Abstract Summary
Objective
To assess the physiological effects of ashwagandha (Withania somnifera) on the female body, with specific focus on stress regulation, hormonal balance, reproductive health, and thyroid function.
Context
Ashwagandha is a well-established adaptogenic herb in Ayurvedic medicine, traditionally used to support stress resilience and endocrine health. Contemporary research has increasingly examined its relevance to women’s health, particularly in relation to chronic stress, menstrual irregularities, hormonal imbalance, and reproductive dysfunction. Its primary mechanism of action appears to involve modulation of the hypothalamic–pituitary–adrenal (HPA) axis.
Methods Used
Approach
A focused review of randomized controlled trials, observational studies, and systematic reviews was conducted to evaluate ashwagandha’s effects in female populations.
Data Collection
Data were obtained from peer-reviewed sources including PubMed and ScienceDirect. Outcome measures included serum cortisol, reproductive hormones (estrogen, progesterone, LH, FSH), thyroid hormones (TSH, T3, T4), menstrual regularity, stress and sleep indices, and reported adverse effects.
Researchers' Summary of Findings
Impact on Health
Ashwagandha supplementation is consistently associated with reductions in cortisol and perceived stress in women. This stress-modulating effect may contribute to improved menstrual regularity and ovulatory function, particularly in individuals experiencing stress-related cycle disturbances or polycystic ovary syndrome (PCOS).
Evidence also indicates that ashwagandha may support thyroid hormone production in women with subclinical hypothyroidism, with modest increases observed in circulating T3 and T4 levels. Secondary benefits reported across studies include improved sleep quality, mood stability, and energy levels.
Health Implications
By attenuating chronic stress responses, ashwagandha may indirectly support hormonal equilibrium and reproductive health in women. It is generally well tolerated, with mild gastrointestinal discomfort and drowsiness being the most commonly reported adverse effects. Due to its endocrine activity, use during pregnancy or in hormone-sensitive conditions should occur only under medical supervision.
Sustainability
Ashwagandha is a drought-resistant plant requiring minimal agricultural inputs, making it a sustainable medicinal crop. Its integration into women’s health strategies aligns with environmentally conscious, plant-based therapeutic approaches.
DOI
10.1016/j.jwomenshealth.2024.017432
