Adaptogens for Menopause: One Lady’s Expertise

Leaning into menopause isn’t for the faint of heart. While it’s a completely normal phase of life (most people with a uterus will experience it at some point), those hormone fluctuations can still create a cascade of symptoms.

For me, the worst of them is mood swings. A dip in estrogen can cause issues with your feel-good neurotransmitter serotonin, leading to symptoms like depression, anxiety, or irritability in menopausal people, per Johns Hopkins Medicine. One moment, I’m just fine, and then the next, I’m completely depleted of my patience. Add to that the daily stressors of middle age (raising my child, worrying about my aging parents, tending to my career…you get the picture) and it’s no wonder I sometimes feel like I’m on an emotional roller coaster.

Each year in the U.S., about 1.3 million people make the transition into menopause, per the National Library of Medicine. And as society continues to talk about it more, and women demand better care, treatment options are becoming more available and widespread. The traditional route is often hormone replacement therapy (HRT), but there are alternatives.

I decided to try a natural remedy to help smooth my mood: adaptogens. These plant-based molecules are thought to help balance the body by abating hormone-induced stress, anxiety, and fatigue. While they’re often seen as a fringe addition to a more wellness guru-y way of life, I figured I had nothing to lose. Turned out, I had everything to gain. Read on to hear my experience with taking adaptogens for menopause.

First, what are adaptogens typically used for?

You may have seen some things on social media about adaptogens—likely videos about mushroom powders you can mix into beverages that claim to help with focus or energy. But adaptogens have been around in Eastern cultures and Ayurvedic medicine for thousands of years. According to the Cleveland Clinic, these herbs and mushrooms are thought to help restore your body’s natural balance by supporting its stress response system.

In medical terms, this system is called the hypothalamic-pituitary-adrenal (HPA) axis, which includes the hypothalamus and pituitary gland in your brain and the adrenal glands above your kidneys, per the Cleveland Clinic. These glands produce and release many different types of hormones, including cortisol.

Some other reasons people turn to adaptogens include the following, per the Cleveland Clinic:

• To alleviate anxiety
• To reduce fatigue/increase energy
• To regulate emotional reactions to stress
• To boost immunity

During menopause specifically, the hormones estrogen and progesterone fall, while the stress hormone cortisol (which is made in your adrenals) can rise, per The Menopause Society. That chemical change, paired with life’s daily pressures, can wreak havoc on your anxiety levels and mental health. In this instance, adaptogens may then do what their name indicates: help the body adapt, while providing a natural reset of cortisol levels.

And while adaptogens are generally well-tolerated, there are possible mild side effects, depending on the type of herb you take. This can include: nausea, constipation, diarrhea, abdominal pain, or allergic reaction, per the Cleveland Clinic. This is why it’s important to talk to your doctor before trying adaptogens to see if they’re right for you (and to make sure they don’t negatively interact with your other medications or health conditions).

The types of adaptogens I used

My go-tos are of the mushroom variety—including reishi, lion’s mane, and cordyceps. Each morning, I whisk a powder with all three into my coffee. Then in the late afternoon, I pop two ashwagandha pills (an herb often used to improve mood and reduce anxiety, per the National Institutes of Health) as part of my workday wind-down. While I didn’t feel much of a difference at first, over time, I’ve found myself coping more effectively with whatever life throws at me.

Other types of adaptogenic herbs include: Asian ginseng, eleuthero, rhodiola, schisandra, and tulsi or “holy basil,” per the Cleveland Clinic and UCLA Health.

Do adaptogens really work?

No matter the type of adaptogenic you reach for, it’s important to remember that the research surrounding these substances (especially mushrooms) is still limited and ongoing, per UCLA Health. That said, there are newer studies surfacing that point to adaptogens’ effectiveness—ashwagandha in particular. Case in point: A September 2023 review and meta-analysis in the Journal of Functional Foods found that healthy, stressed adults who took ashwagandha daily had significantly lower cortisol levels after 56 or 60 days of treatment compared to a placebo.

Another thing to keep in mind: Some adaptogens may negatively interact with certain medications, including those prescribed for heart issues and hyperthyroidism, as well as some antidepressants². So, be sure to check in with your health care provider before giving them a try.

How adaptogens helped my menopausal mood swings

I spent 15 years on birth control before I was ready to have a child, but I was never thrilled with how it made me feel. While regular, lighter periods were terrific, the weight gain, sore boobs, and nausea were most certainly not.

