Adaptogens for Women (ashwagandha, rhodiola, maca): which to choose and when

Polish women aged 30–55 are the group that most often turns to adaptogens – and for good reason. Chronic stress, hormonal fluctuations during perimenopause, decreased libido, adrenal fatigue, and sleep problems are compounding challenges that conventional pharmacology only partially addresses. A study by Skopińska-Różewska et al. (2018) showed improvements in mood and energy in women during perimenopause with 12 weeks of rhodiola supplementation. But which adaptogen is right for a specific woman with a specific issue? This article compares the three main adaptogens for women – ashwagandha, rhodiola, and maca – in terms of hormonal effects, safety, and practical usage protocols.

KEY INFORMATION
• The study by Chandrasekhar et al. (IJPM, 2012) showed a 27.9% reduction in cortisol in women and men taking KSM-66 600 mg/d for 60 days – one of the largest cortisol effects confirmed by RCT.
• Maca (Lepidium meyenii) improves libido in postmenopausal women without directly affecting estrogen – acting through modulation of the central nervous system (Gonzales et al., 2008).
• Ashwagandha is contraindicated during pregnancy (oxytocin-like effects) – other adaptogens require medical consultation during pregnancy.
• Adaptogens do not replace hormone replacement therapy for severe menopausal symptoms but can be a valuable complement.

Ashwagandha for Women – Cortisol, Sleep, and Hormones

Ashwagandha is the first choice adaptogen for chronic stress and sleep disorders in women. Its effect on the HPA axis (cortisol reduction) and GABA-mimetic properties address two of the most common issues for women aged 30–50: elevated cortisol and reduced sleep quality.

Chandrasekhar et al. (Indian Journal of Psychological Medicine, 2012) demonstrated a 27.9% reduction in cortisol after 60 days of KSM-66 600 mg/d. The study by Langade et al. (Cureus, 2019) confirmed a 34% reduction in sleep onset time and an 8.9% increase in sleep duration with 300 mg × 2/d for 10 weeks. Both trials included both women and men, with no significant differences between genders in response to supplementation.

The impact of ashwagandha on hormones in women is subtle and indirect: by reducing cortisol, it decreases the suppression of the gonadotropic axis due to stress. Chronic stress elevates cortisol, which inhibits GnRH, LH, and FSH, disrupting menstrual cycle regularity. Normalizing cortisol through ashwagandha may indirectly improve cycle regularity in women with irregular cycles due to stress.

Ashwagandha and Thyroid in Women: Hashimoto's (autoimmune thyroiditis) affects women significantly more than men. Ashwagandha may stimulate thyroid function (increasing T3 and T4) – which in the case of hypothyroidism with Hashimoto's requires strict monitoring of TSH and thyroid hormones. In treated hypothyroidism with levothyroxine, the use of ashwagandha requires endocrinological consultation and may necessitate adjustment of the levothyroxine dose.

Ashwagandha in Perimenopause: Cortisol naturally increases during perimenopause alongside a decrease in estrogen. Ashwagandha may alleviate the severity of stress symptoms and improve sleep – without directly affecting estrogen. It is not an alternative to HRT (hormone replacement therapy) for severe episodic symptoms but may reduce the intensity of stress and sleep disturbances associated with perimenopause.

Dosage of ashwagandha for women: 300–600 mg/d of KSM-66 extract or 250–500 mg/d of Sensoril. Women with sensitive hormones should start with lower doses (300 mg/d of KSM-66) and assess effects for 4 weeks before increasing. Most clinical studies show no significant differences in response to ashwagandha between women and men at the same doses.

Rhodiola for Women – Energy, Mood, and Menopausal Symptoms

Rhodiola rosea (roseroot) is an adaptogen with a different action profile than ashwagandha. While ashwagandha is "calming" and normalizes cortisol, rhodiola is "energizing" – primarily acting on the monoaminergic system, increasing the availability of serotonin, dopamine, and norepinephrine. This makes it the first choice for physical fatigue, low mood, and brain fog.

Olsson et al. (Planta Medica, 2009) in a study with 60 patients with chronic fatigue showed significant improvement in fatigue (Multidimensional Fatigue Inventory), attention, and quality of life after 28 days of SHR-5 576 mg/d. Effects on fatigue appeared within a week of use.

For women in perimenopause, data regarding mood and depression are particularly interesting. Skopińska-Różewska et al. (Archives of Medical Science, 2018) in a study with women in perimenopause using SHR-5 200 mg/d for 12 weeks showed improvements in mood, energy, and a reduction in depressive symptoms. Rhodiola is not an antidepressant in the clinical sense, but its action on monoamines may be a valuable complement for mild affective symptoms of menopause.

Rhodiola and Anxiety: Bystritsky et al. (Journal of Alternative and Complementary Medicine, 2008) studied rhodiola in patients with generalized anxiety disorder (GAD) at a dose of 340 mg/d for 10 weeks. Results: significant improvement on the HAM-A scale (Hamilton Anxiety Rating Scale) by 37%. This is particularly relevant for women, for whom anxiety is a common component of perimenopausal and postmenopausal symptoms.

