Episode #134: Ashwagandha and PCOS: A Natural Solution for Hormonal Balance

Hi, and welcome back to the PCOS Repair podcast. This episode is one of our supplement highlight episodes, where we get to take a closer look at various supplements that are marketed to aid the symptoms of PCOS. Today, we are looking at ashwagandha. First of all, it’s a plant. It’s an evergreen shrub that grows in Asia and Africa that was commonly and historically used to treat stress. It falls into a category called adaptogens. Adaptogens are believed to help the body resist physical and mental stress. Some of the conditions it is used for include things like insomnia, aging, anxiety, as well as others, but those are the big ones that ashwagandha is known for but it begs the question, anytime we’re considering a supplement, is there any reliable scientific evidence to back up and support the uses of this supplement? In regards to PCOS, we know that stress is a big one. One of the things that we’ve talked about in previous episodes is that sense of perceived stress. We think about someone who’s just busy and rushing and they may have everything perfect. They may be killing it at their job or at their education, and they may have a spotless home, and they may be super fit.

There’s a lot of women with PCOS that are actually quite fit, and they’re just really doing great at their lives. They’re actually holding it together. They wouldn’t even tell you that they are stressed. The problem is that their body is running at a speed that isn’t working for it and so there’s a lot of perceived stress or other ones would just be like everything seems to be fine, but there’s also something going on internally where there’s some fear or some anxiety. Even if on the surface things look okay, we can have things going on inside of us. Another big one of perceived stress is calorie reductions. If you’re constantly living in calorie deficit mode, that doesn’t mean you can’t decrease in calories in a healthy way to lose weight with PCOS. I go into that in other areas but it does take its toll when you’re constantly doing those yo-yo diets or where you’re cutting calories extremely low, that can be very stressful and create perceived stress on the body. Okay, that was a side note, but I just wanted to bring that up because this is one of the areas where ashwagandha is considered to be potentially beneficial for women with PCOS is that it is known for its potential ability to reduce stress.

That’s what the category of adaptogen is for. It’s a substance that helps the body cope with its stress. It’s thought to do this through reducing the activity of the hypothalamic pituitary adrenal or the PA axis, which is the system that helps to regulate our response to stress. That would be how much cortisol and so forth is going to be distributed to the body. There’s also some studies that suggest ashwagandha supplements may be helpful with anxiety. One study and I’ll link to some of these here in the show notes, but one study found It was a small study, only 58 participants, so it’s good to recognize that that’s a fairly small study. They took somewhere between 250 to 600 milligrams of Ashwagandha extract for eight weeks, and they reported having significantly reduced perceived stress, as well as their stress hormone cortisol was lower compared to those who took the placebo. There is some evidence that it points towards this being helpful.

Another interesting benefit potentially of ashwagandha is that it can increase your VO₂ max in your athletic performance. Sometimes it is recommended for athletes for that reason, the same range of dosing. Most studies indicate somewhere around that 1,600 milligrams is necessary to see any real results. Some other sources pointed towards some mental health improvement, conditions such as depression. Again, also that anxiety portion. This one usually took a little higher dosage, closer to 1,000 milligrams daily for about 12 weeks. This is an interesting one. It may help to boost testosterone and increase fertility in men. For anyone who is considering that both partners may be contributing to fertility struggles, this may be something to discuss with your husband or your partner’s doctor, as well as talking to your doctor if it’s a good option for you. In the study that looked at men’s fertility, there was only 43 males, so again, smaller study, and they were aged 40 to 70, which is already a little on the older age, although for men, that’s not… I mean, 70 It’s definitely older, but 40 is not that old for men when we look at fertility but they took it for eight weeks, and there was an 18% greater increase in the DHEAS, which is the sex hormone involved in testosterone production. Than those who took the placebo. That’s a significant increase for that small study. It seemed to improve the volume, motility, and help with low sperm count.

That is an interesting consideration for couples that are concerned about the male aspect of their fertility. It may also reduce blood sugar levels. As you know, if you’ve listened to this podcast for any length of time, blood sugar and glucose and insulin are all things that we talk about quite a bit here. Considering that it’s helpful with several aspects of symptoms that PCOS tends to come with, this may be supplement that’s worth talking to your physician about if it would be a good fit for you. Five different clinical studies with people with diabetes found that treatment with ashwagandha significantly reduced their blood sugar and their hemoglobin A1c, their insulin spikes, and their blood lipids, which are really at risk when you have high blood sugars on an ongoing basis. Again, so that’s potentially really interesting and intriguing for someone with PCOS to consider this particular supplement.

Then it also may reduce inflammation. Again, another area that comes into play with PCOS inflammation. This one, not a lot of studies as far as this goes. The problem with inflammation is there’s inflammation from so many different sources. It’s very difficult to say, Okay, this type of inflammation or people that had gut health inflammation and didn’t have other chronic inflammatory disorders. It’s a little harder to pinpoint exactly what they were looking at because what they did here in the studies, it looks like, is they just measured certain inflammatory markers. If those were elevated, did it improve when they took the supplement? and then it may promote more restful sleep. For people taking this, it’s always difficult to know because is it helping or leading to sleep problems, or is it calming sleep and then leading the other problem? That’s one of those chicken or the egg questions but 50 adults aged 65 to 80, so these were older, were taking 60 milligrams of ashwagandha root per day. For about 12 weeks, they had significantly improved sleep quality and mental alertness upon waking compared to the placebo group. That is also very intriguing. The dosages that seem to be coming across the most when looking at the clinical studies is somewhere in the 500 to 600 milligrams. When you’re looking at to purchase, wanting to get about that much per day. Then whenever we’re looking at a supplement, it’s really important to think about who should not be taking this or when would be a time to not take this.

