Maca vs. Ashwagandha for Perimenopause: Which Is Right for You?

Two Popular Supplements, One Important Question

If you have been exploring natural support for perimenopause, maca and ashwagandha are two names that come up repeatedly. Both are plant-based supplements with a long history of traditional use. Both are marketed for hormonal balance, energy, and mood support. And both have some clinical research behind them.

But they work through different mechanisms, have different strengths, and suit different symptom patterns. Understanding what each actually does helps you make a more targeted choice and avoid taking supplements that are not suited to your specific situation.

What Is Maca?

Maca, or Lepidium meyenii, is a root vegetable native to the Andes mountains of Peru. It has been cultivated for thousands of years and used both as food and medicine. Maca is classified as an adaptogen and is also considered a glucosinolate-rich plant. Notably, maca does not contain plant hormones and is not considered estrogenic. It is thought to work by supporting the hypothalamus and pituitary gland, which regulate hormone production throughout the body.

For perimenopause, maca has been studied primarily for its effects on hot flashes, night sweats, energy, libido, and mood. Several small clinical trials have found that women taking maca reported reductions in hot flash frequency and improvements in mood and libido compared to placebo. The research base is modest but reasonably consistent for these outcomes.

What Is Ashwagandha?

Ashwagandha, or Withania somnifera, is a herb from the Ayurvedic tradition used for centuries in Indian herbal medicine. It is classified as a calming adaptogen, meaning its primary action tends toward reducing anxiety, lowering cortisol, and improving sleep rather than stimulating energy or affecting hormonal output directly.

For perimenopause, ashwagandha has been studied for its effects on stress, anxiety, cortisol levels, sleep quality, and thyroid function. Several clinical trials have found meaningful reductions in self-reported stress and anxiety, along with improvements in sleep quality. Some research also suggests it may support thyroid hormone levels, though women with thyroid conditions should discuss this with their provider before using it.

How Their Mechanisms Differ

Maca is thought to work through the endocrine system, supporting the body to regulate its own hormone production rather than providing hormones directly. It is non-estrogenic, which means it does not bind to estrogen receptors. Its effects on hot flashes and libido are believed to involve central nervous system pathways rather than direct hormonal activity.

Ashwagandha works primarily through the stress-response system, helping to regulate the hypothalamic-pituitary-adrenal axis and reduce the output of cortisol. When stress hormones are chronically elevated, as they often are during perimenopause due to sleep disruption and life demands, this regulatory effect can produce noticeable improvements in anxiety, sleep, and energy.

Which Symptoms Each Tends to Target

Maca tends to be the more relevant choice for women whose primary complaints include hot flashes, night sweats, low libido, low energy, or mood instability linked to hormonal fluctuation. It is also a reasonable option for women who want to avoid anything with estrogenic activity.

Ashwagandha tends to be the more relevant choice for women whose primary complaints are anxiety, a racing or restless mind, difficulty falling or staying asleep, chronic fatigue from stress, or that wired-but-exhausted feeling. If stress and anxiety are at the center of your symptom picture, ashwagandha addresses the root cause more directly than maca does.

What the Evidence Shows

Both supplements have clinical trial support, but the evidence for each is limited in size and scope. Most studies are short-term, use varied formulations, and involve relatively small numbers of participants. Neither has been studied in large-scale, long-term trials specifically in perimenopausal populations.

For maca, some of the most consistent findings are around hot flash reduction and libido improvement in menopausal and perimenopausal women. For ashwagandha, the most consistent findings are around stress, anxiety, and sleep. Claims that go beyond these areas should be held with appropriate caution. The research is preliminary and ongoing.

Safety Considerations

Maca is generally considered well tolerated and is often described as a food rather than a drug, given its nutritional composition. It does not have the hormone-sensitive contraindications that phytoestrogen-containing supplements carry. However, if you have a hormone-sensitive condition such as breast cancer, endometriosis, or uterine fibroids, discuss any new supplement with your healthcare provider before using it.

Ashwagandha may have mild thyroid-stimulating activity, so women with thyroid conditions should discuss it with their provider before use. If you take blood thinners, antidepressants, thyroid medication, or any prescription drugs, check with your provider before adding either supplement.

Can You Take Both?

Some women do use maca and ashwagandha together, as they target different aspects of the perimenopause experience. However, adding supplements one at a time and monitoring your response is a more practical approach. If you introduce two new supplements simultaneously and something changes, you will not know which one is responsible.

Starting with the supplement that most closely addresses your dominant symptoms is a sensible first step. A naturopath or integrative health practitioner can help you build a supplement plan that makes sense for your full picture.

Tracking Whether They Are Working

Because both supplements work gradually and symptoms naturally fluctuate during perimenopause, it can be genuinely difficult to tell whether a supplement is helping without a consistent baseline.

PeriPlan lets you log symptoms and track patterns over time. Tracking your hot flashes, sleep, energy, anxiety, and mood daily before and after starting a supplement gives you real data to assess whether something is actually shifting, rather than relying on general impressions.

Start with What Your Body Actually Needs

There is no universally better supplement between maca and ashwagandha. The better one is whichever matches your actual symptom pattern. If you are unsure, writing down your three most disruptive symptoms and then mapping those to the supplement profiles above is a useful starting point.

Neither supplement is a replacement for hormone therapy or medical care if your symptoms are significantly affecting your quality of life. You are allowed to ask for more than a supplement approach.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.