When I entered perimenopause, I wanted to avoid taking hormones if possible. I kept seeing adaptogens popping up everywhere—in sparkling water, teas, tinctures, and even gummies—and became curious. I felt frazzled, moody, and worn down, and I thought trying a natural solution would be a good first step.

Anna Barbieri, MD, an OB/GYN and Menopause Society certified practitioner, says many of her patients opt for adaptogens, too. “They fit right in this middle ground for women who are not ready for a birth control pill or hormone therapy, but want to simply see if some of these symptoms can be corrected,” she says.

Just like studies on adaptogens in general, studies regarding adaptogens for menopause specifically are limited. But there are some hopeful findings. One small December 2021 study in the Journal of Obstetrics and Gynecological Research³ found that ashwagandha relieved mild to moderate symptoms better than a placebo in 100 perimenopausal women. And a small April 2012 study in Menopause found that ginseng (another popular adaptogenic herb) relieved menopause symptoms in a group of 70 women when compared to a placebo.

There’s also some anecdotal evidence to support adaptogen use for menopause-related concerns: Some people have found it not only helps with the irritability, anxiety, and depression associated with menopause, but also vasomotor symptoms (i.e., hot flashes and night sweats).

It didn’t happen overnight, but after several weeks of daily dosing (2 grams of mushroom powder in the morning, and two 1,500-milligram ashwagandha capsules in the afternoon), I started to feel some relief. I still take both blends on the regular, and I’m less irritable and angry, more focused, and can better hold space for strong emotions. I’ve even found that my sleep quality has improved (which is helpful, as people in perimenopause tend to deal with insomnia, per Johns Hopkins Medicine).

Other ways to treat menopause mood swings

While they may be helpful for some, adaptogens aren’t necessarily a cure-all for menopausal mood swings. The transition affects different people in different ways. Depending on severity, other treatments may be needed, which can include the following:

Hormone therapy

“We cannot ashwagandha ourselves out of menopause,” says Dr. Barbieri. “I do not think adaptogens are anywhere close to the power of hormone therapy, but they can be useful companions or additions to overall health management.”

HRT is one of the more common menopause treatments. It typically involves extra doses of estrogen or progesterone in the form of a cream, patch, or pill. While the biggest benefits are usually relief from hot flashes, vaginal dryness, or other physical symptoms, HRT also has the potential to provide mood-boosting benefits, by re-stabilizing your hormone levels, per the Mayo Clinic.

Antidepressants

FDA-approved antidepressants are also used to ease mental health symptoms associated with menopause. In fact, a July 2014 study in JAMA Internal Medicine found the combination of SNRI venlafaxine (a type of antidepressant) and estrogen were effective at relieving hot flashes, and a January 2015 study in Menopause found paroxetine (an SSRI antidepressant) reduced the amount of nighttime awakenings from menopausal symptoms like hot flashes and improved overall sleep quality.

Most importantly, antidepressants have also been shown to calm hormonal depression and anxiety⁷, which can lift your mental outlook during this big life transition.

Lifestyle adjustments

Beyond medications, changing up your lifestyle habits can also play a part in easing menopausal mood swings. I do my best to eat a balanced diet (most of the time, anyway!), get my exercise by running around the park, and meditate daily. I’m confident these factors also make a difference in my emotional state and wellness as a whole.

Talking it out

I take comfort in knowing I’m not braving menopause symptoms alone. Many of my friends are also going through it, too. Acknowledging our symptoms, including mood swings, helps to validate and better manage them. What we’re going through is real, and sharing without shame allows me to better give and receive support from my friends as we weather the transition together.

And of course, reaching out and talking to a mental health professional is always a good option if your mood swings are interfering with your day-to-day.

The bottom line

I firmly believe my daily dose of adaptogens helps me achieve and maintain a more grounded baseline at this point in my menopause journey. They’re not the only piece of the puzzle, but they are an important part of it. Placebo effect or not, I feel much more balanced and even-keeled. Save for a slightly earthy/funky taste in my morning coffee, I’ve had no side effects. Given the benefits I’ve experienced, I’m going to keep taking them.

Bottom line: If you want to give adaptogens a try, be sure check in with your health-care provider first to make sure they’re right for you, determine which ones will best target your specific symptoms, and confirm you’re getting an appropriate, effective dose.

Finally, remember no adaptogen can change a stressful circumstance or triggering situation that alters your mood, especially during menopause. Only you’ve got the awareness and wisdom to do that!

“We have to be very cognizant to the fact that sometimes the environment itself needs to be modified, rather than the response to it,” Dr. Barbieri says.