Ashwagandha (Withania somnifera) is a revered herb used in traditional Ayurvedic medicine. It is an adaptogen, a botanical recognized for helping the body maintain equilibrium and manage physical and emotional stressors. Adaptogens promote a normalizing effect on bodily processes, bringing an imbalanced system back toward its standard set point without overstimulating it. This ancient root’s relevance is due to its influence on the body’s stress response system, which is connected to overall health.
Ashwagandha’s Role in Stress and Hormonal Balance
The herb’s mechanism of action is centered on its interaction with the Hypothalamic-Pituitary-Adrenal (HPA) axis, often referred to as the body’s central stress-response system. The HPA axis governs the release of cortisol, a glucocorticoid hormone that is elevated during times of physical or psychological stress. Ashwagandha contains active compounds called withanolides that are thought to modulate this axis, helping to regulate and lower chronically elevated cortisol levels.
When the body is under long-term stress, the sustained high levels of cortisol can interfere with the delicate balance of reproductive hormones. This is due to a phenomenon known as “pregnenolone steal,” where the body prioritizes the production of stress hormones over sex hormones like estrogen and progesterone. By supporting the HPA axis and promoting a more balanced cortisol profile, ashwagandha indirectly helps to free up resources for the optimal production and regulation of these reproductive hormones.
Specific Effects on Menstrual Symptoms and Flow
Taking ashwagandha during the menstrual phase is acceptable, especially to manage the psychological and physical symptoms associated with premenstrual syndrome (PMS). The herb’s stress-reducing properties help alleviate common pre-period and period-related emotional symptoms. These benefits include reducing irritability, anxiety, and mood swings often exacerbated by underlying stress.
Ashwagandha’s influence also extends to physical discomfort, helping to soothe menstrual cramps. Studies suggest the herb possesses anti-inflammatory properties, which may work to reduce the intensity of pain caused by uterine contractions. Furthermore, its ability to promote calmness and improve sleep quality can address fatigue, which is a frequent complaint during the menstrual and premenstrual phases.
Regarding cycle timing and flow, ashwagandha is not a primary treatment for heavy bleeding (menorrhagia), and its direct effect on flow volume is not clearly documented. However, its role in balancing reproductive hormones like follicle-stimulating hormone (FSH) and luteinizing hormone (LH) supports overall cycle regularity. By promoting a harmonious hormonal environment, the herb may help regulate cycles that have become irregular due to conditions like Polycystic Ovary Syndrome (PCOS) or chronic stress. Continuing use during the period is often based on seeking relief from stress and mood-related symptoms.
Safety Guidance and When to Avoid Use
While ashwagandha offers benefits for menstrual wellness, its use should be avoided or approached with caution in specific situations. The herb is strongly contraindicated during pregnancy and breastfeeding due to potential abortifacient properties. Individuals with pre-existing thyroid conditions, particularly hyperthyroidism, should not take ashwagandha because it can increase the production of thyroid hormones (T3 and T4).
For those with autoimmune diseases such as lupus, rheumatoid arthritis, or multiple sclerosis, ashwagandha’s immunomodulatory effects could theoretically stimulate the immune system, worsening symptoms. Additionally, caution is necessary if you are taking certain prescription medications. Ashwagandha may interact with sedatives, increasing drowsiness, and it can interfere with medications for diabetes and high blood pressure, sometimes causing an enhanced effect.
The herb can also interfere with thyroid hormone replacement therapies, necessitating careful monitoring of thyroid levels. Since ashwagandha may have mild estrogen-like effects, it is advised to avoid its use in hormone-sensitive conditions like certain cancers or endometriosis. Consult a healthcare provider before starting or continuing ashwagandha, especially if you have a chronic medical condition or are taking prescription medication.