Ashwagandha Benefits for Women: What Trials Show

Small placebo-controlled trials in women found milder perimenopause symptoms and higher sexual function scores after 8 weeks of 600 mg a day of root extract^{1, 2}. It did not raise testosterone in women³. Skip it in pregnancy and breastfeeding⁴.

Ashwagandha (Withania somnifera) is a shrub whose root is used in Ayurvedic medicine⁴. The women-specific trials enrolled 50 to 100 women and lasted 8 to 12 weeks, so they say little about long-term use^{2, 5, 1, 6, 7}. This guide covers only what differs for women. General benefits and dosing sit on our ashwagandha page.

Yes, modestly. Three small trials compared root extract with placebo, and all three found lower symptom scores. None compared it with hormone therapy.

• Perimenopause, 100 women, 8 weeks: 300 mg twice daily lowered the total Menopause Rating Scale score more than placebo (p < 0.0001), with gains in the psychological, somato-vegetative and urogenital domains. 91 women finished¹.
• 60 women aged 45 to 55 with menopausal symptoms, 56 days: the total Menopause Rating Scale score, hot flash events and perceived stress all improved more than with placebo⁶.
• Postmenopause, 66 women, 12 weeks: 600 mg a day changed the sleep score by -5.2 versus -0.8 on placebo and the menopause score by -8.1 versus -1.2. Body fat fell 0.6% versus a 0.03% rise. Bone mineral density did not differ⁷.

Both the perimenopause trial and the 60-woman trial also reported higher estradiol and lower FSH and LH than placebo^{1, 6}. Those are lab changes. The symptom scores are what a woman would notice. Bone mineral density, an exploratory outcome in the 12-week postmenopausal trial, did not differ between groups⁷.

Our pages on ashwagandha for perimenopause and menopause hold the full evidence.

Two 8-week placebo-controlled trials found higher scores on the Female Sexual Function Index (FSFI) with 300 mg twice daily^{2, 5}.

• 50 women, pilot trial: the FSFI total score, and the arousal, lubrication, orgasm and satisfaction domains, improved more than with placebo. The number of successful sexual encounters rose too².
• 80 women aged 18 to 50 with low desire: FSFI rose from 14.20 to 22.62 with ashwagandha and from 14.17 to 19.25 with placebo. The net gain was about 3 points, because placebo also improved by about 5⁵.

In the larger trial, the general health questionnaire gain did not reach significance (p = 0.078), and adverse events were comparable between groups⁵. Both trials enrolled otherwise healthy women, so they do not show whether it helps desire problems tied to menopause, medicines or depression^{2, 5}. See ashwagandha for low libido for the wider evidence.

Probably, but the stress and sleep data come mostly from mixed-sex trials. We found no meta-analysis that reports women separately.

• Stress and anxiety: a meta-analysis of 12 trials in 1,002 adults found lower anxiety (SMD -1.55) and stress (SMD -1.75), though the certainty of evidence was low⁸. Another of 9 trials in 558 patients found a 4.72-point drop on the Perceived Stress Scale and a 2.19-point drop on the Hamilton Anxiety Scale⁹.
• The counterpoint: a 2025 analysis of 6 to 7 trials in 488 participants found cortisol fell by 1.16 µg/dL, but perceived stress did not change significantly (p = 0.40)¹⁰. A 12-week trial in adults aged 40 to 75 also found no difference in stress from placebo (p = 0.867), though fatigue improved¹¹.
• Sleep: a meta-analysis of 5 trials in 400 adults found a small effect (SMD -0.59), larger in people with insomnia, at doses of 600 mg a day or more and over 8 weeks or longer¹². A separate pooled analysis of 5 trials in 254 patients found shorter sleep onset time and better sleep scores¹³.

In postmenopausal women, the 12-week trial above showed a clear sleep score gain over placebo⁷. For the wider stress evidence, see ashwagandha and cortisol and our stress management hub.

No. The effect appears to be sex-specific.

