If you're going through perimenopause or menopause, you've probably noticed that the symptoms don't always arrive one at a time.
Sleep can become harder. Stress can feel more difficult to manage. Hot flashes may appear unexpectedly. Mood and energy can change, too.
That combination has made ashwagandha increasingly popular among women looking for herbal ways to support themselves through the menopause transition.
But popularity isn't the same thing as evidence.
So what does the research actually say about ashwagandha and menopause?
The answer is more interesting than a simple "yes" or "no."
Several recent clinical trials have reported improvements in menopause-related symptoms among women taking standardized ashwagandha extracts. However, the evidence is still relatively limited; the studies have been fairly small, and different ashwagandha preparations have been used.
In other words, there is promising evidence—but not enough to consider ashwagandha a proven treatment for menopause.
What Is Ashwagandha?
Ashwagandha, or Withania somnifera, is a plant traditionally used in Ayurvedic medicine.
Modern supplements typically contain an extract made from the root, although some products use combinations of root and leaf. The plant contains naturally occurring compounds called withanolides.
Today, ashwagandha is commonly marketed for stress, sleep, energy and general wellbeing.
Researchers have also become interested in whether it might have a role during the menopause transition.
That question matters because some menopause symptoms—particularly sleep difficulties, stress and changes in mood—can overlap with areas where ashwagandha has already been studied.
The National Center for Complementary and Integrative Health (NCCIH), however, currently says there isn't enough evidence to determine whether ashwagandha is helpful for menopause.
That doesn't mean the research is negative.
It means we need to look at the individual studies rather than assuming that a few encouraging results prove that the herb works for everyone.
What Does the Research on Ashwagandha and Menopause Show?
One of the more directly relevant studies was a randomized, double-blind, placebo-controlled trial published in 2021.
Researchers enrolled 100 women experiencing menopausal symptoms during perimenopause.
The women were randomly assigned to receive either a placebo or 300 mg of ashwagandha root extract twice daily for eight weeks.
The researchers measured symptoms using established menopause questionnaires, including the Menopause Rating Scale and Menopause-Specific Quality of Life questionnaire. They also measured several reproductive hormones.
The results were encouraging.
Compared with placebo, the women taking ashwagandha experienced statistically significant improvements in their overall menopause symptom scores.
The researchers reported improvements across psychological, somatic and urogenital symptom categories, along with improvements in menopause-specific quality of life.
They also observed changes in hormone measurements, including higher estradiol and lower FSH and LH compared with placebo.
But there's an important distinction here.
A change in a hormone measurement does not automatically mean that an herbal supplement is "balancing your hormones" in a clinically meaningful way.
That's a much stronger claim than the study itself establishes.
What About More Recent Research?
There is now some newer evidence worth considering.
A randomized, double-blind, placebo-controlled study published in 2025 examined standardized ashwagandha extract in 60 postmenopausal women aged 40–55.
Participants received either ashwagandha root extract or placebo for 56 days.
The researchers reported significant improvements in overall Menopause Rating Scale scores, including psychological, somatic, and urogenital symptoms. They also reported reductions in hot-flash events and perceived stress, along with improvements in quality-of-life measurements.
The study also found changes in estradiol, progesterone, FSH, and LH compared with placebo.
Again, that's interesting—but it needs to be kept in perspective.
The trial involved only 60 women and lasted eight weeks.
That's useful evidence for generating confidence that the question deserves further study, but it isn't enough to establish how effective ashwagandha is over several years or whether the results apply broadly to women with different health conditions.
A 2026 Study Looked at Longer-Term Supplementation
Another randomized, double-blind, placebo-controlled study published in the Journal of Menopausal Medicine looked at standardized ashwagandha extract in postmenopausal women over 24 weeks.
Women aged 40–55 received different doses of ashwagandha, shatavari, combinations of the two, or placebo.
The researchers reported dose-dependent reductions in menopause-specific quality-of-life scores among the supplemented groups. They also observed changes in markers associated with bone turnover, vascular function, inflammation and oxidative stress.
This is potentially important because it extends the research beyond an eight-week study.
But there's a catch.
The study tested ashwagandha, shatavari, and combinations of the two, rather than establishing that every effect observed was caused solely by ashwagandha.
So it shouldn't be used to make sweeping claims that ashwagandha prevents osteoporosis, protects the cardiovascular system or reverses estrogen-related changes.
Those questions require much stronger evidence.
Which Menopause Symptoms Might Ashwagandha Help?
Based on the available human research, the most interesting areas are:
Stress
Stress is one of the better-studied uses of ashwagandha generally, and menopause trials have reported reductions in perceived stress.
This is particularly interesting because stress and menopause symptoms can interact in complicated ways.
