Maca Root for Perimenopause: What It Actually Does and How to Use It

What Maca Is and Why It Gets So Much Attention

Maca (Lepidium meyenii) is a root vegetable that grows in the high Andes of Peru, typically at altitudes above 13,000 feet. It has been cultivated and used as food and medicine by Andean communities for thousands of years. In recent decades it has found a large audience in Western wellness communities, particularly among women navigating perimenopause.

The interest is legitimate. Maca is a well-documented adaptogen with a meaningful body of research behind it, particularly for libido and mood. But the marketing has also outpaced the evidence in some areas, so it is worth being precise about what maca actually does and what it does not do.

Maca Is Not a Hormone and Does Not Raise Estrogen

The most important thing to understand about maca is how it does not work. It is not a phytoestrogen. It does not contain plant compounds that mimic estrogen, and multiple studies have confirmed that it does not raise estrogen levels in the blood.

Maca's active compounds, called macamides and glucosinolates, work through different pathways. Macamides appear to influence the endocrine system by supporting the hypothalamus and pituitary gland, the master regulators that tell your ovaries, adrenal glands, and other glands what to produce. Rather than adding hormones to the system, maca appears to support the system that regulates hormone production.

This distinction matters for two reasons. It means maca is not a substitute for hormonal therapy if your symptoms are driven by hormone deficiency. And it means women who are cautious about anything with estrogenic properties do not need to be concerned about maca on that basis.

The Best Evidence: Libido and Sexual Function

This is where maca has the strongest research support. Several randomized controlled trials have found meaningful improvements in sexual desire and function among perimenopausal and postmenopausal women taking maca. One study found that women taking 3.5 grams of maca daily for six weeks reported significant improvements in sexual dysfunction compared to placebo, with the effect persisting at 12 weeks.

Another notable trial found that maca reduced the sexual dysfunction associated with SSRI antidepressants, which cause low libido as a side effect. This is particularly relevant for perimenopausal women who are managing depression or anxiety with SSRIs and find that their libido has declined further.

Low libido during perimenopause is real, common, and often underaddressed. It is driven by declining estrogen, declining testosterone, sleep disruption, mood changes, and relationship dynamics all at once. Maca does not fix all of those drivers, but its effect on sexual desire appears to be genuinely independent of hormone levels, which makes it useful even when hormonal changes are the underlying cause.

Evidence for Mood and Psychological Symptoms

Maca has a small but consistent body of evidence for mood-related outcomes in perimenopause. Studies have found reductions in anxiety, depression, and general psychological distress compared to placebo. One trial specifically in perimenopausal women found improvements in anxiety and depressive symptoms at both 3.5 grams and 6.5 grams per day.

The mechanism here is not fully understood, but researchers point to flavonoid content and the hypothalamic-pituitary influence described above. Maca also contains precursors to serotonin and dopamine, which may contribute to mood effects.

It is worth being realistic about the size of these effects. They are real but modest. Women with significant clinical depression or anxiety deserve a full evaluation and appropriate treatment. Maca is not a substitute for that. But for the low-grade mood changes, irritability, and anxiety that many women experience in perimenopause and would prefer to address without medication, it is a reasonable option to try.

Hot Flash and Hormone-Related Symptoms: More Limited Evidence

The evidence for maca reducing hot flashes is less consistent than the libido and mood data. A few trials have found modest reductions in hot flash frequency, but others have not replicated this. The same applies to night sweats and other vasomotor symptoms.

Some researchers theorize that maca's hypothalamic influence may help stabilize the thermoregulatory disruptions involved in hot flashes. But the trials are small and the results are mixed enough that you should not choose maca primarily for hot flash relief. Other options, including black cohosh, have more consistent evidence for that specific symptom.

Where maca does appear to help indirectly is through better sleep and reduced anxiety, which can lower the perception of hot flash severity even if the flashes themselves are not directly reduced.

Yellow, Red, and Black Maca: What the Colors Mean

Maca comes in several color varieties, most commonly yellow (or cream), red, and black. They grow in the same region but have slightly different phytochemical profiles and some evidence suggesting different effects.

Yellow maca is the most common and the form used in most clinical trials. It is the default option and the one with the broadest evidence base for libido, mood, and general adaptogenic effects.

Red maca has been studied primarily for bone health in animal models and may have some benefits in that area, though human evidence is limited. It is also associated with some prostate health research in men. Some women prefer it for mood, but the evidence differentiating it from yellow is thin.

Black maca has been studied most for energy, physical performance, and memory. Athletes and people with significant fatigue sometimes prefer it. If energy and cognitive function are your primary concerns, it is a reasonable choice, though again the human evidence is modest.

For most perimenopausal women, yellow maca is the right starting point. If you have tried it without satisfactory results, experimenting with red or black varieties is reasonable before concluding maca does not work for you.

Gelatinized vs. Raw Maca: Which Form to Choose

Most maca sold in stores and online is available as raw powder, gelatinized powder, or capsules. The form matters more than it might seem.

Raw maca contains starches and goitrogens, compounds that can interfere with thyroid function in large quantities. It is also harder to digest, and some people experience bloating or digestive discomfort with raw maca, particularly at higher doses.

Gelatinized maca has been cooked and pressure-processed to remove starches. This makes it easier to digest and more concentrated. A smaller dose of gelatinized maca delivers more active compounds than the same weight of raw powder. Most practitioners recommend gelatinized maca for daily supplementation.

If you have any thyroid condition or thyroid concerns, gelatinized maca is strongly preferred over raw. For anyone else, it is still the better choice for tolerability and bioavailability.

Dosing and How to Take It

The doses used in most clinical trials range from 1.5 grams to 3.5 grams per day. A few trials have used up to 6.5 grams. The sweet spot for most women appears to be around 1.5 to 3 grams of gelatinized maca daily.

Starting at 1.5 grams and working up to 3 grams over two to three weeks is a practical approach. Some women find they do well at the lower dose; others need 3 grams to notice an effect. Going above 3.5 grams does not appear to significantly improve outcomes in the trials and may increase digestive complaints.

Maca powder can be added to smoothies, coffee, oatmeal, or yogurt. It has a slightly earthy, nutty, malt-like flavor. Most people find it easy to incorporate into a morning routine. Capsules are also fine and better for those who do not like the taste.

There is no strong evidence favoring morning versus evening dosing. Most people take it in the morning because of its reputation for supporting energy, but taking it at a time you will remember consistently is the most important factor.

How Long Before You Notice a Difference

Maca does not produce effects overnight. The trials showing libido benefits ran for six to twelve weeks. Most women who respond to maca notice changes in energy and mood within two to four weeks, with libido changes typically becoming apparent around four to six weeks.

If you are tracking your symptoms, which is a useful practice regardless, note your baseline energy, mood, libido, and any anxiety levels before starting. Checking back at four and eight weeks gives you a clearer picture than trying to recall how you felt.

If you notice no meaningful change after twelve weeks at 3 grams of gelatinized maca daily, maca is probably not a strong responder for you. That is useful information. Not every supplement works for every person, and the perimenopause experience varies enormously.

Safety, Cautions, and Who Should Talk to Their Doctor First