Ashwagandha Benefits for Women: Studies, Withanolides, Safety

Ashwagandha has been linked to rare but sometimes serious liver injury. Stop taking it and call your doctor if you notice yellowing skin or eyes, dark urine, itching or unusual tiredness.

What is ashwagandha?

Ashwagandha is an evergreen shrub that grows in India, parts of Africa and the Middle East (NCCIH). It is sometimes called winter cherry or Indian ginseng, although it is not related to true ginseng. Its Sanskrit name refers to the distinctive smell of the root (NIH Office of Dietary Supplements, ODS).

In Ayurveda, India's traditional medical system, people have taken the root as a rejuvenating tonic for thousands of years. Today it is usually described as an adaptogen, a loose term for something said to help the body cope with stress. Most supplements use root extract. Some combine root and leaf, and the two parts have different chemical makeups (ODS). For background on the wider tradition, see our guide to Ayurveda.

Ashwagandha benefits for women: what studies show

Most ashwagandha research includes both men and women, and results are not usually split by sex. A few trials focus on women. Here is what the evidence says, roughly from strongest to weakest.

Stress and cortisol. This is the best-studied use. A 2021 systematic review pooled seven trials with 491 adults in India who took ashwagandha extract or a placebo for six to eight weeks. Stress and anxiety scores, sleeplessness, fatigue and blood cortisol (a stress hormone) all fell more with ashwagandha, and the effect looked larger at 500 to 600 mg a day (Lopresti and Smith, summarized by ODS). In one of the earlier trials, 64 stressed adults who took 300 mg of root extract twice a day for 60 days had lower stress scores and lower cortisol than the placebo group (Chandrasekhar et al., Indian Journal of Psychological Medicine, 2012). Not every trial agrees: a 12-week study in 120 adults with overweight found less fatigue but no drop in perceived stress (Smith et al., 2023, via ODS).

Sleep. A 2021 meta-analysis of five studies (372 adults) found a small but real improvement in sleep. Benefits were larger in people with insomnia, at 600 mg a day, and when people took it for at least eight weeks (Cheah et al., via ODS). NCCIH agrees that some ashwagandha preparations may help with insomnia and stress, while the evidence for anxiety is less clear. If sleep is your main goal, our sleep aids guide covers other options too.

Sexual function in women. In a pilot trial, 50 healthy women took 300 mg of a concentrated root extract or a placebo twice daily for eight weeks. The ashwagandha group reported better scores for arousal, lubrication, orgasm and satisfaction, less sexual distress, and more successful sexual encounters (Dongre et al., BioMed Research International, 2015). It was small and short, and it has not been widely repeated.

Perimenopause. In an eight-week trial, 100 perimenopausal women with menopause-type symptoms took 300 mg of root extract twice daily or a placebo, and 91 finished. The ashwagandha group had larger drops in menopause symptom scores, including mood, physical and urogenital symptoms, and better quality-of-life scores. Estradiol rose while FSH and LH fell, and testosterone did not change (Gopal et al., Journal of Obstetrics and Gynaecology Research, 2021). This is promising, but it is one trial, and NCCIH still lists menopause and female fertility among the uses without enough evidence.

Thyroid. In a small trial of 50 adults with subclinical hypothyroidism (a mildly raised TSH without obvious symptoms), 600 mg a day of root extract for eight weeks lowered TSH and raised the thyroid hormones T3 and T4 compared with placebo (Sharma et al., Journal of Alternative and Complementary Medicine, 2018). That same thyroid-stimulating effect is a safety concern: ODS describes three women who developed an overactive thyroid while taking ashwagandha, which resolved after they stopped. Anyone with a thyroid condition, or taking thyroid medication, should use ashwagandha only with their doctor's involvement.

What are withanolides, and why do labels show a percentage?

Withanolides are a family of naturally occurring steroid-like compounds (steroidal lactones) found in ashwagandha. They are thought to drive many of the herb's effects, although lab research suggests other compounds contribute too (ODS). Because withanolide content differs a great deal from one product to the next, manufacturers often standardize their extracts to a set withanolide content and print it on the label.

The range is wide. Extracts used in published trials include products at about 0.7%, 1.5%, 2.5% and 5% withanolides, plus a root-and-leaf extract at around 35% withanolide glycosides (ODS). KSM-66, a branded root extract used in several published trials, is standardized to more than 5%. An expert taskforce that gave ashwagandha a provisional recommendation for generalized anxiety specified 300 to 600 mg a day of an extract standardized to 5% (ODS).

Two practical points follow. First, a higher percentage is not automatically better: the studies that worked used specific extracts at specific doses, and results from one product do not transfer neatly to another. Second, root and leaf extracts are not the same thing, so check which part of the plant a product uses. Most of the research above used root extract.

Forms of ashwagandha and typical doses

Trials of stress and sleep generally ran six to twelve weeks. NCCIH notes that ashwagandha may be safe for up to about three months, and longer-term safety has not been studied well.

Ashwagandha safety: who should avoid it

• Pregnancy. NCCIH says to avoid ashwagandha during pregnancy. Some experts cite old reports that it might cause miscarriage; the American Herbal Pharmacopoeia has since said its own monograph was misquoted on this point (ODS). Either way, there is no safety data to support use in pregnancy.
• Breastfeeding. NCCIH advises against it, and France's food safety agency (ANSES) recommended against use while breastfeeding in 2024 (ODS).
• Liver. LiverTox rates ashwagandha a likely cause of liver injury. Problems usually appear 2 to 12 weeks after starting, often with jaundice and itching, and most people recover within one to four months of stopping. Severe cases, including liver failure, have mostly involved people with existing liver disease, who should avoid it.
• Thyroid and autoimmune conditions. NCCIH recommends against use for people with thyroid or autoimmune disorders.
• Medications. Ashwagandha may interact with sedatives, anti-seizure drugs, thyroid hormone, diabetes and blood pressure medicines, and drugs that suppress the immune system (NCCIH).
• Surgery. Stop ahead of any planned surgery and tell your surgical team (NCCIH).
• Common side effects. Drowsiness, upset stomach, loose stools and nausea are the most often reported.

Is ashwagandha banned anywhere? Yes. Denmark banned ashwagandha in 2023 after a 2020 risk assessment by the Technical University of Denmark raised concerns about pregnancy, thyroid and sex hormone effects. France has advised against it for pregnant and breastfeeding women and people with hormone-related conditions (ODS). In the United States, it is sold as a dietary supplement.

Find it at William's

We carry several forms, so you can match the product to how you want to take it:

• Planetary Herbals ashwagandha, 300 mg, 120 veg capsules: KSM-66 root extract, the branded extract used in several published stress and sleep trials.
• Nature's Way ashwagandha premium extract, 60 vegan capsules: a standardized extract. The label directs one capsule two to three times daily with food, and says not to use it if pregnant.
• Solaray ashwagandha 470 mg, 60 veg capsules: a root extract in a vegan capsule.
• Gaia Herbs ashwagandha gummies, 45 count: organic, fruit-sweetened gummies for people who would rather not swallow capsules.

Shatavari is another Ayurvedic herb many women ask about; see our shatavari guide. And please talk with your doctor before starting ashwagandha if any of the safety points above apply to you.

Frequently Asked Questions