Does ashwagandha help with muscle tension during perimenopause?

That persistent tightness in your neck and shoulders, the jaw clenching, the back that never quite relaxes: muscle tension during perimenopause often has more than one driver. Estrogen and progesterone both influence how your nervous system regulates muscle tone, and as they fluctuate, your muscles can stay in a semi-contracted state more of the time. Cortisol is the other key player. Chronically elevated cortisol keeps the sympathetic nervous system activated, which directly increases baseline muscle tension throughout the body. Ashwagandha addresses the cortisol side of this equation and has anti-inflammatory properties that may also reduce the inflammatory component of chronic muscle tightness.

The evidence specifically on ashwagandha and muscle tension is limited. Most of the relevant research looks at broader stress outcomes, exercise recovery, and inflammation markers. A 2015 study in the Journal of the International Society of Sports Nutrition found that ashwagandha supplementation significantly improved muscle recovery, reduced exercise-induced muscle damage (measured by creatine kinase), and decreased perceived soreness compared to placebo in resistance-trained adults. This is not the same as chronic tension, but the underlying mechanisms (reducing cortisol-driven muscle strain and lowering inflammatory markers) overlap. The direct evidence for perimenopausal muscle tension specifically is mostly anecdotal.

Perimenopause changes the picture in a few ways worth understanding. Progesterone has a mild muscle-relaxing effect through its interaction with GABA receptors. As progesterone declines, this natural buffer against physical tension diminishes. At the same time, the sleep disruption that accompanies perimenopause prevents proper overnight muscle recovery, so tension accumulates across days. Magnesium, which is needed for muscle relaxation at the cellular level, is also depleted by high cortisol. Ashwagandha's cortisol-lowering effect may help on multiple fronts: reducing the sympathetic activation that creates tension, potentially easing magnesium depletion, and supporting better sleep quality (which itself allows muscles to recover overnight).

Studies on ashwagandha and cortisol or recovery outcomes have used 300-600 mg daily of a standardized root extract. The muscle recovery study used 300 mg twice daily (600 mg total) for 8 weeks. KSM-66 and Sensoril are both well-studied; capsule forms are more reliable than powder. Talk to your healthcare provider about the right dose for your situation. Magnesium glycinate taken separately in the evening (studies have used 200-400 mg) addresses the muscle-relaxation pathway more directly and the two may work well together, but discuss combining supplements with your provider.

Ashwagandha pairs well with magnesium glycinate specifically (not magnesium oxide, which absorbs poorly) for muscle tension. Regular physical movement, particularly stretching and yoga, addresses muscle tension through a mechanism no supplement can replicate. Avoiding excessive caffeine helps keep the sympathetic nervous system calmer. If you take muscle relaxants, sedatives, or any medications for anxiety or sleep, discuss ashwagandha with your provider before adding it. Ashwagandha has mild sedative-adjacent activity and interactions with prescription sedatives have not been fully studied.

Muscle tension changes from ashwagandha are likely to be gradual. Cortisol normalization typically begins within 4-6 weeks of consistent use, and physical tension may follow as the nervous system calms down. Women who combine ashwagandha with sleep improvement and regular movement tend to report the most noticeable changes. If tension is primarily in your jaw or neck and associated with stress, you may notice shifts there first. Tension that is mostly physical, from posture or overuse, will not be significantly changed by a supplement.

Muscle tension usually does not require emergency medical attention, but it does warrant a doctor visit if tension is accompanied by unexplained muscle weakness, difficulty swallowing or breathing, severe neck or back pain that radiates down an arm or leg, or new-onset headaches that feel different from anything you have had before. These can indicate nerve compression, thyroid issues, or other conditions that need proper diagnosis. Fibromyalgia, which involves widespread muscle pain, is also worth discussing with a provider if tension is diffuse and severe.

Tracking your muscle tension on a 1-10 daily scale and noting where in your body it lives (neck, jaw, back, whole body) gives you useful baseline data. PeriPlan lets you log physical symptoms alongside sleep quality and stress levels, so you can see whether your tension score consistently goes up after bad sleep nights or high-stress days. Those correlations are valuable for understanding your own patterns and for shaping your approach.

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