Ashwagandha for Women: Menopause, HRT, Hormones and Safety

In women, ashwagandha has been tested mainly for stress and sleep and, in three small trials, menopause symptoms: 100, 60 and 66 women scored lower on a menopause rating scale than on placebo over 8 to 12 weeks. It must not be taken in pregnancy or while breastfeeding, and no study has tested it with HRT, so the GP or menopause clinic decides.^{1, 2, 3} Part of the Wellgard ashwagandha guide.

Evidence at a glance

• Trials: three placebo-controlled menopause trials (226 women) and two sexual-function trials (130 women), all run in India.^{1, 2, 3, 4, 5}
• Largest single trial: 100 perimenopausal women, 300 mg twice a day for 8 weeks.¹
• Strongest measured outcome: Menopause Rating Scale down 8.1 points against 1.2 on placebo in 66 postmenopausal women over 12 weeks.³
• Not tested: use alongside HRT, during breastfeeding, or in women trying to conceive.

Sources checked on 13 October 2026.

What does ashwagandha do for women?

Most ashwagandha trials measured stress, anxiety and sleep in women and men together, at the same doses; those results are in the Wellgard ashwagandha guide, and the doses in how to take ashwagandha. Hormones are where the sexes differ. Across 23 pooled placebo-controlled trials of 1,706 adults, testosterone rose by about 57 ng/dL in men but did not rise significantly in women (5.09 ng/dL), and oestradiol did not change in either sex.⁶ Women-only trials have measured menopause symptoms, sexual function and, in 30 professional footballers, recovery: 600 mg a day for 28 days improved perceived recovery and sleep quality against placebo, on an extract a supplier donated.⁷ Ashwagandha has no authorised health claim in Great Britain, so every benefit here is a trial finding.

Does ashwagandha help with menopause symptoms?

Three small placebo-controlled trials reported lower menopause-symptom scores with ashwagandha root extract than with placebo, in 226 women over 8 to 12 weeks. No product may claim a menopause effect, and no trial has compared ashwagandha with HRT.

All three were small trials run in India, and the perimenopause trial shares an investigator with each sexual-function trial below. The hormone changes were measured, not explained. How ashwagandha sits beside other supplements is on which menopause supplements have evidence; night waking is on perimenopause sleep problems; and stages and treatments are in the Wellgard menopause guide.

Can you take ashwagandha with HRT?

No study has tested ashwagandha alongside HRT in any form, patches, gels and tablets included (PubMed search, 13 October 2026). The NHS menopause treatment page advises you to "talk to a doctor, nurse or pharmacist about HRT and other options available".⁸ Its herbal medicines page asks you to check with a pharmacist before taking a herbal medicine alongside any other medicine.⁹ So the GP or menopause clinic decides whether the two go together. Ashwagandha is not an alternative to HRT.

Is ashwagandha safe in pregnancy, while breastfeeding or when trying to conceive?

No: ashwagandha must not be taken in pregnancy or while breastfeeding. The NHS has no page on ashwagandha; its herbal medicines page says you should not take herbal medicines if "you're pregnant or breastfeeding".⁹ The Dutch public-health institute (8 March 2024), France's food-safety agency (19 April 2024) and Germany's risk-assessment institute (10 September 2024) advise pregnant women against it, and the French and German bodies extend that to breastfeeding. No study has measured ashwagandha in breast milk, and the US lactation database advises avoiding it, especially with a newborn or premature baby.¹⁰

One open-label trial gave 70 women in mid-pregnancy root extract alongside standard anaemia treatment for 12 weeks, on an extract its maker supplied, and recorded no adverse events; it was unblinded and did not report birth outcomes, so the advice stands.¹¹ A 2026 review, whose lead author consults for the supplements trade, judged the evidence that ashwagandha causes miscarriage or birth defects inconclusive.¹² No trial has tested it in women trying to conceive (PubMed search, 13 October 2026). Every other group advised against it is on who should not take ashwagandha.

Does ashwagandha affect thyroid hormones or weight in women?

Thyroxine (T4) rose by 0.61 µg/dL across the 23 pooled trials, with TSH and T3 unchanged.⁶ In 50 adults with untreated subclinical hypothyroidism, 600 mg a day for 8 weeks lowered TSH and raised T4 against placebo.¹³ That matters for women: the main UK cause of an underactive thyroid, Hashimoto's disease, "is most common in women", says the NHS.¹⁴ Anyone with a thyroid condition or on levothyroxine asks the GP first: ashwagandha with levothyroxine. On weight, the 66-woman postmenopausal trial measured body fat 0.6 percentage points lower against placebo,³ while a 2026 pooling of 20 trials in adults found no significant effect on body weight or body fat.¹⁵ Whether it shifts a "cortisol belly", a social-media term rather than a diagnosis, is answered in how to lower cortisol. No study has measured breast size, and no trial has tested ashwagandha for acne (PubMed searches, 13 October 2026).