In this particular instance, ashwagandha has not really had a lot of long-term studies, so we don’t know the long-term effects. We do have a fairly good comfort zone with about three months of treatment. This may be something where you take it for three months and then see how you do without it. Definitely be talking to your doctor as you start and stop and see what their comfort zone with that is. This is important to know because oftentimes this is why I don’t talk about this one as much. Ashwagandha is not safe in pregnancy. High doses may lead to pregnancy For this reason, I don’t highly recommend it. One of the things that is an important aspect for me, if I’m working with women who are trying to get pregnant or improve their fertility, I try to focus on supplements that are going to benefit them that are pregnancy-safe because if they’re actively trying to get pregnant, we don’t know you’re pregnant until you’re two weeks in. Now, typically, you stop most medications once a week. We know we’re pregnant, but if we know we’re trying to get pregnant, I feel like it’s not a good idea to start a supplement that you know is not pregnancy safe.

One option here is if you’re feeling like this supplement really feels like it hits the mark for a lot of things, what I would talk to your doctor about is timing of things. That’s one of the things, too, where I’ve had this conversation with patients before. If we’re looking at trying to improve your health and the goal is to get pregnant and you feel like this is something that would be helpful and it hits all those marks of symptoms and issues and root causes that you’re dealing with, and you’re going to really try hard to do all the lifestyle things to go with it. Options would, of course, include preventing pregnancy with non hormonal contraceptives for three months and then go off of it. Here, in a lot of the studies, we’re seeing that somewhere in the 8 weeks to 12 weeks is we’re seeing improvements, so maybe just for two months, but just being aware that this is not safe during pregnancy. I just want to really highlight that because most supplements that I talk about are considered safe in pregnancy. That’s why I usually talk about them is because there’s something that you can start when you’re trying to repair your cycle when you’re trying to improve your fertility.

This is not one of those, although there’s a lot of benefits that may lead to better health for PCOS, according to what we’re seeing the trend be in the studies, although limited on this supplement. Also, anyone that is about to have surgery should not take this. Anyone with an autoimmune or a thyroid disorder, this is not a great one for you. Then also anyone with liver problems. The reason why we are a little bit concerned about long term use is liver function. Again, there’s really no studies to show us a whole lot about what we would be monitoring or looking at, but I would say it looks like it’s quite safe, according to studies, for a couple of months at a time. If you talk to your doctor, it could be something where you’re ready to take it, you’re ready to combine it with all the lifestyle things, see how far it can get you. Oftentimes, this type of supplement doesn’t need to be taken long term. You’re just trying to write that stress response and get yourself to be in a little bit of a better place with all of that. So it’s not necessarily indicated for long term either. Anyway, just some things to consider about who should not be taking the supplement as well.

So there you have it, my friend. I hope that this gives you a great start towards considering the supplement, if it would be a good addition or if it doesn’t sound like it’s for you to add to your holistic approach for PCOS management. This hopefully gave you some talking points so that you can talk to your health care provider if this is one that’s interesting to you or if it’s one that they have brought up to help you better understand some of the pros and cons of ashwagandha.

As we wrap up this episode, I do want to just touch on a couple of things that come up as we talk about supplements. First of all, what do I mean by a holistic approach for PCOS management? Basically, holistic means a well-rounded approach where we’re coming at things from multiple angles. In the case of PCOS, that’s going to mean our lifestyle. To me, and to many people and to many research articles, is the most important approach but we also include the medical approach, things like birth control medications, labs, monitoring procedures, so forth.

Then we also have supplementation. We are going to come at our PCOS management from multiple angles with multiple specialists and multiple areas of expertise to help us to maximize our ability to promote health in our bodies. As we discuss the various supplements here on the podcast during these Supplement Spotlight episodes, I really want to remind everyone the role of supplements in PCOS management. First of all, 100%, a well-selected supplement can be of benefit for women with PCOS. I don’t want to pooh-pooh supplements or make it sound like they really don’t do a whole lot. So many people have found supplements to be very, very, very, very, very helpful. However, while they may help to relieve certain symptoms, especially things that can aid in lifestyle support, they are not a magical cure. If only you found the right one, your PCOS symptoms would disappear. That just isn’t the case. We hear so many amazing stories about PCOS supplements, and the reason is it’s marketing. It’s really important to keep that in mind and keep it in perspective.

Unfortunately, no matter what you’ve heard and seen on the internet, supplements will not fix your PCOS. Nothing cures your PCOS. Neither does lifestyle but honestly, lifestyle is going to have a greater impact than your supplements. However, the supplements can be of great aid when chosen wisely. The good news, though, is that as you’ve heard in this episode, there’s a lot of promising evidence showing that ashwagandha can offer many helpful benefits when it’s combined with good nutrition, regular movement, and a healthy mindset. If you found this episode helpful, I invite you to go to supplementsforpcos.com and request a free copy of my PCOS supplement guide. In this guide, you will get my PDF downloadable, comprehensive guide to PCOS supplements, and you will also get access to my online dispensary where I share all my favorite brands and a discount for being one of my lovely listeners. Also, be sure to hit the subscribe button to the podcast so that you get notified each and every week when a new episode becomes available. If there is a supplement that you would like me to highlight, let me know over on Instagram. You can send me a DM @nourishedtohealthy. Until next time, bye for now.