What is Ashwagandha?
Ashwagandha also called winter cherry or withania somnifera is an evergreen shrub with yellow flowers, grown in India, parts of North Africa and the Middle East [1]. It is one of the most central herbs in Ayurveda, an alternative form of traditional medicine centred around Indian principles of healing naturally [2]. Ashwagandha has been used for upwards of a thousand years to treat a range of ailments including stress, to improve concentration and increase energy levels [3]. The name refers to Sanskrit for ‘smell of the horse’, referring both to the plant’s scent and its potential ability to increase strength abilities. A huge range of benefits have been claimed for this plant, however this blog will focus on its proposed use to treat PCOS.
What is PCOS?
Polycystic ovary syndrome or PCOS is a common condition affecting how a women’s ovaries function [4]. The three main features seen are:
- Irregular periods meaning your ovaries do not release eggs regularly as they would be expected to in ovulation.
- Polycystic ovaries when your ovaries increase in size and contain many fluid-filled sacs known as follicles surrounding the eggs. Though you do not actually need to have cysts to have PCOS.
- Excess numbers of androgens, hormones normally associated with men which can cause some of the symptoms associated with PCOS.
Common symptoms include irregular periods, an increase in hair growth on the face and body, ovarian cysts. This can also cause a decrease in fertility or infertility [5]. It may also contribute to chronic conditions such as heart disease and diabetes.
Can Ashwangha treat PCOS?
Ashwagandha may be able to treat a number of PCOS symptoms including metabolic syndromes, stress and inflammation.
Ashwagandha has traditionally been used as a remedy for reducing stress and anxiety, which may help those symptoms which are common in women with PCOS [6]. It has been found that the root regulates the neurotransmitter GABA in the brain, reducing the stress pathways [7]. A 6-week trial showed its potential to alleviate stress in 39 individuals, and in another study on sixty participants, 69% reported a decrease in both anxiety and insomnia [8],[9]. Another mechanistic explanation for this, is its effects in reducing the stress hormone cortisol, as supported by a 2019 study examining the impacts of taking 240 mg compared to a placebo [8].
It has also been shown to balance blood sugar levels, helping with metabolic syndrome experienced in PCOS, with the blood-sugar lowering impacts seen in those with and without diagnosed diabetes [9]. It is claimed it can improve insulin sensitivity and as well as stimulating the uptake of glucose by muscle cells. Though for anyone with diabetes, this should be interpreted extremely cautiously and discussed with your doctor before starting any new routine.
Finally, animal studies have suggested Ashwangandha may be able to reduce inflammation by acting on inflammatory pathways by enhancing the action of natural killer T-cells [10]. It has also been associated with a decrease in the inflammatory marker, C-reactive protein, with some studies noting a 36% decrease [11].
Are there any risks with taking Ashwagandha?
Ashwagandha has relatively few risks associated with it. One advantage of Ashwagandha is that it has been used for centuries meaning the possible side effects are relatively well understood [1]. These typically include drowsiness, gastrointestinal problems or diarrhoea, though many people report no side effects. Though people who are pregnant or taking any of: barbiturates, benzodiazepines or anticonvulsants, should not take ashwagandha. One important point is that it is not considered a medicine within the UK and therefore is not subject to as stringent checks as would normally be expected. This means you should apply caution when choosing a supplement as they may not have the correct ingredients as claimed or could have a lower purity than expected. For this reason, make sure you buy from a reputable such as a well-established high street pharmacy chain.
Are there any other benefits of taking Ashwagandha for fertility?
Other than its reported benefits for reducing stress and possibly increasing libido [12], for women, it is not clear that ashwagandha can directly increase fertility which can be a key concern for women with PCOS. The scientific evidence is still very much developing and no conclusive answers have yet been reached for this [13]. Though it does suggest for men, it may improve sperm count and motility [14].
Ashwagandha for PCOS pros and cons summary
In summary, Ashwagha shows a lot of promise for treating the symptoms of PCOS, including stress, metabolic disorder and inflammation. Though it is worth noting that in many cases the dose is not quite clear. Also, the evidence for improving fertility in women is not yet conclusive, with more research being necessary. Importantly if you do decide to take it, be careful to get it from a reputable source and discuss with your doctor before taking it alongside any other medications.