Sleep
Ashwagandha has some evidence for improving sleep in other populations, although that doesn't automatically prove it treats menopause-related insomnia.
Some menopause studies have included sleep-related symptoms within broader menopause-rating scales.
Hot Flashes
The newer 2025 randomized trial reported fewer hot-flash events among women receiving ashwagandha compared with placebo.
That's promising, but one relatively small trial isn't enough to establish ashwagandha as a proven treatment for hot flashes.
Overall Menopause Symptoms
This may actually be where the current evidence is most interesting.
Rather than focusing on one symptom, the trials have measured overall menopause symptom scores and reported improvements across several categories.
That's different from proving that ashwagandha specifically treats one particular menopause symptom.
Does Ashwagandha Increase Estrogen?
This is where online claims can become misleading.
Some clinical studies have reported changes in estrogen-related hormone measurements among women taking ashwagandha.
For example, the 2021 perimenopause trial found higher serum estradiol and lower FSH and LH in the ashwagandha group compared with placebo.
The 2025 trial also reported changes in estradiol, progesterone, FSH and LH.
But this doesn't mean that ashwagandha should be thought of as a natural replacement for estrogen therapy.
Hormone levels naturally change throughout the menopause transition, and the clinical importance of changing an individual hormone measurement is not always straightforward.
So I'd be cautious about any product or article claiming:
"Ashwagandha restores estrogen naturally."
The existing research doesn't justify such a broad conclusion.
Why the Evidence Is Still Considered Limited
This is an important part of the story.
The studies are encouraging, but there are several reasons not to overstate them.
The studies are small
The trials we've discussed included relatively small numbers of women.
Larger studies would give us more confidence that the results aren't simply due to chance or characteristics of the particular participants.
Different extracts are used
"Ashwagandha" isn't one standardized pharmaceutical product.
Different supplements can contain different extracts, plant parts, concentrations and amounts of withanolides.
That makes it difficult to assume that results from one standardized extract will apply to every ashwagandha supplement on the market.
NCCIH specifically notes that clinical studies have used a variety of ashwagandha preparations and that many studies have small sample sizes.
Most studies are relatively short
An eight-week study can tell researchers whether symptoms changed during that period.
It tells us much less about what happens after six months, one year or longer.
That's particularly important when discussing supplements intended for long-term use.
Is Ashwagandha Safe During Menopause?
This is a question worth taking seriously.
NCCIH says ashwagandha may be safe when used short-term, for up to about three months, but there isn't enough information to establish its long-term safety.
Possible side effects include:
- Drowsiness
- Stomach upset
- Diarrhea
- Vomiting
There have also been rare reports linking ashwagandha supplements with liver injury.
Ashwagandha may also interact with certain medications, including some medicines for diabetes and high blood pressure, sedatives, anticonvulsants, immunosuppressants and thyroid medications.
And NCCIH advises against its use in people with certain thyroid or autoimmune disorders.
So "natural" shouldn't automatically be interpreted as "risk-free."
What About Ashwagandha and Thyroid Function?
This deserves particular attention because thyroid symptoms can sometimes overlap with symptoms women experience during midlife.
Ashwagandha may affect thyroid hormone levels, and NCCIH specifically advises against its use in people with thyroid disorders. It can also interact with thyroid hormone medications.
If you're taking thyroid medication or have been diagnosed with a thyroid condition, this isn't a supplement I'd recommend experimenting with casually.
Talk with your healthcare professional first.
So, Does Ashwagandha Actually Work for Menopause?
The fairest answer is:
Possibly—but we don't know enough yet to say how well or for whom.
Several randomized controlled trials have reported improvements in menopause symptom scores, quality of life, stress and, in one recent study, hot-flash frequency.
That's more encouraging than simply relying on traditional use or anecdotal reports.
At the same time, the evidence base remains relatively small, studies have used different extracts and preparations, and long-term safety and effectiveness remain less certain.
That's why NCCIH currently concludes that there isn't enough evidence to determine whether ashwagandha is helpful for menopause.
The Bottom Line
Ashwagandha is one of those herbs where the research is interesting but not definitive.
Small randomized trials have produced encouraging results, particularly for overall menopause symptoms, quality of life and perceived stress. Some research has also reported improvements in hot flashes and changes in reproductive hormone measurements.
But that doesn't mean ashwagandha has been proven to "balance hormones" or replace established menopause treatments.
If you're considering it, the most sensible approach is to look at the specific extract, dose, evidence and safety profile, rather than choosing a product simply because it says "menopause support" on the label.
And if you're taking medication, have a thyroid or autoimmune condition, or are considering long-term use, discuss it with a healthcare professional first.
The research is promising enough to be worth watching.
It's just not strong enough yet to call ashwagandha a proven menopause treatment.