Maca Root for Hot Flashes

Maca might reduce hot flashes, but the only trials reporting it came from a single research group testing its own pre-gelatinised preparation. In the largest, 168 early-postmenopausal women took 2 g a day or placebo for three or four months. The authors reported less frequent and less severe symptoms, hot flushes and night sweats in particular, and a fall in the Kupperman index (a menopausal symptom score) from 22 to 10 (P<0.001) [2]. A 2011 systematic review of four placebo-controlled trials found that all favoured maca on overall symptom scores, not hot flashes specifically, but judged the evidence limited because the trials were few, small and of low average quality [1].

Independent researchers have not confirmed the effect. Two small crossover trials, in 14 Australian and 29 Hong Kong Chinese postmenopausal women, found less depression (and, in one, less anxiety), but neither abstract reports fewer hot flashes [5][6]. The North American Menopause Society does not recommend supplements or herbal remedies for hot flashes, and says hormone therapy remains the most effective treatment [7]. For maca's wider evidence across menopausal symptoms, see maca for menopause.

Maca (Lepidium meyenii) is an Andean plant of the brassica (mustard) family, used for centuries in the Andes for anaemia, infertility and female hormone balance [1]. The research group behind the positive hot-flash trials proposed that its pre-gelatinised maca acts as a 'toner' of hormonal processes along the hypothalamus-pituitary-ovarian axis, the hormone chain linking the brain and the ovaries [3].

In their trials in early-postmenopausal women, oestradiol rose and FSH (follicle-stimulating hormone) fell [2][3]. In perimenopausal women, oestradiol and FSH both rose [4]. These changes don't point in one consistent direction, and they come from the same group's trials.

Independent trials found no hormone effect. In the Australian trial, oestradiol, FSH, LH and SHBG did not change on maca, and maca extracts showed no physiologically significant oestrogenic or androgenic activity in yeast-based tests [5]. The Hong Kong trial also found no change in oestradiol, FSH or SHBG [6]. Memorial Sloan Kettering sums it up: maca appears to modulate some hormone levels in women in some studies but not in others [12].

Every trial that reported fewer hot flashes used 2 g a day of pre-gelatinised maca, taken as two 500 mg capsules twice daily with meals, for two to four months [2][3][4]. The independent trials, which did not report a hot-flash benefit, used 3.5 g a day [5] and 3.3 g a day [6] of maca powder for 6 weeks. None of these trials compared doses.

Products differ. A 2024 review, co-written by the lead author of the positive trials, counted up to 17 colours of maca and found that colour, root size, growing location, cultivation and processing can all change its nutrient and plant-compound content, while research comparing colours remains limited [11]. A product labelled maca may not match what was tested.

All four come from the same research group, tested the same pre-gelatinised preparation and were published in the same journal [2][3][4][9]. The largest randomised 168 early-postmenopausal women at five sites; 124 finished. Maca reduced the frequency and severity of symptoms, hot flushes and night sweats in particular, and the Kupperman index fell from 22 to 10 (P<0.001) [2]. A four-month crossover trial in 34 early-postmenopausal women reported the same pattern of symptom relief (P<0.001), again singling out hot flushes and night sweats [3].

A crossover pilot in 20 perimenopausal women aged 41-50 found that two months of maca eased symptoms in 74-87% of women on the Kupperman index, and the authors listed less frequent hot flushes and night sweats among the benefits; they also noted a distinctive placebo effect early in the study [4]. An earlier pilot in 20 early-postmenopausal women reported less menopausal discomfort, again with a distinct placebo effect, but its abstract does not separate out hot flashes [9].

Two double-blind crossover trials by a team independent of the first group tested maca powder. In 14 postmenopausal women, 3.5 g a day for 6 weeks lowered Greene Climacteric Scale scores for psychological symptoms, including anxiety and depression, and for sexual dysfunction, compared with both baseline and placebo (P<0.05) [5]. In 29 Hong Kong Chinese women, 3.3 g a day for 6 weeks lowered depression and diastolic blood pressure [6].

Both trials scored menopausal symptoms, yet neither abstract reports a hot-flash benefit. The Hong Kong authors suggested Chinese women may report symptoms differently [6]. With 14 and 29 women, both trials were too small to rule out a modest effect.

The only systematic review focused on maca for menopause, from 2011, rated the evidence limited and said safety had not been proven [1]. A 2014 minireview listed maca among herbal extracts that reduced vasomotor symptoms (hot flashes and night sweats) in randomised trials [10], but it drew on the same small trial base.

Wider reviews are cautious about herbs in general. A 2016 meta-analysis of 62 trials of plant-based therapies found modest reductions in hot flashes with phytoestrogens, but 74% of its trials had a high risk of bias in three or more areas [13]. A 2026 review of 30 trials of non-soy herbal supplements found the studies too varied to say whether herbs work [14]. A 2026 systematic review written to inform the International Menopause Society's recommendations found moderate-certainty evidence for black cohosh and Chinese herbal medicine, while most complementary therapies had low or very low certainty evidence [8].

Hormone therapy remains the most effective treatment for hot flashes and should be considered within 10 years of the final period [7]. For women who can't take it, for example after an oestrogen-dependent cancer, or who prefer not to, the North American Menopause Society recommends cognitive-behavioural therapy, clinical hypnosis, SSRIs or SNRIs, gabapentin and fezolinetant (its strongest level of evidence), and oxybutynin [7].

If you want a herbal option, black cohosh for hot flashes is one of the few herbal options rated moderate certainty in a 2026 review [8], although another 2026 review found no measurable effect in the black cohosh trial it included [14].

No independent trial has reported that maca reduces hot flashes. The trials scored symptoms with questionnaires (the Kupperman index and Greene scale) rather than counting hot flashes each day, none ran longer than four months with a placebo group, and none compared maca with hormone therapy or prescription non-hormonal treatment [2][3][4][5][6]. We found no placebo-controlled trial of maca for menopausal symptoms published after 2015.

Maca was taken for up to four months in the placebo-controlled trials, and the 2011 review said its safety had not yet been proven [1]. Memorial Sloan Kettering's patient guidance says no side effects have been reported, while its professional summary lists subjective reports of altered menstrual cycles, moodiness, cramps, gastritis and insomnia [12]. It also advises talking to a clinician if you are pregnant or breastfeeding, as maca may not be safe [12].

Maca can distort testosterone blood tests. In one case report, a woman taking maca had a total testosterone of 25.8 nmol/l on one immunoassay, which fell to 2.9 nmol/l when the sample was rerun on a higher-affinity assay [16].

The trials enrolled healthy women [1], so maca is untested in women with breast cancer or other hormone-sensitive cancers. Memorial Sloan Kettering advises anyone with a hormone-sensitive cancer, such as breast or uterine cancer, to talk to their care team because maca may affect treatment [12]. Lab work adds caution: maca extracts showed oestrogen-like activity in vitro [12], and in two triple-negative breast cancer cell lines a maca extract increased cell migration and raised expression of MMP-1, a gene involved in cancer spread [15]. These are cell studies and don't show harm in people.

Few interactions are documented. Maca lowered diastolic blood pressure in the Hong Kong trial [6], and Memorial Sloan Kettering lists a rat study in which maca enhanced the blood-pressure-lowering effect of losartan, with clinical relevance not yet determined; the study it cites tested a related plant, Lepidium sativum [12]. No trial has combined maca with hormone therapy or with non-hormonal hot-flash medicines, so those combinations are untested.