What Happens During Perimenopause
Perimenopause is the natural stage before menopause when your hormone levels such as oestrogen and progesterone begin to change. It can start as early as your late 30s or early 40s and often lasts several years before your periods stop completely.
During this time, your body goes through big hormonal shifts. These changes can affect your mood, energy, sleep, and even your weight. Every woman’s experience is different, but some symptoms are very common.
Many perimenopausal women notice:
- Hot flashes that come on suddenly, sometimes followed by chills
- Night sweats that interrupt sleep
- Brain fog, forgetfulness, and trouble concentrating
- Joint pain and stiffness that make everyday tasks uncomfortable
- Weight gain, especially around the middle
- Anxiety, irritability, or low mood
- Tiredness or a constant feeling of fatigue
These menopause symptoms happen because hormone levels rise and fall unevenly, affecting everything from sleep to metabolism.
The NHS recommends HRT (hormone replacement therapy) as the most effective way to treat these symptoms. But many women also look for natural options to support their wellbeing, especially those who cannot or prefer not to take HRT. Herbal options such as Ashwagandha are becoming increasingly popular.
However, the NHS warns that herbal and complementary medicines are not regulated to the same standard as prescription medicines. This means it’s not always clear how safe or effective they are. Always check with your GP before starting any supplement. NHS guidance
What Is Ashwagandha?
Ashwagandha, also known as Indian ginseng or winter cherry, is a small shrub that grows in India, the Middle East, and parts of Africa. The scientific name is Ashwagandha Withania Somnifera.
It is known as an adaptogenic herb, meaning it helps your body adapt to stress and restore balance. Adaptogens work by supporting your adrenal glands, which control how your body responds to stress and anxiety.
The ashwagandha root extract is the part most often used in supplements. It contains natural chemicals called withanolides, which are thought to have anti-inflammatory properties, support hormone balance, and protect the body from the effects of stress.
In Ayurveda, Ashwagandha is known as a tonic for strength and vitality. In modern science, it is being studied for its potential to help with sleep quality, energy, mood, and hormone levels.
For women going through perimenopause and menopause, Ashwagandha may offer gentle support for symptoms such as hot flashes, night sweats, joint pain, brain fog, and low mood.
What the Research Says
Modern studies suggest that ashwagandha root extract may help ease some menopause symptoms naturally.
In a clinical study involving 91 perimenopausal women, participants took 300 mg of ashwagandha root extract twice daily for eight weeks. Compared with a placebo group, the women who took Ashwagandha noticed significant improvements in their sleep, energy, mood, and overall quality of life. They also reported fewer hot flashes and night sweats, and reduced joint pain. The Menopause Dietitian
Another review of several studies found that Ashwagandha helped reduce stress and anxiety, improve sleep quality, and support healthy hormone levels. In some cases, women experienced significantly increased relaxation, focus, and energy compared to the placebo group. PMC study
Although these results are encouraging, most research so far has been short-term and involved small groups of participants. Larger, long-term studies in the UK are needed before Ashwagandha can be officially recommended for perimenopause and menopause.
What the NHS Says
The NHS recognises that many women try herbal supplements such as Ashwagandha to manage menopause symptoms. However, it stresses that herbal products are not tested or regulated in the same way as prescribed medicines. Their strength, purity, and safety can vary widely between brands.
Some NHS trusts such as Mendip Vale NHS mention Ashwagandha in their guidance as a herbal option that “may help anxiety and insomnia.” This reflects growing interest in the UK in using adaptogenic herbs to support mental health and sleep. Mendip Vale NHS Trust PDF
However, the NHS still advises that HRT remains the most reliable way to manage common symptoms such as hot flashes, night sweats, and joint pain.
If you decide to try Ashwagandha, the NHS recommends:
- Talking to your GP or pharmacist first, especially if you take medication or have thyroid, liver, or hormone-related conditions
- Choosing a high-quality UK brand that has been independently tested for safety and quality
- Avoiding combining several herbal remedies at once, as their effects can overlap or interfere with each other
The NHS also reminds women that supplements like Ashwagandha are best used alongside, not instead of, evidence-based treatments and healthy lifestyle habits.
Possible Benefits of Ashwagandha for Perimenopausal Women
1. Reduced stress and anxiety
Ashwagandha helps lower cortisol, the body’s main stress hormone. This can make a real difference for women dealing with stress and anxiety caused by hormonal changes. Many report feeling calmer, more focused, and less reactive to everyday pressures.
2. Improved sleep quality
Night sweats and hot flashes often disturb sleep during perimenopause and menopause. Studies show that women who take ashwagandha root extract often notice improved sleep quality, falling asleep faster and waking less often during the night.
3. More balanced hormone levels
Ashwagandha supports the body’s endocrine system, which regulates hormone levels. This may help ease the ups and downs of oestrogen and progesterone that cause symptoms like fatigue, low libido, and mood swings.
4. Clearer thinking and less brain fog
Many women in perimenopause experience brain fog, difficulty focusing, remembering things, or finding words. Some studies show that Ashwagandha can improve mental clarity and cognitive function, helping women feel sharper and more alert.
5. Relief from joint pain and inflammation
Ashwagandha has strong anti-inflammatory properties. This may help reduce joint pain, stiffness, and swelling that often increase when hormone levels drop.
6. Better weight control and energy
Fluctuating hormones and high stress can lead to weight gain, especially around the abdomen. Since Ashwagandha helps reduce cortisol, it may indirectly help with managing weight gain and keeping energy levels steady.
How to Use Ashwagandha Safely
Dosage
Most studies used 300 to 600 mg of ashwagandha root extract daily. The best-known and most researched forms are KSM-66 and Sensoril.
How to take it
Ashwagandha is usually taken in capsule or powder form. It’s best taken with food, once in the morning and once in the evening.
Choosing a quality product
In the UK, supplements are not as tightly regulated as medicines. Look for trusted brands that carry third-party testing or MHRA approval to ensure purity and safety.
Side effects
Ashwagandha is generally well tolerated, but mild stomach upset or drowsiness can occur. Rarely, cases of liver injury have been reported, so always consult your GP before starting. Guardian report
Interactions
Avoid combining Ashwagandha with sedatives, thyroid medication, or HRT without medical advice.
The Bottom Line
Ashwagandha, also called Indian ginseng or winter cherry, is a natural adaptogenic herb that may help perimenopausal women feel more balanced during perimenopause and menopause.
Research shows significant improvements in sleep, stress, joint pain, and brain fog compared with a placebo group. Many women also report better mood, more energy, and fewer night sweats.
However, more research is needed, especially long-term studies in the UK. The NHS does not yet recommend Ashwagandha as a proven treatment for menopause symptoms.
If you want to try it, choose a good-quality supplement, take it safely, and use it as part of a broader wellbeing plan that includes exercise, healthy eating, and enough rest.
