What is Ashwagandha?

Ashwagandha also known as winter cherry or withania somnifera is a yellow-flowering evergreen shrub cultivated in India, North Africa and the Middle East [1]. It is also one of the most prominent herbs in Ayurveda, another branch of traditional medicine founded on Indian ideas of natural cure [2]. For more than a millennium, Ashwagandha has been applied for all kinds of ailments, such as stress, to help you focus and get a lot of energy [3]. The name is Sanskrit for ‘smell of the horse’, and the plant’s odour was also intended to describe its power-building potential.

What is PCOS?

This syndrome affecting ovaries in women, known as polycystic ovary syndrome or PCOS, is a common condition [4].

These are the three most prominent features that can be observed:

• Period irregularity: Your ovaries don’t release eggs as often as they should during ovulation.
• Polycystic ovaries: they occur when your ovaries grow big and have lots of water-filled sacs called follicles surrounding the eggs. However, you do not really have to have cysts in order to have PCOS.
• Excess accumulation of androgens — the male hormones that bring some of the symptoms of PCOS.

Symptoms include untimely periods, hair growth on the face and body, and ovarian cysts. This can also lead to fertility loss or infertility [5]. It can even lead to the disease of chronic diseases, including heart disease and diabetes.

Can Ashwagandha treat PCOS?

Ashwagandha might be able to help with some indirect PCOS symptoms such as metabolic syndromes, stress and inflammation. However, ashwagandha should not be considered a standalone treatment for PCOS.

The Indian herb Ashwagandha has long been used as a natural remedy for stress and anxiety which may alleviate those symptoms found in PCOS-positive women [6]. It has been found the root regulates the brain neurotransmitter GABA reducing stress pathways [7]. A 6-week study confirmed that it could relieve stress in 39 people, and another one on 60 people, 69% reported less anxiety and insomnia [8],[9]. Another mechanistic reason for this is that it lowers the stress hormone cortisol, in a study from 2019 on the effects of taking 240 mg and a placebo [8].

Also, it balances blood sugar, alleviates the metabolic syndrome of PCOS, and has a blood sugar-lowering effect on those with and without diabetes [9]. It’s said to boost insulin resistance and stimulate glucose transport by muscle cells. However, this should be interpreted very slowly for those with diabetes and discussed with a doctor before starting a 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 minor risks associated with PCOS. Ashwagandha's benefits are that it has been used for centuries, and the possible side effects are more than well understood [1].

These include:

• Somnolence
• Digestive problems
• Diarrhoea, but very few people have experienced these effects.

Those who are pregnant or using any barbiturates, benzodiazepines or anticonvulsants should not take ashwagandha.

However, note that in some countries, such as the UK, Ashwagandha is not considered a medicine and, therefore, is not subject to the same strict checks as we would have hoped.

For this reason, make sure you buy from a good supplier, such as a well-established high-street pharmacy company.

Are there any other benefits of taking Ashwagandha for fertility?

While Ashwagandha may be useful for stress reduction and possibly increasing libido [12], there is little scientific evidence supporting the fact that ashwagandha increases fertility.

However, in men, some evidence suggests that Ashwagandha may increase sperm production and circulation [14].

Summary: Ashwagandha for PCOS

In short, Ashwagha has a lot to offer for some related symptoms of PCOS — stress, metabolic disorder, and inflammation, but it should not be considered a standalone treatment.

However, there is no scientific evidence supporting claims that Ashwagandha helps fertility in women. If you do decide to take Ashwagandha, make sure to obtain it from a reputable source and check with your doctor before taking it in conjunction with other medications.