Ashwagandha and Shatavari Extracts Dose-Dependently Reduce Menopause Symptoms, Vascular Dysfunction, and Bone Resorption in Postmenopausal Women: A Randomized, Double-Blind, Placebo-Controlled Study

Abstract

Objectives: In this study, we investigate the effects of dietary supplementation with standardized aqueous extracts of shatavari (Asparagus racemosus , Ar), ashwagandha (Withania somnifera , Ws), or their combination on menopausal symptoms, vascular dysfunction, bone turnover, and serum concentrations of inflammatory and oxidative stress markers in postmenopausal women. Methods: Postmenopausal women aged 40–55 were enrolled in a double-blind randomized study to receive one of six treatments: placebo, Ar 250 mg/500 mg, Ws 250 mg/500 mg, or 500 mg extract combining Ar 250 mg and Ws 250 mg. Primary outcomes were changes in the menopause-specific quality of life (MENQOL) questionnaire, bone mineral density/bone turnover markers (BTMs), and reflection index (RI) after 24 weeks. Secondary outcomes included changes in serum inflammatory and oxidative stress markers, and evaluation of supplement safety and tolerability. Results: Supplemented groups showed significant dose-dependent decrease MENQOL and RI compared with placebo (P < 0.0001). Women supplemented with Ws or Ar extracts had significantly decreased levels of the BTMs C-terminal telopeptide of type I collagen, bone alkaline phosphatase, and receptor activator of nuclear factor kappa-B ligand, and increased osteoprotegerin levels (P < 0.0001). Significantly decreased levels of inflammatory and oxidative stress markers high-sensitivity C-reactive protein and malondialdehyde, and increased glutathione and nitric oxide levels (P < 0.0001) were also observed. Conclusions: Daily supplementation with Ws or Ar extracts dose-dependently reduces menopausal symptoms, vascular dysfunction, bone turnover/resorption, and estrogen deficiency-related inflammation and oxidative stress in postmenopausal women.