Ashwagandha Side Effects for Females: What Women Need to Know

Key Takeaways

• Ashwagandha is generally unsafe during pregnancy and may cause miscarriages or uterine contractions
• Breastfeeding women should avoid ashwagandha due to insufficient safety data for infants
• Women with thyroid disorders, autoimmune conditions, or hormonal imbalances should consult doctors before use
• Common side effects include drowsiness, stomach upset, and potential liver problems in rare cases
• Ashwagandha may interact with birth control, hormone therapy, and other medications commonly used by women

As herbal supplements gain popularity for mood and anxiety treatments, ashwagandha has emerged as one of the most sought-after dietary supplements, particularly among women seeking natural solutions for stress management and overall physical and mental health. This ancient herb from ayurvedic medicine, also known as indian ginseng or withania somnifera, has been traditionally used in the traditional medical system for centuries. However, while clinical trials show promising health benefits, understanding ashwagandha side effects for females is crucial for making informed decisions about taking ashwagandha.

Recent regulatory actions in Denmark and France have highlighted serious safety concerns, particularly for pregnant women and those with certain health conditions. Multiple randomized double blind placebo controlled studies and case reports have revealed specific risks that disproportionately affect women, making it essential to understand both the potential benefits and significant safety considerations before deciding to take ashwagandha.

Pregnancy and Ashwagandha: Critical Safety Concerns

The most serious ashwagandha side effects for females occur during pregnancy. Ashwagandha root extract has demonstrated uterotonic effects, meaning it can stimulate uterine contractions and potentially cause miscarriage. Animal studies and limited human data suggest that the ashwagandha supplement may trigger spontaneous abortion, especially at higher doses commonly found in standardized ashwagandha root extract products.

Healthcare providers strongly recommend that pregnant women avoid ashwagandha entirely. The mechanism behind this risk involves the herb’s ability to stimulate the uterus, potentially leading to premature contractions. Case reports and regulatory reviews from multiple countries, including Denmark’s recent ban on ashwagandha supplements, specifically cite pregnancy risks as a primary concern.

Women planning to conceive should discontinue ashwagandha use at least one month before attempting pregnancy. The herb’s effects on stress hormones and hormone levels can persist in the system, making this precautionary timeline important for safety.

For pregnant women seeking stress management alternatives, healthcare providers typically recommend evidence-based approaches such as prenatal yoga, meditation, regular exercise appropriate for pregnancy, and counseling. These methods can help manage stress without the risks associated with herbal supplement ashwagandha use during this critical period.

Breastfeeding and Ashwagandha Safety

Breastfeeding women face another category of ashwagandha side effects for females due to insufficient safety data regarding infant exposure through breast milk. The National Institute of Diabetes and Digestive and Kidney Diseases and other health authorities lack comprehensive research on how ashwagandha root compounds transfer through breast milk and their potential effects on nursing infants.

Given that ashwagandha can influence thyroid hormone levels, stress hormone production, and immune system function, the potential for these effects to impact a developing infant through breastfeeding creates significant safety concerns. Healthcare providers generally recommend avoiding ashwagandha during the entire breastfeeding period.

For postpartum stress management, safer alternatives include establishing regular sleep schedules when possible, engaging in light physical activity as cleared by healthcare providers, practicing mindfulness techniques, and seeking support from mental health professionals if needed. These approaches can help new mothers manage stress and anxiety treatments without exposing nursing infants to unknown risks.

Most experts suggest waiting until after completely weaning from breastfeeding before considering ashwagandha supplementation. This conservative approach protects both maternal and infant health while allowing women to eventually explore ashwagandha’s stress-reducing benefits when it’s safer to do so.

Hormonal Effects on Women

Ashwagandha’s impact on hormonal systems creates specific concerns for women’s health. The herb can increase thyroid hormone levels, which while potentially beneficial for those with underactive thyroid conditions, poses risks for women with normal or overactive thyroid function. Multiple case reports document women developing thyrotoxicosis—a condition of too much thyroid hormone—after taking ashwagandha supplements.

