Does maca root help with perimenopause symptoms?

Maca root (Lepidium meyenii) is one of the most widely used supplements for menopause and perimenopause, and unlike many botanicals in this space, it has genuine clinical trial evidence behind it. The picture is nuanced: some symptoms have stronger support than others, and individual responses vary. Understanding what the research actually says can help you decide whether it is worth trying.

What maca is and how it works

Maca is an adaptogenic root vegetable from the Peruvian Andes. Its active compounds include glucosinolates, macamides, macaenes, and various alkaloids. Critically, maca is not estrogenic. It does not contain phytoestrogens and does not act on estrogen receptors. This means it is generally considered an option even for women who prefer to avoid estrogen-like compounds. Instead of mimicking hormones, maca appears to work through the hypothalamic-pituitary-adrenal (HPA) axis, helping normalize the signaling between the brain and adrenal glands that regulates stress hormones, energy, and indirectly, FSH and LH levels.

What the research shows

Several randomized controlled trials have examined maca in menopausal and postmenopausal women. Meissner et al. (2006) found that maca supplementation improved estradiol and FSH levels and significantly reduced total menopausal symptom scores compared to placebo. This study is notable because it demonstrated hormonal changes alongside symptom improvement. Stojanovska et al. (2015) found that 3.5g per day significantly reduced anxiety, depression, and diastolic blood pressure in postmenopausal women. Brooks et al. (2008) found that maca improved sexual function and psychological symptoms in postmenopausal women, and this is the area with the most replicated positive findings. Gonzales (2012) conducted a broader safety and efficacy review and found the overall evidence for maca to be generally supportive with a good safety profile.

Which symptoms have the most support

Sexual function and libido: This is the strongest area of evidence. Multiple randomized trials have shown meaningful improvement in sexual dysfunction scores. Mood and psychological symptoms: Consistent evidence across several trials for reduction in anxiety and depression scores. Vasomotor symptoms (hot flashes and night sweats): Promising evidence from the Meissner trial, though not all studies measure these separately. Fatigue and energy: Frequently reported as a benefit in trials, though energy is a secondary rather than primary outcome in most studies. Joint pain, muscle tension, and memory: The mechanisms are plausible (HPA normalization, cortisol reduction, anti-inflammatory compounds) but direct evidence for these specific symptoms is limited.

Dose and form

Studies have used doses of 1.5g to 3.5g per day, most often as powder (which can be stirred into food or drinks), capsules, or liquid extract. Some researchers prefer gelatinized (pre-cooked) maca, which may be easier to digest and better absorbed. Most clinical benefits were seen after 6 to 12 weeks of consistent use. Talk to your healthcare provider about the right dose and form for your situation. If you have a thyroid condition, maca contains goitrogens at higher amounts, and provider guidance is especially important.

Tracking your response

Because maca's benefits are gradual and affect multiple systems at once, daily symptom tracking is one of the best tools you have for evaluating whether it is working. PeriPlan lets you log symptoms across categories, so you can see patterns emerge over weeks rather than relying on overall impressions that can be skewed by a few good or bad days.

Safety considerations

Maca is generally well tolerated. High doses may cause mild gastrointestinal upset in some people. As noted, people with thyroid conditions should get provider input before use. Because it is not estrogenic, it does not carry the warnings associated with phytoestrogen supplements in women with hormone-sensitive conditions. However, supplement quality varies, so choosing a product with third-party testing and transparent sourcing is worthwhile.

When to see a doctor

If your perimenopause symptoms are severe, significantly disrupting your sleep, relationships, or work, or if you are experiencing symptoms that feel unusual or alarming, a healthcare provider conversation should come before or alongside any supplement trial. Effective medical treatments for perimenopause exist, including hormone therapy, and some women benefit significantly from them. Maca is a reasonable complement to a thoughtful overall strategy, but it is not a replacement for medical care when that care is needed.

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