Ashwagandha and PCOS: Is It Helpful or Harmful?

Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions affecting women today, yet so many of us are left with more questions than answers when we’re first diagnosed. Doctors often recommend birth control, weight loss, or metformin—but those don’t always get to the root cause of our symptoms. That’s why so many Cysters turn to natural strategies to manage (and even reverse) their symptoms, like balancing blood sugar, managing stress, and using herbs to support their hormones.

One popular herb in the PCOS world? Ashwagandha. It’s best known for reducing stress and balancing cortisol, which can be super helpful for women with PCOS-related fatigue, anxiety, and insulin resistance.

But here’s the thing: ashwagandha isn’t the best herb for every Cyster. While it has some potential benefits, it can also increase testosterone levels, which could make symptoms like acne, hair thinning, and hirsutism (unwanted hair growth) worse instead of better.

So, should you add ashwagandha to your PCOS healing routine? Let’s break down the pros and cons so you can decide if it’s the right fit for you!

What Is Ashwagandha?

Ashwagandha (Withania somnifera) is an adaptogenic herb also known as Indian ginseng or winter cherry. It’s often used in Ayurvedic medicine, which is an Indian medical strategy that focuses on health and well-being. Ashwagandha is widely used because it includes SO many bioactive compounds that make it beneficial for a variety of ailments!

Here are some:

• Withanolides – Anti-inflammatory and anti-stress
• Alkaloids – Anti-inflammatory and pain-relief
• Saponins – Antioxidant and‌ immune system support
• Flavonoids – Antioxidant 
• Choline – Brain and nervous system support
• Tannins – Anti-inflammatory and antimicrobial 
• Iron – Energy and metabolic health

Is Ashwagandha Good For PCOS?

It depends. While ashwagandha can be helpful for some Cysters, it’s not the best fit for everyone.

Ashwagandha is best known for its ability to reduce stress and lower cortisol levels, which can be super beneficial if you struggle with adrenal fatigue, insulin resistance, or chronic inflammation—all of which are common in PCOS. Some research also suggests it may support thyroid function, which could be helpful for Cysters with thyroid-driven PCOS.

However, there’s a big catch—ashwagandha may also increase testosterone levels in some women, which can make symptoms like acne, hair loss, and hirsutism (unwanted hair growth) worse instead of better. Since many women with PCOS already have elevated androgens, this is something to keep in mind before adding ashwagandha to your routine.

So, is ashwagandha good for PCOS? It depends on your unique hormone profile! If stress is your biggest trigger, it might be a helpful tool. But if you’re already dealing with high testosterone, you may want to try other PCOS-friendly herbs instead.

What Are The Benefits Of Pros and Cons Ashwagandha For PCOS?

Pro: Reduces Stress Levels 

Stress is more than just a feeling—chronic stress levels are a huge driver of PCOS symptoms. When you’re constantly dealing with high cortisol levels, it can lead to blood sugar spikes, insulin resistance, poor sleep, digestive issues, and even worsened hormonal imbalances. That’s why managing stress isn’t just about feeling better—it’s essential for healing PCOS at the root.

This is where ashwagandha shines! It’s an adaptogen, meaning it helps the body adapt to stress by balancing the HPA (hypothalamic-pituitary-adrenal) axis, which controls your stress response. Studies show that ashwagandha can lower cortisol levels, support serotonin and GABA activity (your brain’s “calm and happy” chemicals), and promote relaxation—all of which can help with anxiety, mood swings, and better sleep.

If you struggle with adrenal-driven PCOS, chronic stress, or burnout, ashwagandha might be a helpful addition to your routine. Just keep in mind that lowering stress is only one piece of the puzzle—supporting blood sugar balance, eating nourishing meals, and getting gentle movement in all work together to bring your hormones back into balance!

Con: Increases Testosterone Levels

One of the biggest hormone imbalances in PCOS is elevated androgens (male hormones like testosterone), which can lead to frustrating symptoms like irregular cycles, acne, hair loss, and hirsutism (unwanted hair growth on the face and body). While some herbs are great for naturally lowering androgens, ashwagandha might actually do the opposite.

Most studies on ashwagandha’s effects on testosterone have been done on men, where it’s been shown to significantly increase testosterone levels. While there’s little research confirming this effect in women, it’s something to keep in mind—especially if you have PCOS, since our hormone levels tend to be extra sensitive.