One documented case involved a 32-year-old woman who developed thyrotoxicosis after escalating her ashwagandha intake to address fatigue. Her symptoms included rapid heart rate, anxiety, and excessive sweating, all of which resolved after discontinuing the ashwagandha supplement. Other cases include women aged 32-73 presenting similar hyperthyroid symptoms that resolved upon stopping ashwagandha use.

The herb also influences cortisol and other stress hormones, which can indirectly affect estrogen and progesterone balance. Women with polycystic ovary syndrome (PCOS), endometriosis, or other hormonal disorders should exercise particular caution, as ashwagandha’s hormonal effects may exacerbate existing imbalances.

Research indicates that ashwagandha may slightly increase testosterone levels in some individuals. While this effect is generally mild, women with hormone sensitive conditions or those concerned about hormonal balance should consult healthcare providers before use.

Menstrual Cycle Impacts

Ashwagandha’s influence on stress hormones and the hypothalamic-pituitary-adrenal axis can potentially affect menstrual cycle regularity. Some women report changes in cycle length or intensity after beginning ashwagandha supplementation, though systematic research on these effects remains limited.

The herb’s impact on cortisol levels may influence other reproductive hormones, potentially affecting ovulation timing and menstrual flow. Women tracking their cycles for fertility or health monitoring should be aware of these potential changes and discuss them with healthcare providers.

During different phases of the menstrual cycle, hormonal sensitivity may vary, potentially influencing how women respond to ashwagandha. The luteal phase, when progesterone levels are naturally higher, might be a period of increased sensitivity to the herb’s hormonal effects.

Common Side Effects Affecting Women

The most frequently reported ashwagandha side effects for females mirror those seen in general populations but may present differently due to physiological differences. Gastrointestinal issues, including stomach upset, nausea, and diarrhea, are particularly common when taking ashwagandha on an empty stomach or at higher doses.

Drowsiness represents another significant concern, especially for women balancing work, family, and other responsibilities. Unlike pharmaceutical sedative medications, ashwagandha’s sedating effects can be unpredictable, potentially interfering with daily activities and responsibilities.

Headaches occur in approximately 5-15% of users according to placebo controlled study data. Women may be more susceptible to these headaches, particularly if they’re already prone to hormonal headaches related to menstrual cycles or other hormonal fluctuations.

Skin reactions, while rare, can include rash and itching. Women with known nightshade sensitivities should be particularly cautious, as ashwagandha belongs to the nightshade family. These reactions typically resolve after discontinuing the supplement but may require medical attention if severe.

Serious Side Effects and Risk Factors

Among the most concerning ashwagandha side effects for females are rare but serious liver problems. Multiple cases of ashwagandha induced liver injury have been documented, with symptoms including jaundice, fatigue, and elevated liver enzymes. These cases involved both men and women aged 21-62, with daily dosing between 450-1,350mg sustained over periods ranging from one week to four months.

Women with pre existing liver disease face elevated risks and should avoid ashwagandha entirely. Even healthy women should monitor for signs of liver injury, including yellowing of skin or eyes, dark urine, light-colored stools, and unusual fatigue.

Autoimmune condition exacerbation represents another serious risk. Women with lupus, rheumatoid arthritis, multiple sclerosis, or other autoimmune diseases may experience worsening symptoms due to ashwagandha’s immune system modulating effects. The herb’s ability to stimulate immune function can potentially trigger autoimmune flares.

Blood pressure and blood sugar changes, while typically mild, can be problematic for women managing hypertension or diabetes. Ashwagandha may lower blood pressure and lower blood sugar levels, potentially causing hypotensive or hypoglycemic episodes in susceptible individuals.

Drug Interactions Important for Women

Ashwagandha’s drug interactions pose particular concerns for medications commonly used by women. Birth control pills and hormone replacement therapy may have altered effectiveness when combined with ashwagandha, though research on these specific interactions remains limited. Women relying on hormonal contraception should discuss potential interactions with healthcare providers.