• Pooled analysis: across 23 trials in 1,706 adults, testosterone rose by 57.43 ng/dL in men but only 5.09 ng/dL in women, a significant sex difference. Estradiol was unchanged in both sexes³.
• Perimenopause trial: serum testosterone did not differ between the ashwagandha and placebo groups¹.
• Mixed-sex trial: free testosterone and LH rose significantly only in the men¹¹.

The pooled finding of no estradiol change conflicts with the two trials in symptomatic midlife women, which found higher estradiol^{3, 1, 6}. The data cannot settle the difference.

The evidence is thin for all three.

• PCOS: we found no randomized trial in women with polycystic ovary syndrome. A 2026 narrative review concluded the case for PCOS and PMS rests heavily on preclinical models and extrapolation from other groups, and called for large randomized trials¹⁴. See our PCOS page.
• Fertility: a 2026 systematic review found potential in certain reproductive disorders, but said more study is needed on long-term effects and dosing¹⁵. We found no trial that measured pregnancy or live birth. See female infertility.
• Weight: in 52 chronically stressed adults, 300 mg twice daily for 8 weeks improved food cravings and perceived stress, and the secondary measures including body weight. The abstract reports no abdominal fat measure¹⁶. In postmenopausal women, body fat fell 0.6% versus a 0.03% rise on placebo, a statistically significant but small change (p < 0.01)⁷.

"Cortisol belly" is a popular label for stress-related abdominal fat, not a medical diagnosis. No cited trial measured belly fat directly, so claims that ashwagandha targets it go further than the data^{16, 7}.

There is no female-specific recommended dose. The women's trials used 600 mg a day of root extract where the dose is stated, and the nearest guideline range is 300 to 600 mg a day^{1, 2, 5, 7, 4}.

• 300 mg twice daily for 8 weeks: used in the perimenopause trial and both sexual function trials^{1, 2, 5}.
• 600 mg a day for 12 weeks: used in postmenopausal women⁷.
• 300 to 600 mg a day: the range a dose-response analysis linked to lower stress⁸. An international taskforce provisionally recommends 300 to 600 mg a day of root extract standardized to 5% withanolides for generalized anxiety disorder, with a note that stronger advice needs more data⁴.
• 600 mg a day or more: the sleep benefit was larger at this level in a meta-analysis¹².

Studies used many preparations and doses, which makes firm recommendations hard⁴. More is not safer: reported liver injury cases involved ashwagandha products at 450 to 1,350 mg a day⁴.

We found no trial that compared morning with evening dosing, for sleep or anything else.

• Sleep trials: 300 mg twice daily, with milk or water, for 10 weeks shortened sleep onset time and improved sleep efficiency in people with insomnia¹⁷.
• Night-time dosing: one stress and anxiety trial gave 500 mg once daily at night, with 5 mg of piperine, for 60 days. It improved stress and anxiety scores and lowered morning salivary cortisol, but did not measure sleep¹⁸.

The sleep trials used a split dose, so that is the tested schedule. In an 8-week trial, the sleep gains were larger in people with insomnia than in healthy volunteers¹⁹. Pick a schedule you will keep, since benefits in the trials built up over weeks, not in a single night.

Trials measured effects at 4 to 10 weeks, and some measures needed the full length^{5, 17}.

• Sexual satisfaction: more women on ashwagandha reported improved satisfying sexual encounters than on placebo at week 4 (p = 0.017) and week 8 (p = 0.002)⁵.
• Sleep onset: in a 10-week trial, sleep onset time improved on both ashwagandha and placebo at 5 and 10 weeks, and was significantly shorter than placebo only at 10 weeks¹⁷.
• Cortisol: morning salivary cortisol was lower than placebo at the end of a 60-day trial¹⁸. The trials report cortisol only at the end of treatment, so how soon it falls is not established.

Ashwagandha appears well tolerated for up to about 3 months. Common side effects are mild: stomach upset, loose stools, nausea and drowsiness. Its safety over months or years is not known⁴.

