Ashwagandha and Menopause:

What Adaptogens May Offer During This Life Stage

If you’re navigating perimenopause or menopause, you’ve probably already heard the word adaptogen mentioned somewhere. Ashwagandha in particular keeps coming up in conversations about menopause, and for good reason. A growing body of research has actually looked at this herb specifically in perimenopausal and menopausal women – and that is a reason to celebrate. For centuries, women have been under-researched in medical science. It’s still not UK law for women to be included in clinical trials (I know!).

This isn’t about replacing medical care or HRT. It’s about understanding what the evidence says so you can make an informed choice.

What Is an Adaptogen?

Adaptogens are herbs and mushrooms thought to help the body adapt to stress, largely by influencing the HPA axis – the communication pathway between your brain and adrenal glands. Oestrogen has a natural regulating effect on the HPA axis, so as it declines, many women find their stress response becomes more reactive and harder to switch off. Feeling irritable for no reason? That’s exactly the system adaptogens like ashwagandha are thought to influence.

Perimenopause and menopause symptoms can last 7–9 years according to the NHS, though many women report them lasting considerably longer. Sleep problems are among the most commonly reported, and the link between sleep and hormone changes at this stage is well documented.

What the Research Suggests

A systematic review and meta-analysis found ashwagandha consistently reduces cortisol levels compared to placebo. The broader evidence base is well summarised if you want to dig deeper.

A randomised, double-blind, placebo-controlled trial in 60 women aged 45–55 found Menopause Rating Scale scores dropped from 31.4 to 18.5 (lower is better) in the ashwagandha group vs almost no change in placebo, with meaningful reductions in hot flush frequency and perceived stress. An earlier similarly designed trial using 600mg daily for 8 weeks reported comparable improvements.

Ashwagandha also has a reasonable evidence base for improving total sleep time.

Other Nutrients Associated With This Life Stage

Magnesium supports GABA and melatonin regulation. A systematic review found supplementation may improve sleep quality in older adults. Read about whether we’re all deficient in magnesium here.

For brain fog: a 16-week randomised controlled trial found significant cognitive improvements from lion’s mane vs placebo in adults with mild cognitive impairment. A 4-week trial in women found reductions in depression and anxiety scores.

Building a Supplement Routine

Tonic’s Rest + Recover combines magnesium glycinate with ashwagandha and lemon balm – taken in the evening to signal to your nervous system that it’s safe to wind down.

Tonic’s Focus + Mind pairs lion’s mane with L-tyrosine, B3 and rhodiola rosea for when concentration feels like the main struggle. (Two of my personal favourites.)

Nothing in this piece suggests adaptogens as an alternative to HRT or medical care. HRT remains the most effective treatment for many menopause symptoms. If symptoms are significantly affecting your life, please speak to your GP or a menopause specialist.

This article is for informational purposes only and does not constitute medical advice. Adaptogens are not a substitute for medical treatment.

About the Author

Natalie Louise Burrows is a registered nutritional therapist (BANT, CNHC) and clinic director at Integral Wellness.