Can Women Take Tongkat Ali? Benefits & Side Effects

Women can take Tongkat Ali, and a growing body of research has tested it specifically in female participants. Most of the herb’s reputation centers on male testosterone and libido, so the question is understandable, but several clinical trials have enrolled women and measured outcomes that matter to them: menopausal quality of life, stress hormones, mood, body composition, and sexual function. The picture that emerges is more nuanced than a simple “yes, it works” or “no, skip it,” with some outcomes showing real promise and others falling flat.

What Tongkat Ali Actually Is

Tongkat Ali is the common name for Eurycoma longifolia, a flowering plant native to Southeast Asia whose root has been used in traditional medicine for centuries. Folk preparations, typically aqueous extracts or decoctions of the root, were historically used to support sexuality, fertility, and vitality.¹ The root contains a rich mix of bioactive compounds, with quassinoids making up the largest share. Other constituents include alkaloids, triterpenes, squalene derivatives, and bioactive steroids.² Most modern supplements use a standardized hot-water extract of the root, which is the form tested in the majority of human trials.

How It Affects Female Hormones

The concern women most often raise is whether Tongkat Ali will flood their system with testosterone. The mechanism in cell studies suggests the plant’s main quassinoid, eurycomanone, works partly by inhibiting aromatase, the enzyme that converts testosterone into estrogen.³ That sounds alarming if you picture runaway testosterone, but the actual hormonal shifts seen in studies involving women have been modest and, in at least one context, beneficial.

In an animal model designed to mimic menopause, ovariectomized rats given a standardized Tongkat Ali extract at 500 mg/kg showed increases in progesterone, estrogen, and testosterone levels compared to untreated controls.⁴ The fact that estrogen went up alongside testosterone is worth noting: it suggests the extract does not simply strip estrogen away. The hormonal picture in a living organism appears more balanced than the isolated-cell aromatase data might lead you to expect.

In a human trial of moderately stressed adults that included 31 women alongside 32 men, four weeks of Tongkat Ali supplementation reduced cortisol by about 16% and raised testosterone status by about 37% across the combined group.⁵ The study did not break out testosterone changes by sex in its published results, so we cannot say exactly how much of that increase was driven by the female participants versus the male ones. Still, the women were not excluded from the favorable stress-hormone profile the researchers reported, and no adverse androgenic effects were noted.

Menopausal Quality of Life and Sexual Function

Some of the most relevant evidence for women comes from research on perimenopause and menopause. A randomized, double-blind, placebo-controlled trial gave perimenopausal and postmenopausal women 100 mg per day of a standardized Tongkat Ali water extract for 12 weeks. The treatment group saw a roughly 34% reduction in total menopause-related quality-of-life scores, with the most striking improvements in the physical domain (about a 36% improvement) and the sexual domain (also about a 36% improvement). That sexual-domain improvement was also significant when compared directly to the placebo group.⁶

A separate randomized, placebo-controlled study protocol was designed to evaluate the same standardized extract (Physta) across a broader range of menopausal outcomes including mood, fatigue, sleep quality, sexual function measured by the Female Sexual Function Index, and pain scores.⁷ The fact that researchers are investing in rigorous trial designs specifically for women signals that the preliminary findings were interesting enough to justify larger, more comprehensive studies.

Another trial enrolled perimenopausal and menopausal women and measured secondary endpoints like serum hormone levels, lipid profiles, bone markers, sleep quality, and vitality alongside primary quality-of-life measures.⁸ The breadth of what these studies are measuring reflects growing scientific interest in Tongkat Ali as something more than just a “men’s supplement.”

