Adaptogens for Women: Hormones, Cycles, Fertility and Menopause
What research and health agencies say about ashwagandha, maca, ginseng and other adaptogens for women's hormones, cycles, fertility, sexual function and menopause, and who should check first.
Content last updated . This page has not been medically reviewed.
Safety first. Supplements can cause side effects and interact with medicines. Read mushroom safety and interactions before you use any mushroom product.
Read this first if you are pregnant, breastfeeding, trying to conceive, or have a hormone-sensitive condition. NCCIH (the US National Center for Complementary and Integrative Health) says ashwagandha should be avoided during pregnancy and should not be used while breastfeeding. [1] The European herbal committee (HMPC, 2024) says safety of Rhodiola rosea in pregnancy and lactation has not been established and use is not recommended. [2] The US LactMed database says many sources recommend ginseng not be used during lactation, partly because of possible estrogenic activity. [3] See adaptogens in pregnancy and breastfeeding. Nothing on this page replaces advice from your own clinician.
What the claims say, and a word about the term
Products are often sold to women as "hormone balancing", "cycle support" or "menopause support". "Adaptogen" is a contested term, and regulators do not treat it as a category (see what are adaptogens). This page asks a narrower question: when researchers measured something in women, what did they find, for which plant and which extract? Traditional use (for example, maca grown and eaten in the Peruvian Andes for centuries, and ashwagandha in Ayurveda) is not proof of an effect, and research results for one extract do not carry over to another.What research shows
| Question | What the source found | Evidence label |
|---|---|---|
| Menopausal symptoms, ashwagandha root extract | An 8-week trial of 100 perimenopausal women compared 300 mg twice daily of one root extract with placebo; symptom scores fell more with the extract. [4] A second trial of 60 women aged 45-55 over 56 days reported similar symptom changes. [5] NCCIH says there is not enough evidence to decide whether ashwagandha helps menopause. [1] | Promising but limited |
| Menopausal symptoms, maca (Lepidium meyenii) | A systematic review found four trials, all favorable, but called the evidence limited and said safety "has not been proved yet". [6] | Insufficient evidence |
| Menopausal symptoms, ginseng (Panax species) | A review of 15 trials found reduced hot flashes and symptoms in a few studies, with bias a concern in most; ginseng did not clearly help sexual function or hormone levels. [7] | Mixed |
| Sexual function, ashwagandha root extract | Two 8-week trials (50 and 80 women, 300 mg twice daily) reported higher Female Sexual Function Index scores than placebo. [8] [9] | Promising but limited |
| Hormone levels in women | A 2026 meta-analysis of 23 trials found ashwagandha raised testosterone in men but not in women. [10] In the perimenopause trial, estradiol rose and FSH fell. [4] | Biomarker change, not a clinical outcome |
| Cycles, PCOS and premenstrual symptoms | A 2026 narrative review said the evidence relies heavily on animal models and extrapolation from other groups. [11] Proper evidence not found for large human trials; we searched PubMed on 2026-10-23. | Preclinical; insufficient |
| Female fertility | NCCIH says there is not enough evidence to decide whether ashwagandha helps female infertility. [1] | Insufficient evidence |
Hormone numbers such as estradiol or cortisol are markers. A change in a marker does not show that a woman feels or functions better, and "balancing hormones" is not an established claim for any adaptogen. For thyroid and hormone-balance claims see adaptogens and thyroid or hormone balance claims; for goal-level advice see perimenopause and menopause.
What a reader can do
Bring the product label to a clinician or pharmacist, say if you could be pregnant or are planning a pregnancy (trying to conceive), and track symptoms so a clinician can judge what is working. Heavy bleeding, missed periods or new symptoms need a medical check, not a supplement. See also women's health: when to get help.Frequently asked questions
Do adaptogens balance a woman's hormones?
Not as an established fact. One trial saw estradiol and FSH change in perimenopausal women, but that is a marker, and NCCIH says evidence on menopause is not sufficient. [4] [1]
Is ashwagandha safe for women?
