Many Indian women grow up with Ayurveda at home – a turmeric-milk remedy from a grandmother, a churna from the family vaidya. So it is natural, when perimenopause or menopause arrives, to wonder what Ayurveda can offer. At NuHer, Ayurveda is part of our care, but always alongside modern menopause medicine, never instead of it.
This page explains how Ayurveda sees this stage of life, what the research honestly shows about commonly used herbs, how to stay safe, and how Dr Deepa Apte works with our gynaecologists and menopause specialists.
Rajonivritti: how Ayurveda sees menopause
In Ayurveda, menopause is called Rajonivritti, which means the end of menstruation. The classical texts describe it as a natural phase of life rather than a disease, and Sushruta and other authorities give about 50 years as its usual age.
Ayurveda links many menopausal symptoms to an imbalance of the doshas as the body ages. Aggravated Vata, often together with disturbed Pitta, is associated with hot flushes, sweating, poor sleep, irritability and vaginal dryness. Care therefore focuses on calming and nourishing the body through:
- Ahara (diet) – regular, warm, freshly cooked meals and foods that suit your constitution and digestion
- Vihara (lifestyle) – a steady daily routine, enough rest and gentle movement
- Yoga, breathing and mindfulness – to support sleep, stress and mood
- Rasayana and herbal therapies – rejuvenating herbs and formulations, chosen for the individual
This way of looking at the whole woman – her sleep, digestion, stress and routine, not only her hormones – sits comfortably with good modern menopause care, which also pays attention to lifestyle, nutrition and emotional wellbeing.
What the research says about common herbs
It is important to be honest: research on Ayurvedic herbs for menopause is still limited. Most studies are small and short, use different preparations and doses, and some are open-label (both doctor and patient know what is being taken). Results from one product cannot be assumed for another.
Ashwagandha (Withania somnifera)
Of the herbs discussed here, ashwagandha has the strongest trial so far. In an 8-week randomised, placebo-controlled trial in India, 100 perimenopausal women with mild to moderate symptoms took either 300 mg of an ashwagandha root extract twice daily or a placebo. Women taking ashwagandha had greater improvement in menopause symptom scores and quality of life than those on placebo. This is encouraging, but it is a single, short study of one specific extract.
The US National Center for Complementary and Integrative Health (NCCIH) concludes that there is not yet enough evidence to say whether ashwagandha helps menopause, that short-term use of up to about three months may be safe, and that long-term safety is not well known.
Shatavari (Asparagus racemosus)
Shatavari is traditionally used as a tonic for women's health at every stage of life. A few small clinical studies, often of combination products, suggest it may ease some menopausal symptoms, but good-quality randomised trials are lacking. For now, its benefit for menopause is not proven.
Classical combinations
Ayurvedic physicians often use formulations that combine several herbs. A small open trial from Gujarat Ayurved University, for example, reported improvement in menopausal symptoms in women taking a combination including Ashokarishta and ashwagandha. Studies like this are a starting point, but because there was no placebo group, they cannot tell us how much of the benefit came from the treatment itself.
Safety first
"Natural" does not always mean safe. Herbs are active substances, and some precautions matter:
- Interactions with medicines – ashwagandha may interact with medicines for diabetes, blood pressure, thyroid conditions, seizures and sleep, and with immunosuppressants. Always tell your doctor about every herb and supplement you take, and tell your vaidya about your prescribed medicines.
- Liver safety – liver injury from ashwagandha is rare, but cases have been reported; in one published case series, problems appeared between 2 and 12 weeks after starting. Stop and see a doctor if you notice yellow eyes or skin, dark urine, severe itching or tummy pain.
- Thyroid and autoimmune conditions – NCCIH does not recommend ashwagandha for people with thyroid or autoimmune disorders, and it may interact with thyroid medicines.
- Quality and heavy metals – a US study of Ayurvedic medicines bought online found that about one in five contained detectable lead, mercury or arsenic. Products that deliberately include metals or minerals (rasa shastra preparations) were more likely to contain them. Choose products from licensed manufacturers with clear labels and batch details, and avoid unlabelled powders.
- Pregnancy and breastfeeding – avoid ashwagandha. Remember that pregnancy is still possible in perimenopause.
