Ashwagandha for Testosterone, Fertility and Sexual Health: Claims Checked

Safety first. NCCIH says ashwagandha should be avoided during pregnancy and not used while breastfeeding. [1] Because it may increase testosterone levels, NCCIH says people with hormone-sensitive prostate cancer should avoid it. [1] Anyone trying to conceive, pregnant, or being treated for a hormone-related condition should ask a clinician or pharmacist before using it. See trying to conceive: supplements to ask about.

The claim as marketed

Ashwagandha (Withania somnifera (L.) Dunal, family Solanaceae, accepted name per GBIF) supplements are often promoted for male infertility, among other uses. [2][1] This page checks what the sources we read actually say. Ashwagandha has a long history of traditional use in Ayurveda; that is traditional use only and is not evidence for the claims below.

What the sources say in brief

NCCIH says there is some limited evidence that taking ashwagandha for 2 to 4 months may increase testosterone levels and sperm quality, and that there is not enough evidence on menopause or female infertility. [1] Label: promising but limited for men's testosterone and semen measures; insufficient evidence for women's fertility and menopause.

Testosterone in men

A scoping review concluded that the effects of non-drug measures on testosterone are modest and do not directly translate into clinical benefits. [7] A review of trials in healthy adults reported that increases in testosterone stayed within physiological ranges. [8] A blood number is not the same as a better life or a treated deficiency; see Testosterone and low testosterone and the testosterone booster claim check.

Sperm quality and male fertility

• A 2018 systematic review found four clinical trials, only one of them randomized, so it could not pool randomized trials. [9]
• A 2011 study of 60 men with fertility problems gave 5 g a day of root powder for 3 months. The partners of 14% of the men became pregnant. [10] The abstract describes fertile men as controls, not a placebo group. [10]
• A recent 8-week trial gave 100 healthy men aged 30 to 50 root extract or placebo and reported improvements in semen volume and sperm number, and better scores on a sexual desire questionnaire. [11] These were healthy men, not men diagnosed with infertility.
• A systematic review noted that some animal studies found reversible spermicidal effects, and called for attention to extract preparation and amount. [12]

For general guidance see Male fertility concerns and adaptogens for men.

Women: sexual function, menopause and fertility

• Two small placebo-controlled trials of a root extract in healthy women reported higher sexual function scores: 50 participants in a 2015 pilot, and 80 women in a 2022 trial. [13][14]
• In 100 women with perimenopausal symptoms, a root extract was compared with placebo over 8 weeks. [15] NCCIH still says there is not enough evidence to judge menopause or female infertility. [1]
• A narrative review says it does not seem to raise testosterone in women, unlike in men's studies, and one trial found no rise in females. [16][6]

Funding was not checked for these women's trials. See adaptogens for women.