Thyroid hormone medications present significant interaction risks. Since ashwagandha can increase thyroid hormone levels naturally, combining it with thyroid medications like levothyroxine may result in excessive thyroid hormone levels, causing hyperthyroid symptoms.

Antidepressants and medications for generalized anxiety disorder may have enhanced sedating effects when combined with ashwagandha. This interaction is particularly relevant for women, who are more likely to be prescribed these medications for mental health conditions.

Blood pressure medications and diabetes medications may have enhanced effects when combined with ashwagandha’s natural ability to lower blood pressure and blood sugar. Women taking these medications require careful monitoring and healthcare provider supervision.

Sedative medications, including sleep aids and anti-anxiety prescriptions, may cause excessive sedation when combined with ashwagandha’s natural calming effects. This interaction can be particularly dangerous and may require dose adjustments or discontinuation of one or both substances.

Who Should Avoid Ashwagandha

Certain groups of women should completely avoid ashwagandha due to safety concerns. Pregnant women and those actively trying to conceive face the highest risks due to the herb’s potential to cause uterine contractions and miscarriage.

Breastfeeding women should avoid ashwagandha until after weaning, given the lack of safety data for nursing infants. Women with autoimmune diseases, including lupus, rheumatoid arthritis, and multiple sclerosis, should avoid the herb due to immune system stimulation risks.

Those with thyroid disorders, particularly hyperthyroidism or those taking thyroid hormone medications, should avoid ashwagandha unless specifically supervised by healthcare providers familiar with the herb’s effects on thyroid function.

Women scheduled for surgery should discontinue ashwagandha at least two weeks beforehand, as the herb may interfere with anesthesia and blood pressure control during procedures.

Individuals with known nightshade allergies should avoid ashwagandha, as allergic reactions can range from mild skin irritation to severe systemic responses.

Safe Usage Guidelines for Women

For women who can safely use ashwagandha, following evidence-based dosage guidelines is crucial. Most randomized controlled trial data supports doses of 250-600mg daily of standardized ashwagandha root extract, typically divided into two doses.

Clinical studies have primarily evaluated safety for up to 12 weeks of continuous use. Women should limit initial trials to this timeframe and consult healthcare providers before extending use beyond three months.

Quality supplement selection requires choosing products with third-party testing and standardized extract concentrations. Novel standardized ashwagandha products with KSM-66 or similar standardized extracts have the most robust safety and efficacy data.

Regular monitoring for side effects includes watching for changes in energy levels, sleep patterns, menstrual cycles, and any gastrointestinal symptoms. Women should maintain a supplement diary to track both benefits and potential adverse effects.

Healthcare provider consultation is essential before starting ashwagandha, particularly for women with existing health conditions, those taking prescription medications, or those planning pregnancy in the future.

Alternatives to Ashwagandha for Women

Several adaptogenic herbs offer stress-reducing benefits with potentially better safety profiles for women. Rhodiola rosea has extensive research supporting its stress-reducing effects without the hormonal concerns associated with ashwagandha.

Holy basil (Ocimum sanctum) provides stress management benefits with a long history of safe use, including among pregnant and breastfeeding women in traditional medicine systems, though modern safety data remains limited.

Lemon balm and passionflower offer gentler approaches to anxiety treatments with established safety profiles. These herbs can be used in tea form or as standardized supplements with minimal side effect risks. Additionally, turmeric for anxiety is gaining attention for its potential benefits, offering another natural alternative supported by research.

Non-herbal approaches often provide effective stress management without supplement risks. Regular exercise, particularly yoga and walking, offers proven stress reduction benefits. Mindfulness meditation, progressive muscle relaxation, and cognitive behavioral therapy techniques provide evidence-based stress management tools.

Professional mental health support becomes essential when stress and anxiety significantly impact daily functioning. Licensed therapists can provide specialized anxiety treatments that address underlying causes rather than just symptoms.