The Big Picture

Sarcopenia isn’t just about skipping workouts. It’s a complex, multi-factor condition tied to changes in the nervous system, inflammation, mitochondrial function, nutrition, and, critically, hormonal decline. The review highlights that sex-steroid hormones directly influence muscle metabolism, repair, and regeneration.

How Hormones Affect Muscle

Muscle cells have receptors for both androgens (like testosterone) and estrogens. When hormone levels fall, the signals that tell muscle fibers to grow and repair weaken. This disrupts protein synthesis pathways essential for building and maintaining lean mass. The result: slower recovery, reduced strength, and eventually loss of mobility and independence.

Where DHEA Fits In

DHEA serves as a precursor hormone, converted by tissues into active estrogens and androgens. The review notes that DHEA appears to support mitochondrial energy function and regulate inflammation inside muscle cells, but evidence remains limited compared to testosterone and estrogen studies. Some small trials suggest that DHEA replacement can modestly improve muscle function when paired with exercise, but results are inconsistent.

The Limits and Future Directions

The authors emphasize that no hormone therapy (including DHEA) is currently approved for treating sarcopenia. While hormonal support may hold promise, exercise, adequate protein, and sufficient sleep remain the foundation of prevention. The paper calls for large, controlled clinical trials to define who benefits, what doses are safe, and how best to combine hormones with lifestyle interventions.

According to this Frontiers review, hormonal decline - especially loss of DHEA and other sex steroids -plays a meaningful but partial role in muscle aging. Restoring balance may help, but hormones should be viewed as part of a bigger picture that includes training, nutrition, and recovery.