Does ashwagandha affect hormone health?

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Ashwagandha has shown mixed effects on hormone health measures such as cortisol, testosterone, estrogen, luteinizing hormone, follicle-stimulating hormone, prolactin, and thyroid hormones in human studies. In animal models, ashwagandha appears to reduce the stress-related increase in corticosteroids in serum, and at the higher doses of supplementation (though still within the doses humans use), to fully normalize cortisol to control levels.[1][2][3] The cortisol reductions seen in chronically stressed adults with ashwagandha (300–500 mg over 60–90 days) tend to be in the range of 20%–50% from baseline values, with more of an effect seen in people who self-report high levels of stress.[4][5]

Ashwagandha’s effects on hormones are not limited to cortisol. Preliminary evidence suggests that 500–600 mg of ashwagandha root extract per day may increase testosterone levels in men when taken over 3–6 months. Improvements in testosterone levels, luteinizing hormone, follicle-stimulating hormone, sperm quality parameters, quality of life, and sexual functioning have been seen with ashwagandha use.[6][7][8][9][10][11] Effects on testosterone are more pronounced in men with infertility and low testosterone levels, though ashwagandha may also boost testosterone levels in healthy men as well.[12][13][8][14][9][5] When supplemented by infertile men, ashwagandha enhanced seminal parameters (e.g. sperm count, motility, quality, and vitality), suggesting that it may help to improve fertility. It’s possible that increased testicular and sperm cell antioxidant status may be partially responsible for these effects.[5][9][11][10]

Ashwagandha may also have beneficial effects on hormone health in women. Though current evidence suggests these beneficial effects are less pronounced than those seen in men, there still isn’t enough evidence to say this conclusively. Ashwagandha apparently also improves sexual function in women, but it’s not clear yet whether subjective well being is similarly enhanced.[15] One study did find that ashwagandha use in women with menopause increased estrogen while simultaneously lowering follicle-stimulating hormone and luteinizing hormone levels to produce an overall improvement toward menopausal symptom related quality of life.[16]

References
1.^Bhattacharya SK, Muruganandam AVAdaptogenic activity of Withania somnifera: an experimental study using a rat model of chronic stressPharmacol Biochem Behav.(2003 Jun)
2.^Kour K, Pandey A, Suri KA, Satti NK, Gupta KK, Bani SRestoration of stress-induced altered T cell function and corresponding cytokines patterns by Withanolide A.Int Immunopharmacol.(2009-Sep)
3.^Khan B, Ahmad SF, Bani S, Kaul A, Suri KA, Satti NK, Athar M, Qazi GNAugmentation and proliferation of T lymphocytes and Th-1 cytokines by Withania somnifera in stressed mice.Int Immunopharmacol.(2006-Sep)
5.^Abbas Ali Mahdi, Kamla Kant Shukla, Mohammad Kaleem Ahmad, Singh Rajender, Satya Narain Shankhwar, Vishwajeet Singh, Deepansh DalelaWithania somnifera Improves Semen Quality in Stress-Related Male FertilityEvid Based Complement Alternat Med.(2009 Sep 29)
6.^Ramin Nasimi Doost Azgomi, Afshar Zomorrodi, Hossein Nazemyieh, Seyed Mohammad Bagher Fazljou, Homayoun Sadeghi Bazargani, Fatemeh Nejatbakhsh, Arezoo Moini Jazani, Yadollah Ahmadi AsrBadrEffects of Withania somnifera on Reproductive System: A Systematic Review of the Available EvidenceBiomed Res Int.(2018 Jan 24)
8.^Nasimi Doost Azgomi R, Nazemiyeh H, Sadeghi Bazargani H, Fazljou SMB, Nejatbakhsh F, Moini Jazani A, Ahmadi AsrBadr Y, Zomorrodi AComparative evaluation of the effects of Withania somnifera with pentoxifylline on the sperm parameters in idiopathic male infertility: A triple-blind randomised clinical trialAndrologia.(2018 Sep)
9.^Ahmad MK, Mahdi AA, Shukla KK, Islam N, Rajender S, Madhukar D, Shankhwar SN, Ahmad SWithania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile malesFertil Steril.(2010 Aug)
10.^Gupta A, Mahdi AA, Shukla KK, Ahmad MK, Bansal N, Sankhwar P, Sankhwar SNEfficacy of Withania somnifera on seminal plasma metabolites of infertile males: a proton NMR study at 800 MHzJ Ethnopharmacol.(2013 Aug 26)
11.^Kamla Kant Shukla, Abbas Ali Mahdi, Vivek Mishra, Singh Rajender, Satya Narain Sankhwar, Devender Patel, Mukul DasWithania somnifera improves semen quality by combating oxidative stress and cell death and improving essential metal concentrationsReprod Biomed Online.(2011 May)
13.^Wankhede S, Langade D, Joshi K, Sinha SR, Bhattacharyya SExamining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trialJ Int Soc Sports Nutr.(2015 Nov 25)
14.^Adam Shepherd, Oliver Brunckhorst, Kamran Ahmed, Qihe XuBotanicals in health and disease of the testis and male fertility: A scoping reviewPhytomedicine.(2022 Nov)
15.^Gould DThe biology of ageing: the special senses.Geriatr Nurs Home Care.(1987-Feb)