Dangers of Ashwagandha in Women: Side Effects to Consider

By Maya Richardson

September 5, 2025

Ashwagandha profoundly affects the female body, directly affecting hormones, the thyroid gland, and the nervous system. This effect brings benefits but also poses important risks.

This Ayurvedic herb has been used for thousands of years to promote health, reduce stress, and improve physiology.

Women need to understand the mechanism, drug interactions, and potential side effects before adding ashwagandha to their daily regimen.

Understanding the risks and appropriate dosages helps optimize benefits, protect health, and maintain hormonal balance.

dangers-of-ashwagandha-in-women

Ashwagandha may benefit health, but poses risks and side effects for women.

What is Ashwagandha?

Ashwagandha (Withania somnifera) is an Ayurvedic herb with a long history of use. It has been modernized as a standardized extract, chosen by many women for its promise of stress reduction and energy enhancement. This text presents its origins, mechanisms, and major clinical applications to better understand its potential benefits and risks.

Botanical origin

Withania somnifera belongs to the Solanaceae family and is documented in traditional Indian medicine as a "rasayana" medicine with a systemic restorative effect.

Traditional use

The herb is classified as an adaptogen, used to support the nervous system, increase the ability to adapt to stress, and improve overall health.

Pharmacology

The main active pharmaceutical components include steroidal lactones (withanolides) and alkaloids; the mechanism of action involves modulating the HPA axis, influencing cortisol and neurotransmitters.

Clinical uses

Currently, ashwagandha is commonly used to treat stress and sleep disorders, improve physical performance, and support physiological function.

Evidence (thyroid)

Several clinical studies have reported that ashwagandha may alter TSH, T3, and T4 levels, which is particularly significant for women monitoring thyroid function.

Hormonal Effects in Women

Ashwagandha exerts significant effects on the female endocrine system through various biological mechanisms. The active ingredient withanolides can regulate important endocrine axes, from the thyroid to the ovaries, creating a comprehensive change in hormonal balance.

Thyroid regulation

Ashwagandha can stimulate thyroid activity and increase the synthesis of T3 and T4 hormones, improving basal metabolism and affecting the body's energy.

Reproductive hormones

Some clinical evidence notes an increase in free testosterone and improved estradiol levels in women, which are related to reproductive function and sexual desire.

Cortisol balance

This herb reduces plasma cortisol levels, thereby supporting the HPA axis and limiting chronic stress, a factor that often affects the menstrual cycle.

Clinical implications

These endocrine changes could be applied to support reproductive health, cyclical disorders, and energy regulation in women.

Risks During Pregnancy and Breastfeeding

Ashwagandha poses significant risks for pregnant and breastfeeding women. The potent bioactives may act directly on uterine smooth muscle and the endocrine system, leading to serious consequences for pregnancy and infant development.

Miscarriage risk

Animal studies and limited clinical reports suggest that ashwagandha may stimulate uterine contractions, increasing the risk of miscarriage or premature birth.

Lactation safety

Data on safety during breastfeeding are limited; the active compounds may be excreted in breast milk, potentially affecting the infant.

Hormonal interference

The herb may modulate estrogen and progesterone levels, altering important hormonal cycles during pregnancy and milk production.

Clinical guidance

Pregnant or lactating women should be closely monitored if considering use, with safer alternatives preferred.

Digestive and Gastrointestinal Side Effects

Ashwagandha can significantly affect the digestive system, especially in sensitive or gastrointestinal-disordered women. Its powerful bioactives act directly on the gastric mucosa and intestinal motility, leading to a wide range of clinical manifestations.

Nausea and vomiting

Many women report nausea or vomiting after taking ashwagandha extracts, which is related to gastric irritation and effects on the vomiting center in the brain.

Diarrhea and abdominal discomfort

This herb can increase intestinal motility, causing diarrhea or abdominal cramps, especially when taken in high doses or in combination with other stimulants.

Gut sensitivity

Women with irritable bowel syndrome (IBS) or peptic ulcers are at greater risk of severe reactions, characterized by bloating, indigestion, and acute gastrointestinal upset.

Clinical advice

Careful monitoring and starting with a low dose help reduce the risk of digestive side effects. Also, choose the extract form appropriate for your individual health condition.

Mental Health Considerations

Ashwagandha has a powerful effect on the central nervous system and HPA axis, producing a marked effect on women's mood. Its beneficial effects on regulating cortisol, neurotransmitters, and stress levels can also cause overreactions in sensitive individuals.

Anxiety modulation

This herb can reduce stress and anxiety by modulating GABAergic activity, but high doses can lead to feelings of overstimulation or nervousness.

Interaction with antidepressants

Ashwagandha may interact with antidepressants, benzodiazepines, or sedatives, altering the effectiveness of the treatment or increasing neurological side effects.

