgenic Alopecia (MAA)

Androgenetic Alopecia
Androgenetic Alopecia

The increased level of DHT also results in Male Androgenic Alopecia. In this condition, men experience progressive hair loss on the top and front of their scalps.

It is also called male pattern hair loss. Men suffering from pattern baldness have higher levels of the 5-alpha-reductase enzyme.

Hair alopecia is also a genetic condition, so a person is more prone to hair loss if someone in his family has had it.

Polycystic Ovarian Syndrome (PCOS)

Though DHT doesn’t affect women’s bodies or processes much.

It can cause a common condition called Polycystic Ovarian Syndrome. It happens when the ovaries produce excess androgens, including Testosterone, leading to increased DHT levels.

Increased DHT levels lead to hormone imbalance which causes symptoms like increased body weight, irregular periods, excessive hair growth, and acne.

Treatment of DHT levels

There are many medications and methods to maintain DHT balance.

The following treatments and cures are for the medical conditions caused by the imbalance of DHT levels in the body.

5-alpha-reductase deficiency

To increase the level of DHT enzyme in the body, the following methods can be used:

  • You can get a surgical correction of the male reproductive system to restore fertility
  • There is no specific treatment for female development, as it does not affect them many

Androgen deficiency

Doctors may recommend Testosterone replacement therapy for male hypogonadism and androgen deficiency.

Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia happens when DHT levels are higher than usual. To bring it back to normal following medications are used:

  • Alpha-1 adrenergic antagonists and 5-alpha-reductase inhibitors like finasteride and dutasteride are helpful
  • Alpha-1 adrenergic antagonists can relieve symptoms related to prostate enlargement
  • 5-alpha-reductase inhibitors can reduce the size of the prostate and the symptoms
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Prostate Cancer

If you have prostate cancer, you will require extensive treatment. But to reduce the chances of prostate cancer, you must bring down the DHT levels. 

  • Doctors have used 5-alpha-reductase inhibitors like finasteride and dutasteride
  • These drugs reduce prostate cancer from happening. But higher-risk cancers may occur in some patients

Male Androgenic Alopecia (MAA)

This is a common occurrence in males as the DHT levels increase in the body. To balance the DHT enzymes following medications are used:

  • Oral 5-alpha-reductase inhibitors like finasteride can slow down or reverse hair loss in most patients
  • Another treatment option is topical minoxidil

Polycystic Ovarian Syndrome (PCOS)

PCOS happens in women when the hormones are imbalanced, to regulate the hormones following treatment can be used.

  • Treatment for PCOS is managing symptoms such as weight gain, cholesterol, and irregular levels
  • Other treatments may include lifestyle changes and medications like contraceptives. This will regulate hormones and insulin levels

Side effects of DHT medications

Skin rash
Skin rash

Certain known side effects of DHT medications like finasteride and dutasteride can be:

  • Erectile dysfunction
  • Premature or delayed ejaculation
  • Gynecomastia—excessive fat development and tenderness in the breast area
  • Skin rash
  • Feeling generally sick
  • Vomiting or nausea
  • Hirsutism—darkening and thickening of facial and upper body hair
  • Congestive heart failure due to minoxidil

Conclusion

In conclusion, Dihydrotestosterone (DHT) is an androgen hormone. It plays a significant role in the growth and development of male babies.

DHT influences the production of male reproductive organs and the development of secondary sexual characteristics. 

Other characteristics include maintaining normal physiological processes from prenatal development to adulthood.

Imbalances in DHT levels can prompt different medical issues. These include prostate development, male pattern baldness, and certain hereditary problems.

There are treatments for DHT-related conditions, but they may have negative side effects.

In the future, a better understanding and management of DHT-related issues will result from ongoing research and advancements in treatment strategies.

Frequently Asked Questions

What is the difference between DHT and testosterone?

DHT, a more powerful androgen hormone than Testosterone, is made from Testosterone. The formulation happens through the conversion process facilitated by the enzyme 5-alpha-reductase. DHT exerts a more significant influence on the development of male characteristics. 

Can women have high levels of DHT?

While women have low levels of DHT in their bodies, it is generally not present in high levels like in males. DHT does not play an important role in developing female reproductive organs.

What are the symptoms of low DHT levels in men?

Low DHT levels in men can show various symptoms, such as reduced body and facial hair growth, less prominent or absent development of the male reproductive organs, and a smaller or underdeveloped prostate gland.

Is there a natural way to lower DHT levels?

Natural methods may help lower DHT levels. These approaches include maintaining a healthy weight and reducing stress levels. Another method is incorporating a balanced diet with foods rich in omega-3 fatty acids, such as fish, flaxseeds, and walnuts. It is important to note that natural methods may not provide immediate changes in DHT levels.

Citations:
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