Does ashwagandha help with joint pain during perimenopause?

Aching knees, stiff wrists, hips that hurt when you first get out of bed: if this started in your 40s without a prior injury, perimenopause is a likely contributor. Estrogen plays a genuine anti-inflammatory role in your joints, helping to maintain cartilage and regulate synovial fluid. As estrogen levels drop and fluctuate, joint inflammation can increase, and joints that were previously fine become a daily nuisance. Ashwagandha contains active compounds called withanolides that have demonstrated anti-inflammatory properties in laboratory and clinical research, making it a reasonable candidate to explore for perimenopausal joint pain.

The evidence for ashwagandha and joint pain is more direct than for some of its other uses. A 2015 randomized controlled trial published in the Journal of Ayurveda and Integrative Medicine found that participants taking ashwagandha root extract experienced significant reductions in joint pain scores and stiffness compared to placebo over 12 weeks. A 2021 study in Phytomedicine found similar improvements in knee function and comfort in people with knee discomfort. These studies were not specifically in perimenopausal women, and effect sizes were moderate rather than dramatic. Ashwagandha is not a substitute for NSAIDs in acute inflammation, but for background low-grade joint aching, the research suggests it may genuinely help.

Perimenopause amplifies joint problems through two mechanisms that ashwagandha addresses. First, declining estrogen increases circulating inflammatory cytokines like IL-6 and TNF-alpha. Withanolides appear to inhibit these same inflammatory signals in cell studies and animal models. Second, elevated cortisol from the hormonal disruption of perimenopause keeps the body in a mild state of systemic inflammation. Chronically elevated cortisol also degrades connective tissue over time. Ashwagandha's documented effect of reducing cortisol may slow this process, though this specific mechanism in joint tissue has not been studied directly in human trials focused on perimenopause.

Studies on ashwagandha for joint and musculoskeletal outcomes have used 250-600 mg per day of a standardized root extract, with 12 weeks being the most common evaluation point. Some trials used 500 mg twice daily. KSM-66 and Sensoril are the two best-studied forms. Capsules with a standardized withanolide content of around 2.5-5% are more reliably potent than bulk powders. Talk to your healthcare provider about the right dose for your situation. If you are already taking anti-inflammatory medications, bring that up with your provider before adding ashwagandha.

Ashwagandha pairs reasonably well with omega-3 fatty acids for joint inflammation, since they work on complementary pathways. Curcumin also targets inflammatory cytokines and may add benefit, though research on combining these is limited. Avoid adding multiple anti-inflammatory supplements without guidance from a provider. If you are on blood thinners, prescription anti-inflammatory drugs, or immunosuppressants, check with your provider before starting ashwagandha. Staying active with low-impact movement (walking, swimming, cycling) also protects cartilage and reduces the perimenopause-related joint decline that comes from inactivity.

Joint changes from a supplement are gradual. Inflammation is a slow process and so is its reduction. Most clinical trials saw meaningful changes between 8-12 weeks of consistent use. Some women notice reduced morning stiffness first, before pain scores change. If your joint pain has a clear inflammatory pattern (worse in the morning, improves with movement, affecting multiple joints symmetrically), you may see a better response than if pain is structural or injury-related. Managing sleep also matters, since poor sleep independently raises inflammatory markers.

Joint pain does need medical evaluation when it is accompanied by significant swelling, redness, or warmth in a joint; when it appears suddenly and severely; when only one joint is affected in isolation; or when you also have fatigue, fever, or a rash alongside joint symptoms. These patterns can indicate inflammatory arthritis, gout, or autoimmune conditions that require diagnosis and treatment. Perimenopause-related joint changes are usually diffuse and affect multiple joints rather than a single isolated spot, so a sudden change in one joint is worth having assessed promptly.

Rate your joint pain and stiffness on a 1-10 scale each morning before you get up and moving, since morning stiffness is often the clearest signal of background inflammation. Log it daily for four weeks before starting ashwagandha and for eight to twelve weeks after. PeriPlan lets you track symptoms like this alongside energy, sleep, and mood, giving you a fuller picture of whether anything is shifting. That data is worth sharing at your next provider visit too.

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