Ashwagandha, known botanically as Withania somnifera, is a small evergreen shrub whose roots have been used in traditional Ayurvedic medicine for thousands of years. It belongs to a class of substances called adaptogens, which help the body resist various stressors. Ashwagandha has gained popularity in Western wellness circles for its potential to reduce stress and improve overall well-being. For couples trying to conceive (TCC), the herb’s influence on stress and reproductive hormones raises questions about its safety and efficacy. This article explores the science behind ashwagandha’s effects on fertility markers and provides guidance on its safe use before a confirmed pregnancy.
Ashwagandha’s Role in Stress and Hormonal Balance
The primary mechanism by which ashwagandha may support reproductive health is through its adaptogenic effect on the body’s stress response system, known as the Hypothalamic-Pituitary-Adrenal (HPA) axis. Chronic stress causes the HPA axis to release high levels of cortisol, often referred to as the stress hormone. Studies show that ashwagandha supplementation can significantly reduce serum cortisol levels in adults experiencing chronic stress.
This stress reduction is relevant to fertility because the HPA axis is intricately connected to the Hypothalamic-Pituitary-Gonadal (HPG) axis, which governs reproductive hormones. Elevated cortisol can disrupt the signaling within the HPG axis, indirectly suppressing the production of reproductive hormones, which may impede conception. By reducing stress and moderating the HPA axis, ashwagandha provides an environment more conducive to the balanced function of the reproductive system.
Specific Effects on Male and Female Fertility Markers
Ashwagandha appears to have distinct, measurable effects on reproductive markers, with more consistent evidence in males. For male fertility, the herb has been associated with improved semen quality parameters. Clinical trials suggest that taking ashwagandha for two to four months can lead to increases in testosterone levels and improvements in sperm count, motility, and volume. These improvements are partly attributed to the herb’s antioxidant properties, which help protect sperm cells from damage caused by oxidative stress.
In the context of female reproductive health, the evidence is less extensive but still promising, particularly where stress or mild hormonal imbalance is a factor. Ashwagandha may support the balance of sex hormones by influencing the HPG axis and increasing levels of dehydroepiandrosterone-sulfate (DHEA-S), a precursor to sex hormones. Research also suggests it can enhance sexual function in women. However, more high-quality human studies are necessary to definitively determine its direct impact on female ovulation or regulating menstrual cycles.
Safety Profile While Actively Trying to Conceive
When actively trying to conceive, ashwagandha is generally considered safe for short-term use, typically up to three months, in healthy non-pregnant adults. Any potential side effects are usually mild and may include digestive complaints such as drowsiness, stomach upset, vomiting, or diarrhea. The supplement industry is not rigorously regulated, meaning consumers must prioritize products that are third-party tested and standardized to ensure quality and potency.
The most significant safety concern during the TCC phase is the lack of robust, long-term human safety data. While animal studies have not shown adverse effects at recommended doses, this data cannot be fully extrapolated to humans. Therefore, individuals must be prepared to discontinue use immediately if they suspect or confirm a pregnancy.
Definitive Contraindications and Medical Oversight
The absolute contraindication for ashwagandha use is a confirmed pregnancy or active breastfeeding. Despite conflicting reports regarding its potential to act as an abortifacient, the prevailing medical advice is to avoid the herb entirely during these phases due to insufficient safety data to protect the fetus or infant. The herb must be stopped the moment a positive pregnancy test result is obtained.
Ashwagandha may interact with certain medications, including those for diabetes, high blood pressure, and thyroid disorders, and can also affect the immune system. It is crucial to consult a healthcare provider, such as an OB-GYN or a reproductive endocrinologist, before beginning any new supplement. Medical professionals can assess potential interactions with current medications and determine if the potential benefits outweigh the lack of long-term safety data.