Our Observations: Women who have tried both ashwagandha and rhodiola often describe a clear difference in their effects: ashwagandha is like a "warm blanket" – it calms, facilitates falling asleep, and reduces emotional reactivity to stressors. Rhodiola is like "clean fuel" – it provides energy without caffeine-induced stimulation, but without calming effects. The optimal combination for many women is rhodiola in the morning (energy and mood) and ashwagandha in the evening (cortisol and sleep) – these two adaptogens complement each other rather than compete.

Maca for Women – Libido, Energy, and Hormones in Perimenopause

Maca (Lepidium meyenii) is a plant from the Peruvian Andes grown at altitudes of 4000–4500 m above sea level. It is not an adaptogen in the strict biochemical sense (it does not primarily act through the HPA axis), but it exhibits broad toning and aphrodisiac effects. Its unique feature is the improvement of libido without directly affecting estrogen or testosterone.

Gonzales et al. (Menopause, 2008) conducted a systematic review of 3 RCTs regarding maca and libido in women. The meta-analysis showed a significant improvement in sexual function (SSRI-induced sexual dysfunction and natural) with the use of maca 3–3.5 g/d. – the effects were independent of estrogen and testosterone levels, confirming that maca works through mechanisms other than hormonal (maca alkaloids, macamides).

Maca and menopause: a study by Brooks et al. (Gynecological Endocrinology, 2008) involving 14 postmenopausal women showed that maca reduced the severity of hot flashes and night sweats. No changes were observed in estrogen, progesterone, or FSH levels – which is clinically important: maca is not a phytoestrogen and does not carry the same risks as estrogen-like supplements (e.g., soy isoflavones) in estrogen-sensitive breast cancer.

Maca and energy and endurance: Maca alkaloids may stimulate energy production through mechanisms unrelated to ATP (unlike cordyceps). Several studies in cyclists showed improved ride times and endurance with 14 days of supplementation. For women with chronic fatigue, maca can be a valuable addition – especially when fatigue is related to hormones and the menstrual cycle.

Maca dosage: 1.5–3.5 g/d of dried root powder (gelatinized maca – cooked/processed form better tolerated by the stomach). Effects on libido appear after 6–12 weeks. Maca has a mild, earthy, caramel flavor – it mixes well with cocoa, smoothies, and coffee. In cases of PCOS or endometriosis, the use of maca requires consultation with a gynecologist due to its potential impact on androgens (though there is a lack of conclusive clinical data). Maca is considered safe in hormone-sensitive breast cancer, as it does not exhibit direct estrogenic activity.

Which adaptogen to choose – a selection protocol for women

The answer is not "one size fits all" – it depends on the dominant symptoms and goals. The following protocol helps choose a starting point.

If stress and sleep are the priority: Start with ashwagandha KSM-66 300–600 mg/d in the evening. After 6 weeks, evaluate the effects. If stress is strong and accompanied by sleep disturbances – ashwagandha is the best choice, and there is no need to add other adaptogens at the beginning.

If energy and mood are the priority: Start with rhodiola SHR-5 200–400 mg/d, in the morning. Rhodiola acts faster (effects after 1–2 weeks) and is a better first choice for "flat energy" and low mood without clear sleep disorders.

If libido or perimenopausal symptoms are the priority: Maca 1.5–3 g/d as a starting point, possibly combined with ashwagandha if stress is present. Maca is safe even in hormone-sensitive breast cancer – it does not act estrogenically.

Optimal combination for a woman aged 40–55 in perimenopause: Rhodiola 200–400 mg in the morning + ashwagandha 300 mg in the evening. After 8 weeks – optional addition of maca 1.5 g/d if support for libido and energy is needed. Do not use all three adaptogens simultaneously from the start.

Adaptogens and the menstrual cycle – when and how to use them

The menstrual cycle creates a natural hormonal rhythm that can affect the body's response to adaptogens – and vice versa. Here are some practical tips for women using adaptogens regularly throughout the month.

Follicular phase (days 1–14, from menstruation to ovulation): Estrogen rises, and mood naturally improves. Rhodiola in the morning is particularly a good choice in this phase – it synergizes with the naturally higher energy and can improve physical and mental performance. Ashwagandha can be used in the evening throughout the cycle without special modifications.

Ovulatory phase (around days 14–16): Peak estrogen and LH. Libido naturally increases. Regular use of maca may enhance this peak and improve the subjective feeling of sexual energy. When planning a pregnancy – do not use ashwagandha (potential impact on fertility through hormonal stimulation requires consultation).

Luteal phase (days 15–28, after ovulation): Progesterone dominates, mood may decline, PMS may be present. Ashwagandha shows particular value in this phase – cortisol reduction alleviates typical PMS symptoms (irritability, anxiety, mood swings). Rhodiola may help with fatigue and brain fog before menstruation.

Menstruation (days 1–5): There is no need to interrupt the use of adaptogens. In case of severe cramps – there is no evidence that ashwagandha, rhodiola, or maca exacerbate cramps at therapeutic doses (a different situation than with high doses of ashwagandha reserved for labor trials).

