Ashwagandha (Withania somnifera) is an herb gaining attention for its potential wellness benefits, particularly during times of stress and fatigue. For women navigating perimenopause, understanding its potential effects, including any side effects, is a common and sensible consideration.
While generally considered well-tolerated by many, like any supplement, ashwagandha can have interactions or cause reactions in some individuals. This article explores the reported ashwagandha side effects based on available research, providing practical information for perimenopausal women.
Commonly Reported Ashwagandha Side Effects
Research on ashwagandha’s safety has indicated that it is often well-tolerated. For instance, studies examining ashwagandha root extracts have reported it to be safe in healthy volunteers [1] and in adults experiencing high stress and fatigue [2]. However, some individuals may experience mild side effects.
Digestive upset, such as stomach discomfort, diarrhea, or nausea, has been occasionally reported. These effects are typically mild and often resolve with continued use or by adjusting the dosage. One review highlighted that while ashwagandha is generally safe, gastrointestinal issues are among the less common adverse effects noted in some studies [3].
Some individuals might also experience drowsiness or sedation, particularly at higher doses. This is important to note, especially for those who need to remain alert or are operating machinery. It’s always advisable to start with a lower dose to assess individual tolerance.
Less Common But More Significant Considerations
While rare, some more significant side effects have been discussed in the scientific literature. Liver enzyme elevation, for example, has been reported in isolated cases, though a direct causal link to ashwagandha is not always definitively established across all studies. A critical review of preclinical and clinical evidence on potential adverse effects of ashwagandha is an area of ongoing research [4].
Thyroid function can also be a consideration. Ashwagandha has been observed to influence thyroid hormones in some studies, leading to concerns about potential hyperthyroidism in susceptible individuals. Women with existing thyroid conditions, common during perimenopause, should exercise particular caution and discuss ashwagandha use with a healthcare provider.
Allergic reactions, though uncommon, are possible with any herbal supplement. Symptoms might include skin rash, itching, or swelling. If such reactions occur, discontinuing use and seeking medical attention is recommended.
Ashwagandha and Hormonal Fluctuations in Perimenopause
Perimenopause is characterized by significant hormonal shifts, which can make women more sensitive to the effects of certain supplements. While ashwagandha is sometimes explored for its potential to support mood and stress response [5][2][6], its direct interaction with perimenopausal hormonal changes is not fully understood.
Some research has explored ashwagandha’s influence on sexual function in women, with a pilot study suggesting potential improvements [7]. However, this does not directly address its interaction with the complex hormonal landscape of perimenopause or its potential to exacerbate or alleviate specific menopausal symptoms.
Given the hormonal volatility during perimenopause, women considering ashwagandha should monitor their symptoms carefully and be aware that any new or worsening symptoms could potentially be related to the supplement, even if indirectly.
Dosage and Formulation: Impact on Side Effects
The likelihood and severity of ashwagandha side effects can be influenced by the dosage and the specific formulation of the extract. Higher doses are generally more likely to lead to adverse reactions. Many clinical studies utilize standardized extracts, such as those containing specific percentages of active compounds like withanolides, at varying doses.
For example, studies have investigated doses ranging from 250 mg to 600 mg of root extract daily, often showing good tolerability [2][1]. However, some individuals may be more sensitive even to lower doses. It’s important to adhere to the manufacturer’s recommended dosage or the guidance of a healthcare professional.
The quality and purity of ashwagandha products can also vary. Choosing reputable brands that provide third-party testing and clear labeling of ingredients and concentrations may help minimize the risk of unexpected side effects due to contaminants or inconsistent potency.
When to Exercise Caution or Avoid Ashwagandha
Certain groups of women, particularly those in perimenopause, should approach ashwagandha with extra caution or avoid it altogether. As mentioned, individuals with existing thyroid conditions should be particularly careful due to the herb’s potential influence on thyroid hormones. Those on thyroid medication should consult their doctor before considering ashwagandha.
Women who are pregnant or breastfeeding are generally advised to avoid ashwagandha. While some studies have explored its safety in pregnant women, the evidence base is still developing, and caution is warranted [8].
Individuals with autoimmune conditions, such as lupus, rheumatoid arthritis, or Hashimoto’s thyroiditis, should also consult a healthcare provider before using ashwagandha, as it is considered an adaptogen and may stimulate the immune system, potentially exacerbating symptoms in some cases. Furthermore, those on immunosuppressants should avoid ashwagandha due to potential interactions.
References
- Safety of Ashwagandha Root Extract: A Randomized, Placebo-Controlled, study in Healthy Volunteers. Complementary therapies in medicine, 2021
- Exploring the efficacy and safety of a novel standardized ashwagandha (Withania somnifera) root extract (Witholytin®) in adults experiencing high stress and fatigue in a randomized, double-blind, placebo-controlled trial. Journal of psychopharmacology (Oxford, England), 2023
- Pharmacological evaluation of Ashwagandha highlighting its healthcare claims, safety, and toxicity aspects. Journal of dietary supplements, 2021
- Potential Adverse Effects of Ashwagandha: A Critical Review of Preclinical and Clinical Evidence. Phytotherapy research : PTR, 2026
- Efficacy of Withania somnifera supplementation on adult’s cognition and mood. Journal of Ayurveda and integrative medicine, 2022
- A proprietary herbal extract of ashwagandha root for stress and anxiety in healthy adults: a randomized, double-blind, three-arm, placebo-controlled efficacy and safety study. Journal of medicine and life, 2026
- Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study. BioMed research international, 2015
- Efficacy and safety of Ashwagandha (Withania somnifera) root extract in pregnant women: a prospective, randomized, comparative, open-label, 12-week study. Frontiers in global women’s health, 2026
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease. Content is for informational purposes only and is not medical advice; consult a qualified healthcare provider before starting any supplement. As an Amazon Associate we earn from qualifying purchases.
