Is Ashwagandha helpful during perimenopause?

It seems like every few years there’s a new supplement or herb that takes off like wildfire. In recent years, Ashwagandha (Ash-wah-gan-da) is having its heyday which has prompted a lot of my patients to include it in their regular supplement regimen 

Like most herbs, Ashwagandha is not intended for use by everyone. Each herb has its own personality and uses and may not be well-suited for some people. In order to better understand if Ashwagandha is right for you, let’s highlight traditional uses of this popular plant.

Ashwagandha (Withania somnifera) is an Indian herb commonly used in Ayurvedic medicine and is in the nightshade family, like tomatoes, white potatoes, eggplants, and peppers. It’s also known as Indian ginseng and most of the medicine is found in the root. 

Ashwagandha is best known as an adaptogen, which means it helps the body adapt to and recover from stress. It has a calming effect and is also used to reset sleep. In particular, it helps with staying asleep throughout the night. In fact, withania means “one to cause sleep”.  Ashwagandha also leaves you feeling more rested and refreshed in the morning.

In addition to helping with sleep and stress, Ashwagandha is an anti-inflammatory and has been used to help reduce inflammatory changes associated with osteoarthritis and rheumatoid arthritis. Ashwagandha may also enhance the efficacy of chemotherapy and promote the formation of new red and white blood cells. 

One of the most common reasons I use Ashwagandha is for thyroid support as it helps with thyroid hormone production and secretion. Ashwagandha provides a minimal amount of iron, which is also important for thyroid hormone production and useful if someone has an iron deficiency. 

Ashwagandha is a warming herb so it should not be solely used by someone who is already warm (think hot flashes and night sweats). While a lot of my patients have low or suboptimal levels of iron, if someone had higher iron levels, I would stay away from using this herb. It is also commonly used for fertility support so if that is not your goal, use with caution.

While Ashwagandha is generally safe, I have had a few patients develop headaches from it, possibly due to their reaction to the nightshades, which can be problematic for some. 

The most frequent issue I see with Ashwagandha (assuming it’s a good fit) is dosing. Since it has become popular, it seems like every supplement company has some form of Ashwagandha supplement available. But with any supplement or herb, taking a therapeutic dose is crucial if you want it to have a positive impact on your health. 

A lot of people prefer to take herbs as in capsules. For Ashwagandha, a therapeutic dose is 3-6 grams of the root per day. Regrettably, the vast majority of supplements available provide an extremely low dose of Ashwagandha, to the point where you’d have to ingest practically half a bottle for a single dose. 

While it may not be as palatable, I prefer to use Ashwagandha as a tincture. Typical dosing for a tincture is 1/2 tsp to 1 tsp three times a day in water. For either the capsule or tincture, it may take at least a few weeks to fully see benefits. As always, consult with your healthcare provider if you’re thinking of adding this useful herb to your daily regimen. 

Unfortunately, there is almost no research on the benefits of Ashwagandha and perimenopause specifically. However, since we know disrupted sleep and hypothyroidism are common in perimenopause, Ashwagandha may be an important component of supporting your body to move through perimenopause with ease.