Ashwagandha for Perimenopause: Does It Help?

Key Findings

The study concluded that Arth perimenopause multisymptom capsules (containing ashwagandha root extract, vitex extract, and black cohosh) significantly reduced perimenopausal symptoms compared to placebo. The primary outcome, measured by the Greene Climacteric Scale (GCS), showed a 45% reduction in total symptom scores in the treatment group versus 18% in the placebo group (p < 0.001). Secondary outcomes included improvements in hot flashes (60% reduction vs. 25% in placebo, p < 0.001), sleep quality (55% improvement vs. 20% in placebo, p < 0.001), and mood disturbances (35% reduction in anxiety, 40% reduction in depression scores via HADS, p < 0.01). The supplement demonstrated a favorable safety profile, with adverse events comparable to placebo and no serious side effects reported.

Study Design

This was a 12-week, randomized, double-blind, placebo-controlled trial conducted in 2025. The study enrolled 150 women aged 45–55 years experiencing perimenopausal symptoms. Participants were randomized 1:1 to receive either Arth capsules or placebo. The primary endpoint was change in GCS scores from baseline to week 12. Secondary endpoints included hot flash frequency, sleep quality (Pittsburgh Sleep Quality Index), and mood (Hospital Anxiety and Depression Scale).

Dosage & Administration

The supplement contained 300 mg ashwagandha root extract (KSM-66), 200 mg vitex extract, and 160 mg black cohosh per capsule. Participants took one capsule twice daily (total daily dose: 600 mg ashwagandha, 400 mg vitex, 320 mg black cohosh) with meals. Placebo capsules were identical in appearance and administered on the same schedule.

Results & Efficacy

• GCS total score: Treatment group improved from baseline (mean: 28.5) to week 12 (mean: 15.6), a 45% reduction vs. placebo (28.2 to 23.0, 18% reduction; p < 0.001).
• Hot flashes: Frequency decreased by 60% in the treatment group (from 7.2/day to 2.9/day) vs. 25% in placebo (7.1/day to 5.4/day; p < 0.001).
• Sleep quality: PSQI scores improved by 55% in the treatment group (baseline: 10.8 to 4.9) vs. 20% in placebo (10.7 to 8.6; p < 0.001).
• Mood: Anxiety (HADS-A) and depression (HADS-D) scores decreased by 35% and 40%, respectively, in the treatment group vs. 12% and 15% in placebo (p < 0.01).
  All results were statistically significant, with effect sizes ranging from moderate to large (Cohen’s d = 0.6–1.2).

Limitations

1. Combination formulation: Effects cannot be attributed to ashwagandha alone, as the supplement included multiple herbs.
2. Short duration: 12 weeks may be insufficient to assess long-term efficacy or safety.
3. Sample homogeneity: Participants were limited to women aged 45–55 with moderate-to-severe symptoms; results may not generalize to broader populations.
4. Funding bias: The study was sponsored by the supplement manufacturer, potentially influencing outcomes.
5. Mechanistic gaps: Hormonal changes (e.g., estradiol, cortisol) were not measured, limiting understanding of biological pathways.

Clinical Relevance

This study suggests that a multisymptom nutraceutical approach may offer clinically meaningful relief for women seeking nonhormonal alternatives to HRT. The observed reductions in GCS and HADS scores indicate potential utility for managing vasomotor, sleep, and mood-related symptoms. However, the combination formulation prevents conclusions about ashwagandha’s individual efficacy. Users should consider consulting healthcare providers to assess suitability, particularly given the lack of long-term safety data. Future research isolating ashwagandha’s role and evaluating extended use is warranted.

Note: This analysis is based solely on the provided study summary. Full details (e.g., statistical methods, hormonal data) may be available in the original publication (PubMed ID: 40677428).