Stress, Cortisol, and Mood

The stress-hormone study mentioned earlier deserves a closer look because it is one of the few trials where both sexes were given identical treatment. The 63 participants, almost evenly split between men and women, were screened for moderate stress before being randomized to either Tongkat Ali or placebo. After four weeks, the supplemented group showed improved cortisol-to-testosterone ratios, alongside better self-reported mood states including lower tension, anger, and confusion.⁵

For women dealing with chronic low-grade stress, the cortisol-lowering effect is arguably more practically useful than any testosterone increase. Chronically elevated cortisol is linked to disrupted sleep, weight gain around the midsection, and mood instability. Whether the mood improvements observed in this trial were driven by cortisol reduction, testosterone changes, or some combination is not entirely clear, but the direction of the results was consistent: people felt better, and the women in the group were part of that improvement.

Body Composition and Physical Performance

If you are a woman interested in Tongkat Ali for gym performance or body recomposition, the evidence is less encouraging. A study of exercise-trained males and females given Tongkat Ali supplementation for four weeks found no differences between the supplement group and the placebo group for lean body mass, fat mass, body fat percentage, handgrip strength, mood, sleep, vigilant attention, or salivary free testosterone and cortisol.⁹ In short, four weeks of supplementation did nothing measurable for body composition or strength in people who were already training.

That said, a pilot study of physically active older adults reported more dramatic numbers for women over a five-week supplementation period: total testosterone rose by about 49%, free testosterone by about 122%, and muscular hand-grip force by roughly 14%. These are eye-catching figures, but pilot studies are small and exploratory by nature. Pilot findings are designed to justify further research, not to serve as reliable benchmarks. Until a larger, properly powered trial replicates these numbers, they should be treated as preliminary rather than promotional.

The disconnect between the four-week body-composition trial showing nothing and the pilot study showing impressive gains in older women probably comes down to differences in study population, duration, dosing, and especially study size. For now, anyone expecting dramatic body changes from Tongkat Ali alone will probably be disappointed.

What About PCOS and High-Androgen Conditions?

Women with polycystic ovary syndrome or other conditions involving elevated androgens might understandably worry that a supplement with any testosterone-raising potential is a bad idea. One animal study explored this question from an interesting angle: researchers induced a PCOS-like state in female rats using exogenous testosterone, then treated them with a Tongkat Ali fraction. The treated animals showed fewer irregular estrous cycles and less damage to ovarian follicle structures. The researchers attributed the reversal effect to anti-estrogenic properties of the plant’s quassinoids.¹⁰

This is a single animal study and should not be taken as evidence that Tongkat Ali treats PCOS. But it is an interesting wrinkle: the extract did not worsen the high-androgen condition and in fact appeared to normalize some of the disruption. The mechanism may involve the plant’s ability to modulate the overall hormonal milieu rather than simply pushing testosterone in one direction. If you have PCOS or another androgen-sensitive condition, this is not a green light to self-treat with Tongkat Ali, but it does suggest the picture is more complex than “raises testosterone, therefore bad for women with high androgens.”

Safety Profile in Women

The limited clinical trial data available have not flagged serious adverse effects in female participants. In the menopausal quality-of-life trial, women took 100 mg daily for 12 weeks without notable safety concerns.⁶ The stress-hormone trial included women for four weeks with no reported adverse androgenic effects.⁵

A preclinical toxicology study on a combined herbal formulation containing Tongkat Ali and Labisia pumila (another Southeast Asian plant sometimes marketed alongside it) found no significant toxicity at standard dose levels across a range of measures including blood counts, serum chemistry, and organ function. However, at a very high dose of 2,000 mg/kg body weight, microscopic tissue changes appeared in some organs, suggesting an early stress response. The researchers estimated the safe threshold to be above 500 mg/kg but below 2,000 mg/kg body weight.¹¹ For context, human supplement doses are typically in the range of 100 to 400 mg of standardized extract per day, far below these thresholds even after adjusting for body weight differences between species.

There are no published data on Tongkat Ali during pregnancy or breastfeeding, so it should be avoided in those situations. Women on hormone therapy, hormonal contraceptives, or medications for hormone-sensitive cancers should consult a healthcare provider before adding any supplement that influences sex hormones.

