So, you’ve probably seen the TikToks or heard your friend rave about how ashwagandha basically "deleted" her stress. It's the darling of the supplement world right now. But honestly? It isn't just some magic herb that everyone can pop like candy without consequences. While the ancient Ayurvedic roots of Withania somnifera are deep, the way it interacts with a woman's specific biology—especially hormones—is kinda complicated.
If you’ve started taking it and feel a bit "off," you’re not imagining things.
Let's get real about the actual data. Most of the glowing reviews come from short-term studies, usually around 8 to 12 weeks. We don't actually have much solid info on what happens when you stay on it for a year or two. And for women, the side effects can range from "annoying bathroom issues" to "wait, why is my period late?"
The Hormonal Ripple Effect
Most people take ashwagandha to lower cortisol. It’s great at that. But your hormones don't exist in a vacuum. When you pull the lever on one hormone, others tend to shift too.
For some women, this is a win. A 2025 study published in Frontiers in Reproductive Health looked at women going through perimenopause. They found that ashwagandha actually helped increase estradiol (a form of estrogen) and lowered follicle-stimulating hormone (FSH). For someone dealing with hot flashes, that’s great news.
But there’s a flip side.
📖 Related: Why the EMS 20/20 Podcast is the Best Training You’re Not Getting in School
Why Your Thyroid Might Be Mad at You
Ashwagandha is known to give your thyroid a little "nudge." It can increase the production of T4. If you have an underactive thyroid (hypothyroidism), this might feel like a boost in energy. However, if your thyroid is already running hot or you have Graves' disease, ashwagandha can tip you over into thyrotoxicosis.
Basically, your heart starts racing, you feel shaky, and you might get sudden bouts of anxiety—which is ironic, considering most people take it to stop anxiety.
The Testosterone Factor
Here’s something most influencers won't tell you: ashwagandha can bump up testosterone levels. In men, that’s usually the goal. In women, especially those already dealing with PCOS (Polycystic Ovary Syndrome), more testosterone is the last thing they need.
If you notice:
- New, stubborn acne along your jawline.
- Hair thinning or weird "peach fuzz" where it wasn't before.
- Your cycle suddenly getting wonky.
It might be time to put the bottle down.
👉 See also: High Protein in a Blood Test: What Most People Get Wrong
The Digestive "Glitch"
The most common ashwagandha side effects woman users report aren't actually hormonal—they’re in the gut.
The plant contains compounds that can irritate the lining of your intestines if you take it on an empty stomach. We're talking nausea, loose stools, or that "I need a bathroom now" feeling. It’s usually mild, but if you’re already sensitive to nightshades (like tomatoes or peppers), your gut might react even more strongly because ashwagandha is part of that same botanical family.
Why "Natural" Doesn't Always Mean Safe in Pregnancy
I have to be blunt here. If you are pregnant or trying to be, you should probably skip the ashwagandha.
Historically, in high doses, this herb was used in some cultures as an abortifacient (something that induces a miscarriage). While modern supplements aren't typically that potent, we just don't have the safety data. The German Federal Institute for Risk Assessment (BfR) recently warned in 2024 that pregnant and breastfeeding women should stay away because of potential impacts on fetal development and the lack of research on how it transfers into breast milk.
The Rare But Serious: Liver Safety
This is the one that scares people, and for good reason. Reports of liver injury—specifically "herb-induced liver injury"—have been ticking up as the supplement’s popularity exploded.
✨ Don't miss: How to take out IUD: What your doctor might not tell you about the process
A 2024 case study followed a 25-year-old woman who developed jaundice and severe itching just one month after starting ashwagandha. Her liver enzymes were through the roof. The good news? Her liver completely recovered about ten weeks after she stopped the supplement.
It’s rare, but it happens. If your skin or eyes start looking yellow, or if you’re suddenly itching like crazy for no reason, stop taking it immediately and see a doctor.
How to Navigate This (The Actionable Part)
If you’re still wanting to give it a go, don't just grab the cheapest bottle at the grocery store.
- Check your baseline: Get a quick blood panel for your thyroid (TSH, T4) and liver enzymes before you start. It gives you a "before" picture.
- The 3-Month Rule: Most clinical experts, including those at the NIH, suggest not taking it for more than three months at a time. Take a break. Let your HPA axis reset.
- Take it with food: Seriously. A little fat (like avocado or peanut butter) helps the fat-soluble withanolides absorb better and protects your stomach lining.
- Watch the "Emotional Blunting": Some women report feeling "meh" or "anhedonic" (unable to feel joy) after long-term use. If you feel like a robot, your dose is likely too high or you’ve been on it too long.
- Quality matters: Look for "KSM-66" or "Sensoril" on the label. These are standardized extracts used in actual clinical trials, so you at least know what’s in the capsule.
Ashwagandha is a powerful tool, but it's still a tool. Treat it with the same respect you'd give a prescription medication, and pay attention to what your body is trying to tell you.
Next Steps for Safety:
- Audit your current stack: Check if your "Stress Relief" multivitamin already contains ashwagandha to avoid accidental double-dosing.
- Schedule a 90-day reminder: If you start today, set a calendar alert for three months from now to evaluate if you actually still need it or if it's time for a "washout" period.
- Monitor your cycle: Keep a period tracking app updated; any shift in cycle length or flow after starting the herb is a signal to consult a professional.