Some smaller studies suggest that ashwagandha may help reduce some menopause symptoms, such as hot flashes. However, scientists do not know much about how it works or whether it is safe for long-term use.

An older woman experiencing a hot flush, with ashwagandha root and supplements either side of her.Share on Pinterest
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Ashwagandha is a type of nightshade, belonging to the same family of plants as tomato and eggplant. It has a long history of medicinal use in Ayurveda, but scientists have only begun to research it fairly recently.

It seems likely that ashwagandha increases levels of the gamma-aminobutyric acid (GABA) neurotransmitter. Other drugs doctors sometimes prescribe for hot flashes, such as gabapentin, also do this.

Read on to learn more about ashwagandha and menopause.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Ashwagandha, or Withania somnifera, is a flowering shrub that grows in Asia and some parts of Africa. Other names for it include Indian ginseng and winter cherry.

Ashwagandha is an important herb in Ayurveda, which is a traditional form of medicine that originates in India.

Some refer to ashwagandha as a nootropic, which is a term for supplements and herbs that claim to boost brain performance.

Some practitioners claim ashwagandha is an adaptogen, which is a substance that helps the body adapt to various kinds of stress.

The concept of adaptogens is theoretical. There is no conclusive evidence that all herbs people consider to be adaptogenic universally help with both mental and physical stress.

Scientists do not know a lot about how ashwagandha affects the body. Preliminary studies indicate it may:

  • Affect GABA receptors: GABA is a neurotransmitter that decreases nervous system activity. Analysis of compounds in ashwagandha suggests that the plant may affect GABA receptors, which could explain why it has a tranquilizing effect on some people.
  • Reduce inflammation: Ashwagandha contains compounds that are steroids. Similarly to corticosteroids, these compounds reduce inflammation.
  • Increase testosterone: Ashwagandha may increase testosterone in males, but it is unclear whether this also occurs in females.
  • Increase thyroxine: Thyroxine is the main hormone the thyroid gland produces. There have been some case reports of high thyroxine levels in people taking ashwagandha, suggesting it may stimulate thyroxine production.

There is only one recent study that looks at ashwagandha’s impact on menopause symptoms in humans.

A 2021 randomized controlled, double-blind, placebo-controlled study asked the participants to take either a placebo or 300 milligrams of ashwagandha root twice daily for 8 weeks. The researchers assessed the:

The ashwagandha group experienced:

  • a statistically significant reduction in hot flashes and urinary symptoms
  • an increase in estradiol, FSH, and luteinizing hormone
  • a reduction in the menopause-related quality of life score

The two groups did not show significant differences in testosterone levels.

However, only 91 people completed the study. To confirm the results, future studies need to replicate the results in a larger group.

Some research also suggests that ashwagandha can lower blood glucose levels, provide antioxidant benefits, and offer anti-tumor benefits. However, more research is necessary to prove this.

The most common side effects of ashwagandha include:

Less common side effects include:

There are several known risks of taking ashwagandha, and some individuals should not take it. This includes people who:

  • are or could be pregnant
  • are taking certain medications
  • have certain health conditions

Allergies and intolerance

As with any medication, people can have an allergic reaction to ashwagandha.

Those who have an intolerance to nightshades may also find that ashwagandha causes symptoms.

Increased thyroxine levels

A few case studies have reported thyrotoxicosis in people taking ashwagandha supplements. This condition occurs when there is too much thyroid hormone in the body, causing toxicity.

An older 2005 case study describes a healthy 32-year-old female developing thyrotoxicosis after taking ashwagandha. The person was not taking any other medications or substances at the time, and after stopping taking the supplement, the symptoms improved.

Contamination with heavy metals

Some Ayurvedic remedies contain heavy metals, such as lead and arsenic.

Sometimes, these toxic metals are in the remedies due to a belief they have health benefits. Other times, they get into herbal supplements unintentionally through soil contamination.

The Food and Drug Administration (FDA) does not regulate ashwagandha products. This means that manufacturers of such products do not have to prove that the ashwagandha they use is pure or of high quality.

Therefore, it is advisable to look for herbal products that have undergone third-party testing to prove they are safe.

Drug interactions

Ashwagandha may act on the GABA system, which is why it may interact negatively with other substances that do the same thing. These include:

Some evidence suggests ashwagandha may interfere with the metabolism of other drugs, but it is unclear whether this is the case or what the clinical relevance is.

Withdrawal symptoms

No studies have looked into whether stopping ashwagandha causes withdrawal, but some anecdotal reports suggest that it can. People stopping taking this herb might want to gradually taper down the dosage.

Delayed care

Ashwagandha is not a substitute for medical care. Relying on this herb may mean that people delay contacting a doctor.

If a person is not sure whether they are entering menopause, has any severe or unusual symptoms, or is considering taking ashwagandha, they should seek guidance from a healthcare professional.

Ashwagandha may alleviate some menopause symptoms, such as hot flashes and urinary symptoms. However, there is still a lot scientists do not know about this herb.

Although it is an important part of Ayurveda, there are few high quality trials testing its effects and safety in people experiencing menopause.

Before trying ashwagandha, it is advisable to contact a doctor who is knowledgeable about menopause. They may be able to offer guidance on ways to reduce symptoms, or, if a person wants to take ashwagandha, they may offer recommendations for reputable brands.

It is especially important to consult a doctor if a person is already taking other medications or has any health conditions, such as thyroid disease.