Pregnancy and breastfeeding

Some experts advise against ashwagandha in pregnancy because reports suggest it may cause spontaneous abortion, and the NIH notes it may not be safe during pregnancy or breastfeeding. France's food safety agency recommended against it in pregnant and breastfeeding women in 2024, and Denmark banned it in 2023⁴. A 12-week open-label trial in 70 second-trimester women reported no adverse events and stable liver, kidney and thyroid markers²⁰. That trial is too small and short to rule out rarer harms, so it does not change the advice.

Liver

Five patients in an Icelandic and US case series developed liver injury 2 to 12 weeks after starting an ashwagandha product. They had jaundice, nausea, lethargy and itching. Liver tests normalized in 1 to 5 months in four of the five²¹. A series from India found 8 patients with single-ingredient cases. Three with chronic liver disease went into acute-on-chronic liver failure, and all three died²².

Thyroid

The signals point in two directions. In 50 people with subclinical hypothyroidism, 600 mg a day for 8 weeks lowered TSH and raised T3 and T4 versus placebo²³. In a bipolar disorder trial, T4 rose by 7% to 24% in the three ashwagandha patients with abnormal results²⁴.

The NIH lists three case reports of thyrotoxicosis in women aged 32 to 73 that resolved after stopping, and warns of a possible interaction with thyroid hormone medicine⁴. A man in Japan developed painless thyroiditis two months after starting it²⁵. A pooled analysis found a modest T4 rise of 0.61 µg/dL with no effect on TSH or T3³. If you take levothyroxine, see levothyroxine and supplements and the pages for hypothyroidism and hyperthyroidism.

Medicines

Ashwagandha may interact with antidiabetes drugs, blood pressure medicines, immunosuppressants and sedatives⁴. For antidepressants, see SSRIs and supplements.

Match the decision to your situation, using the schedules the trials tested.

• Pregnant, trying to conceive or breastfeeding: do not take it⁴.
• Liver disease or abnormal liver tests: avoid it unless a clinician agrees. Fatal liver failure was reported in people with chronic liver disease²².
• Thyroid condition or thyroid medicine: ask your clinician first and recheck thyroid tests, since thyroid levels changed in trials and case reports^{23, 4}.
• None of the above, with perimenopause symptoms or low desire: the schedule tested in the trials was 300 mg twice daily of root extract for 8 weeks, then reassess^{1, 5}.
• Poor sleep: the sleep benefit in a meta-analysis was larger at 600 mg a day or more and over 8 weeks or longer¹².
• After 12 weeks: stop or review with a clinician, because the trials do not cover longer use⁴.

For the same question about another supplement, see creatine for women. Our ashwagandha page covers the full evidence base.

We searched the biomedical literature on 29 October 2026 for trials, meta-analyses and case reports of ashwagandha in women, and read the PubMed records of 24 studies and the NIH Office of Dietary Supplements fact sheet. We prioritized placebo-controlled trials in women and meta-analyses of randomized trials, then safety reports. We read abstracts rather than full texts, and we did not review product labels or non-English sources. Evidence specific to women is limited to small, short trials, and the stress and sleep data come mostly from mixed-sex trials.

