As you approach your 40s and near menopause as a woman, your hormone levels can shift, impacting everything from stress response to sleep quality. One of the biggest culprits is cortisol. Cortisol is your body’s primary stress hormone. When it’s thrown off-balance, you may experience issues like restless sleep, fatigue, and even weight gain. Naturally, many women seek out supplements promising to restore hormonal balance and support better sleep.
But do any of them actually work? According to Dr. Gillian Goddard, a New York-based endocrinologist and adjunct assistant professor of medicine at NYU Grossman School of Medicine, the answer is nuanced. While a few supplements show some promise, she emphasizes the importance of approaching them with caution—especially given the lack of long-term data and regulation. Find all of her expert insight below.
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1. Ashwagandha
One supplement that often comes up in conversations around stress and cortisol is ashwagandha, an adaptogenic herb that has been used in medicine for yeras. As Dr. Goddard tells us, research suggests it may have a positive effect on stress hormones.
"There is some evidence published in a recent meta-analysis that ashwagandha can lower cortisol levels and raise serotonin levels," she says. However, like any supplement, it's important to take Ashwagandha with a (metaphorical) grain of salt. "These effects were small and it's not clear if they were associated with a clinical benefit," she reminds us.
"There's also some evidence that it reduces stress and improves sleep," she says.
However, she emphasizes, "I'm cautious about recommending ashwagandha because all the trials are short—the longest trials are only 90 days—and small, often enrolling just a few dozen patients. That means we don't know if the effects of ashwagandha persist if you take the supplements for longer periods of time." Good to know!
2. Magnesium
If your main goal is improving sleep, Dr. Goddard points to a more consistently supported option: magnesium.
"I do often recommend magnesium," she says. "There is some evidence that it improves sleep if taken by mouth at bedtime. It both reduces the time needed to fall asleep and improves sleep quality."
Unlike ashwagandha, magnesium has a more established track record when it comes to sleep support, making it a go-to recommendation for many healthcare providers. While it may not directly lower cortisol levels, better sleep itself can help regulate the body’s stress response over time.
Use Caution With Supplements Overall
Even with these options, Dr. Goddard emphasizes that supplements should never be viewed as a cure-all—especially when it comes to complex hormonal systems like cortisol regulation.
She also highlights a larger issue with the supplement industry: lack of oversight. "In general, I'm cautious about recommending supplements because they're not subject to the same scrutiny as medications," she says. "Clinical trials are often small and of poor quality."
Additionally, she explains that supplements are regulated differently than prescription drugs. "Supplements are also regulated by the FDA as food (not as medication) which means marketing claims don't need to be evidence-based and quality control measures don't ensure that products contain the quantities of the active ingredient that they say they do."
The Bottom Line
While supplements like ashwagandha and magnesium may offer some support for stress and sleep, they’re far from magic fixes—especially when it comes to balancing cortisol. If you’re considering adding either to your routine, it’s worth discussing with a healthcare provider to ensure it’s appropriate for your individual needs.
Ultimately, sustainable improvements in cortisol balance and sleep often come down to a bigger picture: consistent sleep habits, stress management, and overall lifestyle—not just what’s in your supplement cabinet.
