If you have polycystic ovary syndrome (PCOS), you may have seen somewhere that ashwagandha is a good supplement for someone with a hormonal imbalance. This article will outline the potential benefits of ashwagandha for PCOS, what the research shows, and who should avoid ashwagandha.

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What Is Polycystic Ovarian Syndrome (PCOS)?

PCOS is a common hormonal disorder that affects approximately 1 in 10 women of reproductive age in the United States. While the exact cause of PCOS is unknown, genetics and environmental factors are believed to play a strong role in this health condition. 

Insulin resistance and inflammation are linked to PCOS. One of the hallmark clinical signs of PCOS is high androgen levels, or male sex hormones, such as testosterone or DHEA-S. High androgens can cause a range of symptoms such as:

• Anovulatory cycles, irregular periods
• Fertility issues or infertility
• Hirsutism (unwanted and excessive hair growth)
• Hair loss
• Acne
• Fatigue

It’s important to note that different people often present with different symptoms of PCOS. Keep this in mind when we get into the benefits of ashwagandha for PCOS.

What Is Ashwagandha

Ashwagandha is an ancient herb that has been used for centuries in the traditional ayurvedic treatment of different ailments. It is known by many names, including Withania somnifera, Indian winter cherry, and Indian ginseng.

Ashwagandha, recognized as an adaptogen because of its adaptogenic properties, enhances the body’s stress resilience and improves the immune system (1).

Ashwagandha For PCOS Symptoms

Like many aspects of PCOS, studies are lacking. We will derive the research outlined here from studies focusing on each specific symptom; these studies did not exclusively involve individuals with PCOS.

Remember that PCOS presents differently in different people. You’ll need to consider the individual symptoms you’re looking to improve to determine if it will be beneficial for you. 

As always, consult with your healthcare provider to determine if ashwagandha is a good option for you. 

Stress and Anxiety

Individuals with PCOS commonly report experiencing anxiety and chronic stress. Some women with PCOS also experience elevated cortisol levels, which is a hormone that the adrenal glands produce. Cortisol is commonly referred to as our stress hormone.

Elevated cortisol levels can increase insulin levels, which is another hormone responsible for maintaining normal blood sugar levels. High insulin levels are associated with high androgens, weight gain, and struggling with weight loss. 

Studies have shown a positive effect and significant reduction in stress and anxiety levels in those who use ashwagandha supplements (2, 3). Studies also have also shown that ashwagandha may help decrease serum cortisol levels (4). 

Most studies showing a decrease in cortisol and stress levels utilize a dosage of 250-300mg ashwagandha per day.

Sleep

Many women with PCOS report poor sleep quality. Sleep dysfunction can further worsen the root causes of PCOS, such as insulin resistance and inflammation.  

A recent meta-analysis noted favorable effects of ashwagandha supplementation on sleep quality. Those who noticed the most prominent benefits were those who had been diagnosed with insomnia, utilized a dosage of 600mg/day or more, and also utilized supplementation for over 8 weeks (5). 

Blood Sugar Levels & Insulin Resistance 

Insulin resistance is present in up to 70% of those with PCOS, and more than half of those with PCOS will develop type 2 diabetes before age 40 (6).

Some research has shown that ashwagandha may significantly reduce blood sugar levels, hemoglobin A1c, and insulin levels (7). 

Ashwagandha may be helpful in improving insulin sensitivity in those with PCOS. 

Cholesterol Levels

High cholesterol levels are another common metabolic complication associated with PCOS. Many women experience elevated LDL (bad) cholesterol levels, low HDL (good) cholesterol levels, and elevated triglycerides. 

Research has shown a significant decrease in total and LDL cholesterol levels with ashwagandha supplementation indicating that it may be a useful tool for lowering cholesterol levels (8).

Inflammation

Chronic low grade inflammation is at the core of many PCOS symptoms. C-reactive protein (CRP) blood levels are one metric that can indicate if inflammation is present.  

Multiple studies have demonstrated that ashwagandha possesses the ability to decrease CRP levels and alleviate general inflammation. Ashwagandha has been widely recognized for its anti-inflammatory properties.

Thyroid Function

Your thyroid is a gland that’s responsible for producing just the right amount of hormones for your body to function optimally. When your body produces too much thyroid hormones (hyperthyroidism) or too little thyroid hormones (hypothyroidism), it can cause many symptoms including weight changes, increased tiredness, and fatigue (9). 

Hypothyroidism, particularly Hashitmoto’s thyroiditis (an autoimmune disease that can cause hypothyroidism), occurs at a 3x higher rate in those with PCOS (10). 

One small randomized controlled trial showed that 600mg of ashwagandha helps improve TSH, T3, and T4 in those with subclinical hypothyroidism after an 8 week period (11).

Research on the supplementation of ashwagandha and hyperthyroidism is lacking. However, one could anticipate that ashwagandha might worsen hyperthyroidism symptoms due to its potential to raise T3 and T4 levels. This could potentially lead to a serious condition called thyrotoxicosis. 

A recent case report details how a 73 year old woman was using ashwagandha root extract to self-treat hypothyroidism. After using ashwagandha for 2 years, she developed symptoms of hyperthyroidism and thyrotoxicosis. Ultimately, these symptoms were linked to the ashwagandha usage (12). 

Testosterone Levels

Androgens, like testosterone, are often elevated in those with PCOS. High testosterone can contribute to common PCOS symptoms such as unwanted hair growth, hair loss, acne, and irregular menstrual cycles. 

Studies have shown ashwagandha can increase testosterone levels in men. While the theory hasn’t been tested in women, especially not in women with PCOS, it’s suspected that ashwagandha may increase testosterone levels in women also. 

If your testosterone levels are elevated, it may be best to avoid ashwagandha. 

Recommended Dosage Of Ashwagandha

Most research has shown that doses of 250-600mg daily are effective at improving various symptoms. 

One research study showed that doses up to 1250mg daily were safe and well tolerated (13). 

Like other herbal supplements, there are potential side effects with the use of ashwagandha. The most commonly reported side effects are digestive upset, nausea, vomiting, and diarrhea.

Who Should Avoid Ashwagandha?

While the majority of research does seem favorable for ashwagandha, individuals falling into any of the following categories should avoid it: 

• Pregnant or breastfeeding
• Hyperthyroidism
• Autoimmune disease 
• Those with high testosterone should be cautious about starting ashwagandha 

The NIH cautions that there is some evidence that ashwagandha may interact with some medications, including those for diabetes, high blood pressure, immunosuppressants, sedatives, anti-seizure medications, and thyroid replacement medications (14).

Since most studies examining ashwagandha have been small, short-term studies…we still do not understand any potential long term effects.

Bottom Line

Ashwagandha is an ancient herb that has been used for centuries in ayurvedic medicine to treat a variety of ailments.

Research shows that there are potential health benefits for those with PCOS, such as an improvement in sleep, stress, blood sugar levels, cholesterol levels, and inflammation. It may help improve thyroid levels in those with hypothyroidism.

Ashwagandha may increase testosterone levels, so may not be the best option for those who already struggle with elevated testosterone levels.

Pregnant women, breastfeeding individuals, those with hyperthyroidism, autoimmune diseases, or those taking certain medications should not use it.

Most studies examining ashwagandha have been small, short-term studies. We need more research to understand the long-term effects of this adaptogen.

Disclaimer: This serves solely for educational purposes and should not be interpreted as medical advice. It’s always important to talk to your healthcare provider before starting any supplements. 

If you want to learn everything you need to know about PCOS and how to manage it with nutrition, lifestyle changes, and supplements, check out the Conquer PCOS Course!

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