International Journal of Forest, Animal and Fisheries Research (IJFAF) ISSN: 2456-8791 [Vol-9, Issue-2, Apr-Jun, 2025] Issue DOI: https://dx.doi.org/10.22161/ijfaf.9.2 Article DOI: https://dx.doi.org/10.22161/ijfaf.9.2.2 Int. J. Forest Animal Fish. Res. www.aipublications.com/ijfaf Page | 17 Role of Dehydroepiandrosterone (DHEA) in the Pathophysiology and Clinical Manifestations of Polycystic Ovary Syndrome (PCOS) Aprajita Shukla, Sneha Verma * , Ramakant, Ambuj Mishra, Kesar Farzana Department of Science, Maharishi School of Science and Humanities, Maharishi University of Information Technology, Lucknow, U.P., India *Corresponding author email: drsnehaverma@yahoo.com Received: 19 Mar 2025; Received in revised form: 16 Apr 2025; Accepted: 23 Apr 2025; Available online: 02 May 2025 ©2025 The Author(s). Published by AI Publications. This is an open-access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/) Abstract— Polycystic ovary syndrome (PCOS) is a prevalent endocrinopathy with a complex etiology involving metabolic, reproductive, and psychological components. Dehydroepiandrosterone (DHEA), an adrenal androgen and stress biomarker, has been implicated in PCOS pathophysiology, yet its role remains controversial. To critically examine the contribution of DHEA to the development and clinical progression of PCOS, emphasizing its hormonal, metabolic, and neuroendocrine implications. This review synthesizes evidence from clinical, biochemical, and experimental studies evaluating DHEA levels and regulatory pathways in women with PCOS, including analyses of phenotypic variation, adrenal versus ovarian androgen production, and stress-axis dysregulation. Elevated DHEA and its sulfated form (DHEAS) are observed in a subset of women with PCOS, particularly those exhibiting hyperandrogenism. However, findings across studies remain inconsistent due to heterogeneity in diagnostic criteria, age-related hormonal variability, and methodological differences. DHEA has been shown to influence ovarian function, metabolic status, and neuropsychological symptoms, suggesting a multifactorial role in PCOS pathogenesis. DHEA contributes to the complex hormonal milieu of PCOS and may serve as both a biomarker and a mechanistic factor in its pathophysiology. Standardized measurement protocols and stratified phenotypic analyses are essential for elucidating its diagnostic and therapeutic relevance. Keywords— Polycystic ovary syndrome, DHEA, hyperandrogenism, HPA axis, metabolic dysfunction, adrenal androgens I. INTRODUCTION Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder affecting approximately 5–15% of women of reproductive age worldwide. Initially characterized by Stein and Leventhal in 1935, PCOS is now recognized for its broad clinical spectrum, encompassing reproductive, metabolic, and psychological disturbances. The Rotterdam criteria, endorsed globally, define PCOS as the presence of at least two of the following: oligo- or anovulation, clinical and/or biochemical hyperandrogenism, and polycystic ovarian morphology (PCOM) on ultrasonography. PCOS is associated with several comorbidities including insulin resistance, dyslipidemia, type 2 diabetes mellitus, obesity, cardiovascular risk, infertility, and mood disorders. The heterogeneous nature of PCOS complicates its diagnosis and management and suggests a multifactorial etiology that integrates genetic susceptibility, environmental exposure, and neuroendocrine dysregulation. One hormone of growing interest in PCOS research is dehydroepiandrosterone (DHEA), a weak androgen