Does ashwagandha help libido in women?

Two small placebo-controlled trials reported higher sexual-function scores after 8 weeks of 300 mg twice a day. In a 50-woman pilot, part-funded by the extract's maker, Female Sexual Function Index scores and successful sexual encounters rose more than on placebo.⁴ In 80 women aged 18 to 50 with low sexual desire, scores rose from 14.2 to 22.6 against 14.2 to 19.3 on placebo, with similar side effects in both groups.⁵ Both trials share an investigator with the perimenopause trial. Neither makes ashwagandha a treatment for a sexual-function problem; low desire that troubles you is worth raising with a GP.

What we don't know

• No study has tested ashwagandha alongside HRT, in any form.
• No study has measured it in breast milk, and the one pregnancy trial did not report birth outcomes.
• No trial has tested it in women trying to conceive or, on its own, in women with polycystic ovary syndrome (PCOS).
• Every menopause trial was run in India and lasted 8 to 12 weeks.

Frequently asked questions

What are the side effects of ashwagandha for women?

Few were recorded in the women-only trials: in 80 women, two reported nausea and one drowsiness on ashwagandha, similar to placebo, and the 66-woman menopause trial recorded no serious adverse events.^{3, 5} Germany's institute lists nausea, diarrhoea, drowsiness, headaches and rashes among reported effects, and liver-injury cases call for caution; the full list is on the side effects of ashwagandha.

Can women take ashwagandha every day?

Every women-only trial cited here gave it daily, for 4 to 12 weeks; none ran longer.^{1, 2, 3, 4, 5, 7} Longer use, breaks and stopping are on is ashwagandha safe to take daily.

How much ashwagandha should a woman take a day?

No trial has tested a dose by sex. Every women-only trial cited here used 600 mg a day of root extract, mostly as 300 mg twice a day, the same total as many trials in men.^{1, 2, 3, 4, 5} The doses by outcome are on how to take ashwagandha.

Does ashwagandha raise oestrogen?

Not on average: across 23 pooled trials, oestradiol did not change in women or men.⁶ Two menopause trials, of 100 and 60 women (the second on an extract its maker supplied), measured oestradiol higher and FSH and LH lower than placebo after 8 weeks.^{1, 2} Neither explained the change, and no product may claim to raise oestrogen.

Can ashwagandha affect the pill?

No study has tested ashwagandha with the pill or any other hormonal contraception. The NHS lists hormonal contraception, such as the combined pill, among medicines that do not mix well with herbal medicines, so ask a pharmacist before combining them.⁹

Sources

1. Gopal et al., 2021. Randomised trial, 100 perimenopausal women, 8 weeks; funding not checked (full text not reachable). PubMed 34553463.
2. Vani et al., 2026. Randomised trial, 60 women aged 45 to 55, 56 days; extract supplied by its maker, no conflicts declared. PubMed 41561822.
3. Obhrai et al., 2026. Randomised trial, 66 postmenopausal women, 12 weeks; funding not checked (full text not reachable), no financial disclosures in the abstract. PubMed 42742071.
4. Dongre et al., 2015. Randomised pilot trial, 50 women, 8 weeks; the extract's maker supplied it and met some costs. PubMed 26504795.
5. Ajgaonkar et al., 2022. Randomised trial, 80 women, 8 weeks; one maker's extract, no funding statement, no competing interests declared. PubMed 36447681.
6. Fornalik et al., 2026. Pooled analysis, 23 randomised trials, 1,706 adults; no conflicts declared. PubMed 41740946.
7. Coope et al., 2025. Randomised trial, 30 female footballers, 28 days; extract donated by a supplier; correction published 2025 (PubMed 40179018). PubMed 39954269.
8. NHS. Treatment for menopause and perimenopause. Page last reviewed 19 May 2026. nhs.uk.
9. NHS. Herbal medicines and complementary therapies. Page last reviewed 1 May 2026. nhs.uk.
10. Drugs and Lactation Database (LactMed). Withania, revised 15 December 2024. Reference database entry. PubMed 30000965.
11. Ajgaonkar et al., 2026. Open-label randomised trial, 70 pregnant women, 12 weeks; extract supplied by its maker. PubMed 41767760.
12. Tallon et al., 2026. Systematic and ethnobotanical review, no pooling; lead author at a UK consultancy serving the supplements trade. PubMed 40887707.
13. Sharma et al., 2018. Randomised trial, 50 adults with subclinical hypothyroidism, 8 weeks; funding not checked. PubMed 28829155.
14. NHS. Underactive thyroid (hypothyroidism). Page last reviewed 28 April 2025. nhs.uk.
15. Zhu et al., 2026. Pooled analysis, 20 randomised trials, 1,249 adults; no conflicts declared. PubMed 42199854.

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