Sleep impact

Some women experience deeper sleep, while others report nightmares or difficulty sleeping due to the mild stimulant effect.

Clinical guidance

Monitoring psychological symptoms and working with a specialist can help optimize benefits, reduce the risk of side effects, and avoid unwanted drug interactions.

Autoimmune and Thyroid Conditions

Ashwagandha has a powerful effect on the immune system and thyroid function, which has important implications for women with autoimmune or endocrine disorders. The active ingredient withanolides acts directly on cytokines and thyroid hormones, leading to immune function and metabolism alterations.

Autoimmune modulation

The herb can stimulate the immune response, increasing cytokine production and lymphocyte activation, potentially triggering flares of autoimmune diseases such as lupus, rheumatoid arthritis, or Hashimoto's.

Hyperthyroidism risk

Ashwagandha promotes T3 and T4 synthesis, leading to increased basal metabolism; women with hyperthyroidism may experience tachycardia, anxiety, tremor, and insomnia.

Clinical implications

Regular medical monitoring and dosage adjustments help reduce the risk of adverse effects, while providing a safe basis for considering herbal supplements in sensitive populations.

Drug Interactions Specific to Women

Ashwagandha has the potential for complex drug interactions, particularly affecting women who are taking hormonal medications, thyroid medications, or oral contraceptives. These interactions involve hormone regulation, liver enzymes, and drug metabolism.

Birth control interference

The herb may interfere with the effectiveness of hormonal contraceptives due to its ability to alter estrogen and progesterone levels, which may affect menstrual cycle regularity and contraceptive effectiveness.

Thyroid medication interactions

Ashwagandha increases T3 and T4 hormone levels, which may alter the effects of levothyroxine or other thyroid medications, requiring dosage adjustments.

Hormone-related drugs

The herb interacts with other hormone-regulating medications, including hormone replacement therapy or osteoporosis medications, affecting clinical efficacy and potential side effects.

Clinical guidance

Women should seek medical advice before combining ashwagandha with any hormonal or endocrine medications to ensure safety and optimize therapeutic effects.

Dosage and Safety Guidelines

Ashwagandha should be used according to the dosage and medical instructions to ensure safety, especially for women with a history of endocrine or immune disorders or who are pregnant and breastfeeding. Appropriate dosage helps to optimize benefits while minimizing side effects.

Recommended dosage

The recommended dose ranges from 300–600 mg of a standardized extract with 5% withanolides per day; the dose should be divided into 1–2 doses to effectively absorb and reduce the risk of gastrointestinal disorders.

Monitoring and supervision

Regular clinical monitoring, including thyroid hormone testing, liver and kidney function assessment, and checking for signs of gastrointestinal or neurological disorders, is necessary to adjust the dose promptly.

Form selection

Choose a standardized extract form; avoid the raw powder form if there is a history of gastrointestinal sensitivity. Combination with other foods or drugs should be considered to reduce interactions.

Clinical guidance

Consulting with a health care professional before starting or adjusting dosage helps ensure safety, maximize benefits, and minimize risks for women.

Conclusion

Ashwagandha has many potential benefits for women's health, from stress reduction to improved sleep and support for sexual function. These benefits stem from its ability to regulate hormones, impact the HPA axis, and affect the immune system.

However, its powerful effects also come with significant risks. Before using it, women should consider factors such as thyroid, autoimmune disease, pregnancy, breastfeeding, and digestive health.

→Learn about ashwagandha drug interactions to ensure safety and avoid unwanted side effects.

Regular medical follow-up and appropriate dosage selection can help optimize benefits and minimize health risks.

Frequently Asked Questions (FAQs)

  • Is Ashwagandha Safe for Pregnant Women? – Ashwagandha may stimulate uterine contractions, increasing the risk of miscarriage or premature birth. Pregnant women should avoid use or use only under close medical supervision.
  • Can breastfeeding women take ashwagandha? – Safety data is limited. The active ingredient may pass into breast milk, affecting the newborn. Consult your doctor before use to protect the health of the mother and baby.
  • How does ashwagandha affect reproductive hormones? – The herb may increase free testosterone and estradiol, regulate menstrual cycles, improve libido, and affect a woman's hormonal balance.
  • What are common digestive side effects? – Women may experience nausea, diarrhea, bloating, or indigestion, especially when taking high doses or if they have irritable bowel syndrome. Low doses and standardized extracts reduce this risk.
  • How does Ashwagandha interact with medications? – Herbs may affect the effectiveness of birth control pills, thyroid medications, or hormone therapies. Medical monitoring and consultation with a physician can help avoid side effects and optimize treatment.
Article by

Maya Richardson

Maya overflows with a passion for writing and researching health. Her deep love of words and her endless curiosity helps Maya to empower those around her with invaluable information about a healthier lifestyle.

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