- Surgery and cancer – tell your surgeon about any herbs before a planned operation (NCCIH advises not taking ashwagandha before surgery), and if you have had a hormone-sensitive cancer, speak to your specialist before taking any herb or supplement.
Ayurveda alongside modern menopause care
For many women, hormone replacement therapy (HRT) is the most effective treatment for hot flushes and night sweats, and it also helps protect bones. Ayurveda is not a replacement for HRT when HRT is the right choice for you. Equally, not every woman wants or can take hormones, and some prefer to begin with lifestyle and herbal support. At NuHer, you do not have to choose one world or the other.
About Dr Deepa Apte
Dr Deepa Apte is a consultant medical doctor and Ayurvedic physician with more than 20 years of clinical and teaching experience. She holds an MBBS, a postgraduate qualification in gastroenterology and a BAMS, all from KMC Warangal. Because she is trained in both modern medicine and Ayurveda, she combines Ayurvedic principles with evidence-informed lifestyle medicine – nutrition, herbal therapies, yoga and mindfulness. She also trains healthcare professionals internationally in Ayurvedic practice.
How integrative care works at NuHer
- A medical assessment first. One of our gynaecologists or menopause specialists, such as Dr Priyanka Mehta, looks at your symptoms, history and any risks, and explains your treatment options, including HRT or body-identical hormones where suitable.
- An Ayurvedic consultation. Dr Apte looks at your digestion, sleep, energy, stress and daily routine, and suggests diet, lifestyle, yoga and, where appropriate, herbal support.
- One joined-up plan. Any herbs are checked against your other medicines and your health history, so that everything you take works together safely.
- Review and adjust. Your doctors follow up to see what is helping. If symptoms are not improving, other treatments are discussed openly.
Our clinical dietitian and counsellors can also be part of your plan. You can see us at our Nariman Point clinic or by video consultation across India.
Questions women ask
Can Ayurveda cure menopause?
Menopause is not an illness to be cured; it is a natural stage of life. Ayurveda may help some women feel better through diet, routine, yoga and herbs, but the evidence for specific herbs is limited. The aim is to ease symptoms and support your long-term health.
Is ashwagandha good for menopause?
One well-designed but small trial found that a specific ashwagandha root extract eased perimenopausal symptoms over eight weeks. That is promising, but not yet proof. It is not suitable for everyone, so check with a doctor first, especially if you take other medicines or have a thyroid or liver condition.
Can I take Ayurvedic medicines with HRT?
Often, yes, but only after your doctors have checked the combination. Tell both your gynaecologist and your Ayurvedic physician about everything you take.
Is Ayurveda safer than HRT?
Not automatically. Both have benefits and risks. Herbs can interact with medicines, affect the liver or be contaminated if poorly made. For most healthy women under 60, or within 10 years of their last period, the benefits of HRT for troublesome symptoms generally outweigh the risks. Your doctor will help you weigh this up for you personally.
How do I start?
Take our free menopause test to understand your symptoms, then book a consultation.
References
- Modi MB, Donga SB, Dei L. Clinical evaluation of Ashokarishta, Ashwagandha Churna and Praval Pishti in the management of menopausal syndrome. Ayu. 2012;33(4):511–516. https://pmc.ncbi.nlm.nih.gov/articles/PMC3665193/
- Gopal S, Ajgaonkar A, Kanchi P, Kaundinya A, Thakare V, Chauhan S, Langade D. Effect of an ashwagandha (Withania somnifera) root extract on climacteric symptoms in women during perimenopause: a randomized, double-blind, placebo-controlled study. J Obstet Gynaecol Res. 2021;47(12). https://pubmed.ncbi.nlm.nih.gov/34553463/
- National Center for Complementary and Integrative Health (NCCIH). Ashwagandha. Updated March 2023. https://www.nccih.nih.gov/health/ashwagandha
- Björnsson HK, Björnsson ES, Avula B, et al. Ashwagandha-induced liver injury: a case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020;40(4). https://pubmed.ncbi.nlm.nih.gov/31991029/
- Saper RB, et al. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet. JAMA. 2008;300(8):915–923. https://pubmed.ncbi.nlm.nih.gov/18728265/
- The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7). https://pubmed.ncbi.nlm.nih.gov/35797481/
