Does maca root help with hot flashes during perimenopause?

Hot flashes are one of the hallmark symptoms of perimenopause, and for many women they are the most disruptive. They arrive without warning, send body temperature soaring for seconds to minutes, and often repeat multiple times a day or jolt women awake at night. As estrogen levels drop and fluctuate, the hypothalamus becomes hypersensitive to small changes in body temperature and responds by triggering a cascade that dilates blood vessels and raises skin temperature. Some women are exploring maca root as an alternative or complement to conventional treatments. Here is what the research actually shows.

Maca root (Lepidium meyenii) is an adaptogenic root vegetable from the Peruvian Andes, containing active compounds including glucosinolates, macamides, macaenes, and plant sterols. Crucially, it is not estrogenic. It does not supply estrogen or bind to estrogen receptors. This is an important distinction from phytoestrogens like black cohosh or soy isoflavones. Maca appears to work through the hypothalamic-pituitary-adrenal (HPA) axis and may normalize FSH and LH signaling, which influences how the hypothalamus regulates temperature.

For hot flashes specifically, there is meaningful clinical evidence. Meissner et al. (2006) conducted a double-blind placebo-controlled trial with perimenopausal women using pre-gelatinized maca and found significant improvements in menopausal symptom scores including vasomotor symptoms, the category that covers hot flashes and night sweats. The maca group also showed measurable changes in hormonal markers including estradiol, FSH, and ACTH compared to placebo, suggesting real biological effects rather than placebo response.

Stojanovska et al. (2015) studied postmenopausal women taking 3.5 grams of maca per day for six weeks and found significant reductions in psychological symptoms alongside a reduction in diastolic blood pressure. While this study focused more on mood symptoms, the broader hormonal and stress-regulatory effects are consistent with vasomotor benefit reported in earlier work.

A review by Gonzales (2012) examined the cumulative evidence for maca's efficacy across multiple menopausal endpoints and concluded that vasomotor symptoms, including hot flashes and night sweats, are among the areas where evidence is most promising. The review also noted the favorable safety profile of maca across the studies examined.

The non-estrogenic mechanism is particularly relevant for women who cannot or prefer not to use hormone therapy or phytoestrogens, including some women with hormone-sensitive conditions. Because maca works through different pathways, it may be a viable option where estrogenic supplements are contraindicated, though you should always confirm this with your provider.

Studies have used doses ranging from 1.5 to 3.5 grams per day of maca in powder or capsule form. Gelatinized (pre-cooked) maca is generally better tolerated digestively. Talk to your healthcare provider about the right dose for your situation before starting.

Hot flashes vary significantly from woman to woman in frequency, intensity, and triggers. Tracking them with a consistent log before and after starting maca gives you meaningful data. PeriPlan includes symptom tracking designed for exactly this purpose, making it easy to see whether your hot flash pattern is genuinely changing rather than just varying naturally day to day.

For perimenopausal hot flashes, the full toolkit includes behavioral strategies (keeping cool, layering clothing, identifying triggers like alcohol and spicy food), mind-body practices including paced breathing (which has evidence for reducing flash intensity), and if appropriate, discussions with your provider about hormone therapy or other prescription options. Maca fits well as one non-hormonal option within that broader picture.

Those with thyroid conditions should check with their provider before starting maca, as its glucosinolate content can affect thyroid function at higher doses. An initial GI adjustment period of one to two weeks is possible, particularly with raw maca powder.

When to see a doctor: If your hot flashes are severely disrupting sleep consistently, affecting your quality of life significantly, or are accompanied by night sweats that drench your clothing, a thorough conversation with your healthcare provider about all available options is important. You do not have to manage this alone or wait it out.

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