August 23, 2024
Ashwagandha for PCOS: Exactly What You Need to Know
Table of Contents
Key Takeaways
I remember when I was officially, or rather, unofficially diagnosed with Polycystic Ovarian Syndrome (PCOS). There was an office visit to my OBGYN as a result of having infrequent periods. A ultra sound later, they said, “you have PCO-like symptoms. You have cysts but you don’t exhibit all the classical characteristics of the diagnosis like male pattern hair growth, and weight gain but you do have cystic acne and some missed periods.” The remedy: they prescribed a general birth control pill.
Fast forward to about 15 years later, what if there were recommendations like Ashwagandha for PCOS? Would that help with my reduce the painful cystic acne that would become so inflamed? Would it improve the consistency of my periods? Read further to see what current research says about Ashwaghanda possibly supporting PCOS.
What is PCOS?
First, let me talk about what PCOS actually is. According to a review by the Journal of Clinical Medicine in 2023, Polycystic ovary syndrome (PCOS) is a bit of a complicated puzzle, affecting both hormones and metabolism. It usually shows up as issues like irregular periods, trouble with ovulation, weight gain, insulin resistance, and those pesky polycystic ovaries. A mix of things—like diet, lifestyle, environmental toxins, genetics, gut health, and weight—can all play a part in increasing the risk of PCOS.
These factors can throw the body’s balance off, leading to high insulin levels, oxidative stress, increased androgens and disruptions in how eggs develop. Not to mention those unpredictable menstrual cycles (this was so annoying for me!). Interestingly, the gut microbiome might have a hand in the development of PCOS, adding another piece to the puzzle.
I had bloodwork to help determine where my hormones were, and one of the high ones were DHEA. With someone living with PCOS you’ll see the following possible differences in your bloodwork:
- Luteinizing hormone (LH): Follicle stimulating hormone (FSH) ratio might increase
- DHEA might be high
- FSH secretion might decrease
- Testosterone might be high
- Sex hormone binding globulin (SHBH) might be low
- Insulin levels might be high
- Glucose tolerance might be low
If you’re one of the women who struggles with PCOS read on to see if Ashwagandha will help to reduce its symptoms.
How Does Ashwagandha Work for Women with PCOS?
Ashwagandha is a medicinal herb that has been used for thousands of years in traditional Ayurvedic medicine. It is often referred to as an adaptogen, meaning it helps the body manage stress by reducing cortisol levels as mentioned in a research review published in Journal of Functional Foods in 2023. I also can’t forget that you’ll see another name for Ashwagandha called withania somnifria, which is latin for sleep inducing.
Since PCOS causes a variety of hormone imbalances, it can cause stress within the body. Being that Ashwaghanda is an adaptogen it can absorb that stress.
Hormone Balance
Ashwagandha is perhaps best known for its ability to lower cortisol levels. Cortisol is the body’s primary stress hormone. Chronically high levels can lead to hormonal imbalances, such as those seen in conditions like PCOS and adrenal fatigue. By reducing cortisol, ashwagandha can help reduce the stress response. All which can keep your other hormones in check!
According to a small study published by Medicine in 2019, with 60-days of ashwagandha consumption, it was linked to more significant decreases in morning cortisol and DHEA-S levels. Remember DHEA-S is a type of androgen, a male sex hormone. Higher levels of DHEA and cortisol may indicate increased stress.
he adrenal cortex produces cortisol and DHEA in different layers, and disruptions in their regulation link to anxiety and depression. Ashwagandha appears to help balance hypothalamic-pituitary-adrenal (HPA) axis activity, potentially reducing stress by lowering morning cortisol and DHEA-S levels. The picture below describes what the HPA axis is and how ashwaghanda might help.
Stress Management
As an adaptogen, ashwagandha helps the body maintain balance during periods of stress. It modulates the stress response, making the body more resilient to stressors. This means that ashwagandha can help you stay calmer and more balanced in the face of stress. This just simply reduces the likelihood of feeling overwhelmed or burnt out!
Body Image and Self Esteem
Ashwagandha positively influences neurotransmitters like serotonin and dopamine, which regulate mood. Balanced mood can lead to reduced stress and, by extension, more balanced hormone levels.
Several studies show that ashwagandha helps reduce symptoms of anxiety and depression, often worsened by chronic stress. More specifically a review found in the Journal of Herbal Medicine in 2021 found that ashwaghnda extract to reduce stress and anxiety.
By lowering cortisol and supporting neurotransmitter balance, ashwagandha contributes to improved mental health and emotional well-being. This can also include perceived stress and anxiety.
Blood Sugar Regulation
Researchers have found that ashwagandha improves insulin sensitivity. Insulin sensitivity refers to how effectively your body’s cells respond to insulin, allowing glucose to enter the cells for energy. High sensitivity means your body requires less insulin to manage blood sugar levels which supports metabolic health. Improved insulin regulation leads to more stable blood sugar levels and reduces the risk of hormonal imbalances.
To further support blood sugar levels, which reduces overall inflammation aim to make half of your plate with veggies. Some of my favorites are the dark leafy greens like broccoli and spinach.
Inflammation
Inflammation is not always a bad thing! It helps isolate the affected area and prevent the spread of infection. Cytokines like interleukins and TNF-α signal immune cells to the affected area, while histamine increases blood flow and vessel permeability, causing redness and swelling. Prostaglandins and bradykinin contribute to pain and inflammation, and cortisol helps regulate the process by suppressing excessive inflammation.