NCCIH says it may be safe short term (up to 3 months) but should be avoided in pregnancy and while breastfeeding; rare liver injury and medicine interactions are documented. [1]
Does maca help menopause symptoms?
A systematic review found limited evidence from four small trials and said safety had not been proved. [6] A 2018 review said maca's reproductive-health claims cannot be fully supported yet. [12]
Can adaptogens help me get pregnant?
NCCIH says there is not enough evidence on ashwagandha and female infertility. [1] Rhodiola has no fertility data in the European monograph. [2] Talk to a clinician before trying to conceive with any supplement.
Can I take an adaptogen with hormone medicines?
Sources we read did not describe interactions with birth control or menopausal hormone therapy, which is not the same as safe. Ask a pharmacist. [1]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Limits of the research
Safety
- Side effects: NCCIH lists drowsiness, stomach upset, diarrhea and vomiting for ashwagandha, and rare liver injury. [1] LactMed lists headache, high blood pressure, sleeplessness, rash and vaginal bleeding as common ginseng effects. [3]
- Hormone-sensitive conditions: the sources we read name hormone-sensitive prostate cancer, not breast or gynecologic conditions, for ashwagandha. [1] Because ginseng has possible estrogenic activity and ashwagandha changed estradiol in one trial, ask your specialist first. See herbs and hormone-sensitive conditions.
- Medicines: NCCIH says ashwagandha might interact with diabetes and blood pressure medicines, immunosuppressants, sedatives, anticonvulsants and thyroid hormone medicines. [1] Interactions with birth control or menopausal hormone therapy: sources we read did not describe them; see supplements and hormone medicines and how interactions work.
- Surgery: NCCIH says ashwagandha is not recommended before surgery. [1] Tell your surgical team about every supplement.
- Quality: labels and contents can differ; see quality testing and certifications.
References
- National Center for Complementary and Integrative Health (NIH). Ashwagandha: Usefulness and Safety. Read 2026-10-23.
- European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). European Union herbal monograph on Rhodiola rosea L., rhizoma et radix, Final, Revision 1. EMA/HMPC/24177/2023, 20 March 2024. Read 2026-10-23.
- Ginseng. LiverTox/LactMed (NIH), 2006. PubMed 30000873. Read 2026-10-23.
- Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study. The journal of obstetrics and gynaecology research, 2021. PubMed 34553463. Read 2026-10-23.
- A prospective, randomized, double-blind, placebo-controlled study on efficacy and safety of Ashwagandha root extract (Withania somnifera) for managing menopausal symptoms in women. Frontiers in reproductive health, 2025. PubMed 41561822. Read 2026-10-23.
- Maca (Lepidium meyenii) for treatment of menopausal symptoms: A systematic review. Maturitas, 2011. PubMed 21840656. Read 2026-10-23.
- Using ginseng for menopausal women's health care: A systematic review of randomized placebo-controlled trials. Complementary therapies in clinical practice, 2022. PubMed 35691259. Read 2026-10-23.
- Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study. BioMed research international, 2015. PubMed 26504795. Read 2026-10-23.
- Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract for Improvement of Sexual Health in Healthy Women: A Prospective, Randomized, Placebo-Controlled Study. Cureus, 2022. PubMed 36447681. Read 2026-10-23.
- Hormonal Modulation with Withania somnifera: Systematic Review and Meta-Analysis of Randomized-controlled Trials. Planta medica, 2026. PubMed 41740946. Read 2026-10-23.
- Withania somnifera in Women's Hormonal Modulation: A Narrative Review With Implications for Polycystic Ovary Syndrome and Premenstrual Syndrome. Cureus, 2026. PubMed 41694897. Read 2026-10-23.
- Is the hype around the reproductive health claims of maca (Lepidium meyenii Walp.) justified?. Journal of ethnopharmacology, 2018. PubMed 28811221. Read 2026-10-23.
- NHS (UK). Treatment for menopause and perimenopause. Read 2026-10-23.