Writing in the Journal of Menopausal Medicine researchers in India explored whether standardized aqueous extracts of ashwagandha and shatavari, alone or in combination, would alleviate menopause symptoms, improve vascular function, regulate bone turnover and reduce inflammatory and oxidative stress markers in women between the ages of 40 and 55.
Findings from the study—which was funded by Natreon, Inc., part of the Kerry Group—indicated that daily supplementation with either ingredient reduced inflammation and oxidative stress, considered key contributors to postmenopausal bone and vascular decline.
Botanical solutions for managing menopause
Up to 85% of postmenopausal women reportedly experience at least one menopause-related symptom in their lifetime. Vasomotor symptoms such as hot flashes and night sweats affect most women during this transition, stemming from vascular endothelial dysfunction.
Estrogen deficiency can trigger various physiological and psychological issues, including hot flashes, night sweats, fatigue, sleep disturbances, weight gain, vaginal dryness, anxiety, depression, irritability and cognitive difficulties.
Estrogen deficiency also contributes to vascular dysfunction by increasing reactive oxygen species (ROS) and reducing nitric oxide (NO) production, and studies have shown that menopausal women with hot flashes have lower antioxidant activity.
Postmenopausal women also face accelerated bone loss, increasing their risk of osteoporosis and fractures. Estrogen suppresses proinflammatory cytokines that drive bone loss while enhancing cytokines that protect bone, and its absence can lead to increased oxidative stress, impairing bone formation and promoting resorption.
Ashwagandha (Withania somnifera) is traditionally known for its stress reducing effects, and studies have highlighted its ability to lower inflammation and oxidative stress while improving vascular health and antioxidant levels.
Similarly, shatavari (Asparagus racemosus) has long been used in Ayurvedic medicine for women’s health, as its roots contain phytoestrogen, anti-inflammatory and antioxidant compounds.
Study details
The researchers recruited 123 postmenopausal women and assigned them to consume either 250 mg or 500 mg ashwagandha branded as Sensoril, 250 mg or 500 mg shatavari which was supplied by Natreon, a combination of the two ingredients at 250 mg each, or a placebo.
Participants took two capsules daily (morning and evening) for 24 weeks and had blood samples taken at baseline and at four, eight, 12 and 24 weeks.
They also completed a menopause-specific quality of life questionnaire at each visit and were evaluated for vascular function, bone mineral density (BMD), bone turnover markers (BTM) and inflammation and oxidative stress biomarkers such as high-sensitivity C-reactive protein (hsCRP), malondialdehyde (MDA), glutathione (GSH) and nitric oxide (NO).
Results showed that higher doses of ashwagandha and shatavari led to greater improvements in menopause-related quality of life (MENQOL), though no synergistic effects were observed. Ashwagandha was found to outperform shatavari at equivalent doses, particularly in the psychosocial and physical domains.
Similarly, blood vessel function tests showed improved vascular endothelial function across all supplemented groups, however the ashwagandha produced a greater effect than shatavari.
Bone metabolism markers also improved, with the 500 mg ashwaghanda dose yielding the greatest reductions in bone resorption biomarkers and the highest lumbar spine BMD T-score increase after 24 weeks.
Furthermore, supplementation was found to significantly reduce inflammatory and oxidative stress markers, with ashwagandha outperforming shatavari and their combination.
The researchers noted as surprising that shatavari did not show a synergistic effect or superior results given its known phytoestrogenic properties. In contrast, ashwagandha demonstrated strong cardioprotective effects by reducing myocardial injury and improving antioxidant enzyme profiles.
The researchers noted that dietary supplementation presents a feasible strategy for menopause symptom management, concluding that their findings establish “two nutraceutical ingredients that have demonstrated efficacy for attenuating bothersome symptoms and adverse health effects of menopause.”
They did however note several study limitations, including the relatively small, homogenous sample size.
“Future research should be considered in larger and different populations of women, such as peri- and post-menopausal women at risk for osteopenia from different geographical regions and racial/ethnic backgrounds, to further evaluate preventative therapeutic potential of these nutraceutical interventions,” they wrote.
Source: Journal of Menopausal Medicine. doi: 10.6118/jmm.24025. “Ashwagandha and Shatavari Extracts Dose-Dependently Reduce Menopause Symptoms, Vascular Dysfunction, and Bone Resorption in Postmenopausal Women: A Randomized, Double-Blind, Placebo-Controlled Study”. Authors: Pingali, U. et al.