A new placebo-controlled trial backs ashwagandha’s sleep and menopause claims with data
STUDY: Obhrai S et al, Menopause 2027
STUDY TYPE: Randomized, double-blind, placebo-controlled trial
FUNDING: Sandu Pharmaceuticals Ltd. (India); tablets only
Background
Menopause brings disrupted sleep, fat gain, and psychological symptoms together, tied to shared hormonal pathways. Hormone therapy addresses all three but carries cardiovascular and cancer concerns. Ashwagandha, an Ayurvedic adaptogen, was tested here as a multi-symptom alternative.
The Study
- 66 postmenopausal women (ages 45-65) in India; 63 completed 12 weeks (33 ashwagandha, 30 placebo).
- Randomized to ashwagandha root extract, 600 mg/day, or identical placebo, taken nightly.
- Primary outcomes: sleep quality (Sleep scale (PSQI)), menopausal symptoms (Menopause Rating Scale), and body fat by DXA.
Results
Sleep quality improved far more with ashwagandha: PSQI scores fell 5.0 points versus 0.6 with placebo (P < 0.001, r = 0.80); poor sleepers dropped from 82% to 12%.
Menopausal symptoms fell 8.2 points versus 1.1 (P < 0.001, r = 0.78), past the threshold for clinical meaning. Body fat dropped 0.6% with ashwagandha while placebo patients gained slightly (P < 0.001, r = 0.63). Quality of life improved broadly; bone density didn’t differ.
Side Effects
No adverse events in either group, and no one stopped treatment. Monthly liver, kidney, thyroid, and blood counts showed nothing concerning.
Limitations
Small, single-center trial (63 completers) with three co-primary outcomes and no correction for multiple comparisons; 12 weeks is too short to judge bone effects.
Practice Implications
These gains are large, with a clean safety profile over 12 weeks. For a patient wanting an alternative to hormone therapy or an SSRI for menopausal sleep and mood symptoms, a standardized ashwagandha extract at 600 mg nightly is reasonable to suggest, with the caveat that this is one small trial awaiting confirmation. Check liver, kidney, and thyroid function periodically if a patient stays on it long-term.
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