If you already struggle with high androgens, adding ashwagandha to your routine could potentially make symptoms like acne, hair loss, and irregular cycles worse. That being said, hormone balance is complex, and every body reacts differently! If you’re considering ashwagandha, it’s a good idea to track your symptoms and listen to your body to see how it affects you. And if lowering testosterone is your goal, herbs like spearmint may be more beneficial options.

Pro: Regulates Thyroid Hormones 

Hypothyroidism is really common with PCOS, and about 25-40% of women with PCOS have some kind of thyroid dysfunction. Basically, it’s when your thyroid glands don’t produce enough T3 and T4 hormones to support metabolism, energy, and other essential body functions. It’s another contributor to PCOS fatigue, weight gain, hair loss, mood issues, and more. 

The withanolides in ashwagandha have been shown to stimulate the production of T3 and T4! And the anti-inflammatory and antioxidant properties of ashwagandha can protect the thyroid cells from autoimmune and oxidative stress damage, supporting overall thyroid health! If you have hypothyroidism, Hashimoto’s, or other thyroid-related health conditions, be sure to talk to your doctor first if you’re interested in ashwagandha, as it may interfere with your medications.

Con: May Interfere with Medications

If you take medication for PCOS-related issues like insulin resistance, thyroid dysfunction, or high blood pressure, you’ll want to be extra cautious with ashwagandha. This herb can interact with several common medications, potentially altering their effects or making them too strong.

• Insulin Resistance & Diabetes Medications: Ashwagandha may lower blood sugar levels, which could enhance the effects of medications like metformin or other diabetes drugs. While this might sound beneficial, it can actually lead to blood sugar dropping too low (hypoglycemia), causing dizziness, fatigue, and shakiness.

• Thyroid Medications: As mentioned earlier, some research suggests ashwagandha can stimulate thyroid hormone production, which could interfere with medications for hypothyroidism (like levothyroxine). If you have thyroid PCOS, this could be especially important to monitor.

• Blood Pressure Medications: Some research suggests that ashwagandha can lower blood pressure. So taking it alongside blood pressure-lowering medications could cause levels to drop too low, leading to dizziness, fainting, or weakness.

Because PCOS is a condition that already affects multiple systems in the body, adding a new supplement like ashwagandha should always be done with caution. If you’re currently on medication, it’s best to consult your doctor before adding ashwagandha to your routine to ensure it won’t interfere with your treatment plan.

Pro: Improves Sleep

Getting enough sleep isn’t just about feeling rested—it’s essential for hormone balance, metabolism, and overall health. But if you have PCOS, you’ve probably noticed that quality sleep can feel impossible. Women with PCOS are more likely to struggle with insomnia, restless sleep, and even sleep apnea due to hormone imbalances, high cortisol levels, and blood sugar fluctuations. And when sleep is off? Everything gets worse. Poor sleep can worsen insulin resistance, increase inflammation, and throw hormones even further out of balance.

Building a solid nighttime routine is key—things like setting a consistent bedtime, getting natural sunlight during the day, and avoiding blue light before bed all help. But if you need extra support, ashwagandha may help! This adaptogenic herb not only lowers stress, can also promote relaxation for more restful sleep. Although ashwaganda is not part of my own sleep routine, I wanted to share this information in case it is helpful for your routine.

How To Take Ashwagandha For PCOS

Although I don’t take ashwagandha myself, if you’re considering adding ashwagandha to your routine, I can’t stress enough how important it is to find a high-quality, third-party tested supplement to ensure purity and potency. Most studies on ashwagandha use doses between 300-600 mg per day, but the right amount can vary based on individual needs.

Because ashwagandha can interact with medications and affect hormone levels, it’s best to check with your doctor before adding it to your routine—especially if you’re managing PCOS-related conditions like insulin resistance, thyroid imbalances, or high cortisol.

Ashwagandha is not for everyone, so be your own best health advocate!

Remember that there is no magic pill or herb to get rid of our PCOS symptoms. But also remember that everyone’s PCOS journey is different (it isn’t one-size-fits-all!) However, by trusting the process, listening to your body, and doing the research, it is possible to find the lifestyle that works uniquely for your PCOS body in order to manage (and even reverse) your symptoms. When combined with the right nutrition, slow weighted workouts, high-quality supplements, and stress management…herbs can also be helpful for your PCOS journey! We’re here to help you every step of the way.

You can find more resources and support on The Cysterhood app. Download it today to get everything you need to start thriving with PCOS!