Practical advice: if you are using adaptogens for the first time and are a woman with sensitive hormones or an irregular cycle – keep a cycle diary for the first 3 months. Note the length of the cycle, the severity of PMS, sleep quality, and energy. This will help assess whether the adaptogen is helpful and whether it disrupts the hormonal rhythm.

Adaptogens and PCOS and endometriosis

Two of the most common gynecological conditions – PCOS (polycystic ovary syndrome) and endometriosis – affect approximately 15–20% of women of reproductive age. Both conditions are associated with hormonal disorders, inflammation, and chronic stress. Can adaptogens help?

In PCOS: insulin resistance and hyperandrogenism (excess androgens) are key features. Ashwagandha may gently lower insulin resistance and reduce cortisol (which exacerbates hyperandrogenism under stress). However, there are no RCTs specifically in women with PCOS. Maca – controversies: some sources suggest that maca may exacerbate hyperandrogenism due to its impact on androgens in women with PCOS. There is a lack of clinical evidence confirming or excluding this risk. In PCOS, a gynecological-endocrinological consultation is mandatory before using any adaptogens that affect hormones.

In endometriosis: inflammation and estrogen-dependent growth of ectopic tissue are key factors. Maca – because it is not a phytoestrogen and does not directly stimulate estrogen receptors, it is potentially safer than soy isoflavones. Ashwagandha and rhodiola – due to their anti-inflammatory effects and cortisol reduction, may alleviate chronic pain and fatigue associated with endometriosis. Supplementation with adaptogens in endometriosis should be agreed upon with the attending gynecologist.

Safety of adaptogens for women – specific issues

Women have several specific risk factors when using adaptogens that do not apply to men or apply to them to a lesser extent.

Pregnancy: Ashwagandha is absolutely contraindicated. Maca – insufficient RCT data; during pregnancy, avoid supplements, use only as food (traditional Ayurvedic amounts). Rhodiola – insufficient data; caution is recommended. During pregnancy, any herbal supplements require obstetric-gynecological consultation.

Breastfeeding: There is no clinical data on the safety of any of the three adaptogens during breastfeeding. The active compounds of adaptogens may pass into breast milk to an undetermined extent. The principle of caution: avoid adaptogen supplementation while breastfeeding until sufficient safety data is available.

Hashimoto / thyroid disorders: Ashwagandha may exacerbate symptoms of hyperthyroidism or interfere with levothyroxine. Women with Hashimoto should use ashwagandha only under the supervision of an endocrinologist. Rhodiola and maca have no documented interactions with the thyroid.

Hormonal medications (HRT, contraception): None of the three adaptogens show documented clinically significant interactions with HRT or hormonal contraceptives. As a precaution – inform your gynecologist when using adaptogens during HRT, as effects on cortisol and hormones may slightly modify the response to hormonal therapy.

Also read about the properties of rhodiola for stress and fatigue.

Frequently Asked Questions

Which adaptogen is best for women for stress and cortisol?

Ashwagandha (KSM-66) is the most researched adaptogen for cortisol reduction. Chandrasekhar et al. (IJPM, 2012) demonstrated a 27.9% reduction in cortisol after 60 days of 600 mg/day. Rhodiola is better for acute stress and physical fatigue; ashwagandha is better for chronic stress with hypercortisolism and sleep disorders.

Does rhodiola help with depression in menopausal women?

Studies indicate the potential antidepressant effect of rhodiola through modulation of serotonin, dopamine, and norepinephrine. Skopińska-Różewska et al. (2018) showed improvement in mood and energy in perimenopausal women with SHR-5 200 mg/day. This effect does not replace psychiatric therapy but may support mild affective symptoms of menopause.

How does maca affect libido and hormones in women?

Maca (Lepidium meyenii) improves libido in women without directly affecting estrogen or testosterone. Gonzales et al. (Menopause, 2008) in a meta-analysis of 3 studies showed improved libido in postmenopausal women with maca 3–3.5 g/day. It works through alkaloids (macamides, macaenes) that modulate the central nervous system.

Are adaptogens safe during pregnancy?

Ashwagandha is contraindicated in pregnancy due to the oxytocin-like effects of withaferin A. For maca and rhodiola, there is insufficient safety data from RCTs in pregnancy – caution and consultation with a gynecologist are recommended before using any adaptogens during pregnancy.

When to take adaptogens during the menstrual cycle?

There is no need to interrupt the use of adaptogens at a specific phase of the cycle. For PMS, rhodiola and ashwagandha may alleviate irritability and fatigue in the luteal phase. Continuous use of maca shows more even effects on libido. In cases of endometriosis or PCOS, a gynecologist's consultation is mandatory.

How to combine adaptogens for women?

Safe combination: ashwagandha in the evening (cortisol, sleep) and rhodiola in the morning (energy, mood). Maca can be added after 8 weeks if support for libido is needed. Do not combine rhodiola with SSRI/SNRI medications without consulting a doctor due to potential serotoninergic effects.

This article is for informational and educational purposes and does not replace consultation with a doctor. If you are pregnant, breastfeeding, taking medications, or have chronic conditions, consult the use of supplements or herbs with a specialist.

Author: Michał Waluk · Published: 2026-05-04 · Updated: 2026-05-04