1. Gopal S, et al. Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study. J Obstet Gynaecol Res. 2021;47(12):4414-4425. doi:10.1111/jog.15030
2. Dongre S, et al. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study. Biomed Res Int. 2015;2015:284154. doi:10.1155/2015/284154
3. Fornalik M, et al. Hormonal Modulation with Withania somnifera: Systematic Review and Meta-Analysis of Randomized-controlled Trials. Planta Med. 2026;92(8):790-805. doi:10.1055/a-2802-8363
4. National Institutes of Health, Office of Dietary Supplements. Ashwagandha: Is it helpful for stress, anxiety, or sleep? Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Ashwagandha-HealthProfessional/
5. Ajgaonkar A, et al. 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;14(10):e30787. doi:10.7759/cureus.30787
6. Vani I, et al. A prospective, randomized, double-blind, placebo-controlled study on efficacy and safety of Ashwagandha root extract (Withania somnifera) for managing menopausal symptoms in women. Front Reprod Health. 2025;7:1647721. doi:10.3389/frph.2025.1647721
7. Obhrai S, et al. Effects of Withania somnifera root extract on sleep quality, body composition, and menopausal symptoms in postmenopausal women: a randomized, double-blind, placebo-controlled trial. Menopause. 2026. doi:10.1097/GME.0000000000002894
8. Akhgarjand C, et al. Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials. Phytother Res. 2022;36(11):4115-4124. doi:10.1002/ptr.7598 Our study summary.
9. Arumugam V, et al. Effects of Ashwagandha (Withania Somnifera) on stress and anxiety: A systematic review and meta-analysis. Explore (NY). 2024;20(6):103062. doi:10.1016/j.explore.2024.103062 Our study summary.
10. Albalawi AA. Dual impact of Ashwagandha: Significant cortisol reduction but no effects on perceived stress - A systematic review and meta-analysis. Nutr Health. 2025;31(4):1395-1408. doi:10.1177/02601060251363647 Our study summary.
11. Smith SJ, et al. Exploring the efficacy and safety of a novel standardized ashwagandha (Withania somnifera) root extract (Witholytin®) in adults experiencing high stress and fatigue in a randomized, double-blind, placebo-controlled trial. J Psychopharmacol. 2023;37(11):1091-1104. doi:10.1177/02698811231200023 Our study summary.
12. Cheah KL, et al. Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. PLoS One. 2021;16(9):e0257843. doi:10.1371/journal.pone.0257843 Our study summary.
13. Fatima K, et al. Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis. Hum Psychopharmacol. 2024;39(6):e2911. doi:10.1002/hup.2911 Our study summary.
14. Namysł M, et al. Withania somnifera in Women's Hormonal Modulation: A Narrative Review With Implications for Polycystic Ovary Syndrome and Premenstrual Syndrome. Cureus. 2026;18(1):e101431. doi:10.7759/cureus.101431
15. Roy D, et al. Effects of Ashwagandha on Reproductive Health: A Systematic Review of Sex-Specific Hormonal and Fertility Outcomes. Phytother Res. 2026;40(8):4813-4832. doi:10.1002/ptr.70128
16. Choudhary D, et al. Body Weight Management in Adults Under Chronic Stress Through Treatment With Ashwagandha Root Extract: A Double-Blind, Randomized, Placebo-Controlled Trial. J Evid Based Complementary Altern Med. 2017;22(1):96-106. doi:10.1177/2156587216641830
17. Langade D, et al. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study. Cureus. 2019;11(9):e5797. doi:10.7759/cureus.5797 Our study summary.
18. Majeed M, et al. A standardized Ashwagandha root extract alleviates stress, anxiety, and improves quality of life in healthy adults by modulating stress hormones: Results from a randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2023;102(41):e35521. doi:10.1097/MD.0000000000035521 Our study summary.
19. Langade D, et al. Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study. J Ethnopharmacol. 2021;264:113276. doi:10.1016/j.jep.2020.113276 Our study summary.
20. Ajgaonkar A, et al. Efficacy and safety of Ashwagandha (Withania somnifera) root extract in pregnant women: a prospective, randomized, comparative, open-label, 12-week study. Front Glob Womens Health. 2026;7:1767865. doi:10.3389/fgwh.2026.1767865
21. Björnsson HK, et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020;40(4):825-829. doi:10.1111/liv.14393
22. Philips CA, et al. Ashwagandha-induced liver injury-A case series from India and literature review. Hepatol Commun. 2023;7(10). doi:10.1097/HC9.0000000000000270
23. Sharma AK, et al. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. J Altern Complement Med. 2018;24(3):243-248. doi:10.1089/acm.2017.0183
24. Gannon JM, et al. Subtle changes in thyroid indices during a placebo-controlled study of an extract of Withania somnifera in persons with bipolar disorder. J Ayurveda Integr Med. 2014;5(4):241-5. doi:10.4103/0975-9476.146566
25. Hayashi M, et al. Painless Thyroiditis by Withania somnifera (Ashwagandha). Cureus. 2024;16(3):e55352. doi:10.7759/cureus.55352