Product Quality Is a Real Concern

One risk that applies equally to men and women is the problem of contaminated or adulterated products. An analysis of 100 Tongkat Ali herbal preparations sold in Malaysia found that 26% contained mercury levels between 0.53 and 2.35 parts per million, exceeding the country’s quality limit of 0.5 ppm for traditional medicines.¹² A similar survey found that 17% of products contained lead at levels between roughly 10 and 20 ppm, also above the regulatory threshold.¹³

These studies tested products labeled as “Tongkat Ali hitam” (a related species sometimes sold under the same brand umbrella), but the broader point holds for any botanical supplement sourced from unregulated or poorly regulated supply chains. Heavy metal contamination is not something you can taste or smell, and chronic exposure to mercury or lead carries serious long-term health risks. If you decide to try Tongkat Ali, look for products that use a standardized, tested extract (Physta is the most-studied branded extract in women’s trials), and choose brands that provide third-party certificates of analysis showing heavy metal testing.

Dosing for Women

Clinical trials in women have used doses in the range of 100 to 400 mg of standardized water extract per day. The menopausal quality-of-life study that showed significant improvements used 100 mg daily, which is on the lower end of what most supplement brands sell per capsule. The stress-hormone trial used 200 mg daily. There is no established evidence that higher doses produce proportionally better results in women, and the preclinical toxicology data suggest that very high doses carry at least theoretical risk.

Starting at 100 mg daily and staying in the 100 to 200 mg range appears to be the best-supported approach for women based on current evidence. Taking it with food can reduce the mild nausea or stomach discomfort that some people report, though gastrointestinal complaints have not been a prominent finding in the controlled trials.

Where the Evidence Is Still Thin

The honest assessment is that the body of clinical evidence specifically in women is small. Most Tongkat Ali research has been conducted in men, and even those studies tend to be short-duration with modest sample sizes. The menopausal trials are promising, but the total number of women studied in randomized, placebo-controlled settings is probably in the low hundreds across all published work.

Areas where women-specific data are particularly sparse include long-term safety beyond 12 weeks, effects on fertility and menstrual regularity in premenopausal women, interactions with hormonal contraceptives, and outcomes in women with hormone-sensitive cancers. The PCOS-related findings are from a single animal study. The bone-health data come from an animal model where orchidectomized (castrated) rats were supplemented with Tongkat Ali and showed preserved bone calcium.¹⁴ Whether this translates to women experiencing postmenopausal bone loss is an open question that has not been tested in a human trial.

The ovariectomized-rat study did examine bone biochemical markers in a female animal model and found that the extract influenced reproductive hormone levels in a direction that could theoretically support bone health.⁴ But there is a long road between “influenced markers in a rat” and “prevents fractures in a 60-year-old woman.” Anyone taking Tongkat Ali for bone health is making a speculative bet, not following established evidence.

Interactions With Medications and Other Supplements

Because Tongkat Ali influences cortisol and sex hormones, it could theoretically interact with several categories of medication. The aromatase-inhibiting activity observed in cell studies raises a flag for women taking aromatase inhibitors for breast cancer: would the supplement enhance the drug’s effect unpredictably, or would it compete for the same biochemical pathway? No clinical data address this, which is reason enough to avoid combining them without medical supervision.

Similarly, women on hormone replacement therapy might find that adding a supplement with hormonal effects muddies the picture. If your provider is titrating your estrogen or progesterone dose based on lab work and symptom tracking, introducing an uncontrolled variable like a botanical extract makes that process harder. Blood pressure medications, blood thinners, and diabetes drugs have not been studied for interactions with Tongkat Ali, and the absence of evidence is not the same as evidence of safety.

Some supplement companies combine Tongkat Ali with other adaptogens like ashwagandha or maca, or with vitamins like D3 and zinc. There is no published research evaluating these combinations in women, so any claimed synergy is marketing, not science.