Ashwagandha (KSM‑66®) & the Menopause Transition Bridge Method™

The menopause transition is not a sudden event but a gradual biological shift that unfolds over several years. Menopausal hormone therapy (MHT) is often prescribed for the management of menopausal symptoms in women under 60 years of age or within 10 years of menopause without contraindications. Antidepressant medications are often co-prescribed with MHT for mood and symptom relief.

Supporting women through this transition involves addressing symptoms while also helping the body adapt to the underlying hormonal changes. One natural medicine gaining attention in clinical research is Ashwagandha (Withania somnifera), particularly a standardised root extract known as KSM‑66®.

Understanding menopausal symptoms

During menopause, declining ovarian function leads to changes in hormones such as oestrogen and progesterone. These changes can contribute to a range of symptoms affecting both physical and emotional wellbeing.

Common symptoms include:
•     Hot flushes and night sweats
•     Sleep disturbance
•     Anxiety or mood changes
•     Fatigue and reduced resilience to stress
•     Muscle or joint discomfort
•     Vaginal dryness and changes in libido

Within the Menopause Transition Bridge Method™, these symptoms are viewed as signals from the body that the underlying hormonal landscape is shifting. Addressing both symptoms and the biological drivers behind them
forms an important part of supporting women across the menopause transition.

What the Ashwagandha research shows

A recent randomised, double‑blind, placebo‑controlled clinical study investigated the effects of Ashwagandha root extract on menopausal symptoms.

The study included 60 women aged between 45 and 55 years who were experiencing menopausal symptoms. Participants were followed for eight weeks (56 days). Women in the treatment group took 300mg of Ashwagandha root extract (KSM‑66®) twice daily, while the control group received a placebo.

Researchers measured outcomes using the Menopause Rating Scale, a validated tool that evaluates three domains of menopausal symptoms:

• Psychological symptoms – anxiety, irritability, mood changes and difficulty concentrating

• Somatic symptoms – hot flushes, sweating, sleep problems and musculoskeletal discomfort

• Urogenital symptoms – vaginal dryness, bladder issues and changes in libido

After eight weeks, women taking Ashwagandha experienced a significant reduction in overall symptom scores compared with the placebo group. Many participants also reported fewer hot flush episodes, improvements in sleep and mood and better overall quality of life.

In earlier clinical work, some women began noticing improvements in symptoms such as hot flushes and mood within approximately four weeks, with further improvement by eight weeks.

Effects on hormone balance

An important aspect of the study was the evaluation of hormonal markers associated with menopause.

Women taking Ashwagandha showed:
•     Increased oestradiol levels
•     Increased progesterone levels
•     Reduced follicle‑stimulating hormone (FSH)
•     Reduced luteinising hormone (LH)

Within the Menopause Transition Bridge Method™, these findings are particularly relevant because rising FSH and LH are characteristic hormonal changes of menopause. Improvements in these markers suggest Ashwagandha may support a more balanced hormonal environment during the menopause transition.

How Ashwagandha may work

Ashwagandha is traditionally classified as an adaptogenic herb. Adaptogens help the body regulate its response to stress and support overall resilience.

Researchers suggest several mechanisms that may contribute to its benefits during menopause:

•      Regulation of the hypothalamic‑pituitary‑adrenal (HPA) stress axis
•     Support for mood and sleep through GABA‑related pathways
•     Anti‑inflammatory and antioxidant activity
•     Improved resilience to physical and emotional stress

These mechanisms align well with the Menopause Transition Bridge Method™, which emphasises supporting multiple interconnected systems during this stage of life rather than focusing on a single symptom.

Safety & tolerability

Ashwagandha was well tolerated in the clinical study where more than 90% of participants reported good to excellent tolerability and only mild unrelated adverse events were recorded.

A natural tool within a broader menopause strategy

Within the Menopause Transition Bridge Method™, herbal medicines such as Ashwagandha may play a role in supporting the body through hormonal change while improving resilience to stress, sleep disturbance and mood changes.

Referenced from:

Vani I, Muralidhar G, Rao BS. (2026). A prospective, randomized, double‑blind, placebo‑controlled study on efficacy and safety of Ashwagandha root extract (Withania somnifera) for managing menopausal symptoms in women. Frontiers in Reproductive Health.