A review found in Sage Journals from 2019, indicates that cytokines are high in those living with PCOS. Women with PCOS are insulin resistant and face a higher risk of coronary heart disease (CHD) and type 2 diabetes states a study conducted by the World Journal of Diabetes in 2022.
Fertility
The World Health Organization mentions that PCOS is a leading cause of infertility, affecting an estimated 8% to 13% of women of reproductive age.Research has shown how Ashwaghanda can help to improve the regularity of a period. In a small study published by Integrative Medicine Research in 2016 it improved the Follicle Stimulating Hormone (FSH) in women.
How Much Ashwagandha to Take for PCOS?
First, speak with your healthcare provider or a registered dietitian (like me!) to ensure that you are safely trying a new supplement. According to the National Institutes of Health Ashwagandha supplementation appears to be well tolerated for up to 3 months of use. Research appears to show that taking doses less than 450 mg daily is tolerated.
Who Should Not Take Ashwaghanda?
Now, I don’t want to go on stating this herbal supplement is the cure all without balancing out the other side of it. Taking large doses in the amount of 450- 1,350 mg daily has been associated with serious side effects, including liver injury, particularly when taken with other medications. When they stopped taking the supplement with symptoms like jaundice and abdominal discomfort, which improved after discontinuation of the supplement 450 mg to 1,350 mg daily. There are some other groups of individuals who should not take the supplement in any form, which includes:
- Individuals with liver conditions – Due to the risk of liver injury.
- Those taking thyroid hormone medications – Ashwagandha may affect thyroid function.
- People on certain medications – Including antidiabetes medications, antihypertensives, immunosuppressants, and sedatives, due to potential interactions.
- Pregnant women – Ashwagandha may increase the risk of spontaneous abortion.
- Breastfeeding mothers – The safety of ashwagandha during breastfeeding is uncertain.
- Men with hormone-sensitive prostate cancer – Ashwagandha may increase testosterone levels, which could be unsafe.
Bottom Line on Ashwaganha for PCOS
It is generally safe for consumption however, it’s good to note that they come in several forms: powder, capsule/tablet, tincture (liquid extract), tea, and gummies. I personally, have a preference for my patients to start off with and it is in tea form.
The reason I often present is it can be part of an enjoyable nighttime routine! Also, the amount in tea form can be enjoyed on and off throughout the week and can still provide the desired effects. Most tea bags have 2 grams and often the tea bags may have 1 to 3 grams of ashwaghanda root in each bag. This can range to about 100-300 mg per tea cup serving. This is a lower dose in which I prefer.
Again, ALWAYS talk with your healthcare provider or registered dietitian (ME! to ensure you’re a candidate for taking this herbal supplement, especially since research indicates it can be helpful towards PCOS related symptoms!
Disclaimer: This article is not intended to provide medical advice, diagnosis, opinion, treatment or services. This article and the links contained in it provide general information for educational purposes only. The information provided in this article is not a substitute for medical care, and should not be used in place of the advice of your physician or registered dietitian.
We are a health and wellness site, with work written by Registered Dietitians or Medical Professionals, please review our editorial process here.
Frequently Asked Questions
Generally, yes, ashwagandha and inositol can generally be taken together, especially for managing PCOS symptoms. Ashwagandha helps reduce stress by lowering cortisol, while inositol improves insulin sensitivity and supports ovarian function. Combining them may offer complementary benefits for hormone balance and metabolic health. However, it’s important to consult a healthcare provider before starting both supplements to ensure they are safe and appropriate for your specific needs. This is particularly crucial if you’re taking other medications or have existing health conditions.
Ashwagandha is generally safe for most women, but it’s important to be aware of potential side effects. Some may experience mild gastrointestinal issues like upset stomach, diarrhea, or nausea. In rare cases, it can cause dizziness, drowsiness, or headaches, and high doses have been linked to liver damage, especially when combined with other medications. Additionally, because ashwagandha can influence hormone levels, women with thyroid disorders or hormone-sensitive conditions should exercise caution. Always consult your healthcare provider before adding ashwagandha to your routine to ensure it’s the right choice for you.
Ashwagandha doesn’t directly increase hair growth in women, but it can support healthier hair by reducing stress and balancing hormones. Stress and hormonal imbalances are common causes of hair loss, and ashwagandha’s ability to lower cortisol and stabilize hormones may help prevent hair thinning.
While ashwagandha is generally safe for most people, it’s important to be aware of potential risks. High doses may cause gastrointestinal issues like upset stomach, diarrhea, or nausea. Rarely, ashwagandha has been associated with liver damage, especially when taken with other medications. It can also influence hormone levels, so those with thyroid disorders or hormone-sensitive conditions should use it with caution. Pregnant or breastfeeding women, and individuals on certain medications, should consult their healthcare provider before starting ashwagandha.
Christa is a media dietitian and nutrition consultant in the New York City area. She works with various brands and has been featured in dozens of outlets such as Women’s Health, EatingWell, and Peoples Magazine as a nutrition expert. Being a fact checker for EatingWell Magazine and a Medical Reviewer for Nourish, she brings her extensive experience within the field to provide compassionate, inclusive care using science for intimate and personalized messaging.
Christa brings warm laughter, joy, and medical expertise to any conversation allowing for honest science-based discussions with authenticity at their core.
In her private practice, she works with men and women suffering from emotional traumas that cause binge eating disorders exacerbating their type 2 diabetes, PCOS and insulin resistance.
