education

Female Hormones & Menstruation 101

By Mary Bove ND, Medical Herbalist

Mary Bove

Dr. Mary Bove is a herbal advocate, educator, and innovator holds a Doctorate of Naturopathic Medicine, Midwifery Certification and Diploma of Phytotherapy/Herbal Medicine. She practiced Naturopathic Family Medicine, herbal Medicine, and Midwifery for over 30 years, specializing in naturopathic pediatrics, botanical medicine, natural prenatal care and homebirth.

Once full-time faculty at Bastyr University, Dr Bove chaired the departments of Botanical Medicine and Naturopathic Midwifery. Dr Bove is the author of the Encyclopedia of Natural Healing for Children and Infants and co-authored Herbs for Women’s Health.

Mary has been published in many magazines, journals and collaborative books on botanical and natural medicine. She has worked as Medical Educator and in formulation research and product development for Gaia Herbs Brevard, NC, belonging to Gaia’s Scientific Advisory Board for over 35 years. Dr Bove currently consults, lectures, writes, and teaches internationally for Heartwood Institute on the topics of naturopathic medicine, botanical medicine, pediatrics, natural pregnancy and childbirth, traditional food medicine, and mind-body healing.

Female Hormones & Menstruation 101
Female Hormones & Menstruation 101

Hormones are one of the body's great mysteries: We usually know that they're important, we might know that they matter, but we are often not exactly sure what they do or how they impact health and wellness.

Though hormones play an integral role in women's (and men's) health during all life stages, their mention is usually limited to the sex hormones during puberty, menstruation and menopause, often only in reference to emotional health. These undervalued offspring of the body's glands perform diverse functions, supporting everything from hunger levels to the sleep-wake cycle. Hormones promote crucial aspects of health such as the body's fight-or-flight impulse and programmed cellular death (apoptosis).

Simply put, hormones are the body's messengers. Secreted into the blood, they carry vital information to organs and tissues. When the hormones are functioning normally, the body's systems also function normally. Compare the body's complex system of hormones to your mobile phone network. For your device to function normally, you need to be within your network's range or have a Wi-Fi connection, in most cases, but sometimes calls are dropped, you run out of data for the month or your battery dies.

The hormones with which most people are familiar are the sex hormones, particularly estrogen and progesterone in women. While those hormones tend to get the most attention during puberty, at every point from menarche through menopause, a woman's body is working to keep the hormones in normal balance.

To understand the role that hormones play in the body, first we should look at the menstrual cycle and the normal ebbs and flows of hormones that accompany it. In addition to estrogen and progesterone, there are two other hormones that are relate to a woman's cycle, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are brain hormones that help regulate ovarian activity.

menstrual cycle chart

The menstrual cycle is divided into two sections: the follicular phase (days 1-14) and the luteal phase (days 15-28). The luteal phase coincides with the natural increase of progesterone, as well as a number of normal physical and emotional events that are not present during the follicular phase, as the body prepares to shed the lining of the uterus. Supporting a healthy response to stress, as well as the body's natural increased demand for progesterone, helps support the luteal phase of the menstrual cycle.

When bleeding begins on Day 1, hormone levels are relatively low, but as it tapers off by days 4 to 6, estrogen levels begin to increase.

About halfway through the cycle (Day 14 in a 28-day cycle), estrogen reaches peak levels, and the reproductive system receives hormonal signals from FSH and LH via the brain. FSH tells the ovaries to ovulate, while LH signals for progesterone to be made. At that point, as estrogen decreases, progesterone increases, until it peaks during the third week. (Progesterone production is dependent on ovulation. It is secreted by the corpus luteum, the area within the ovary where ovulation has occurred.)

Estrogen and progesterone work in concert, and they "talk" to each other from one cycle to the next. Estrogen works to lay down the cells in the uterine lining, called the endometrium, while progesterone engorges the tissue to get it plump and ready for an egg to be implanted. By the end of the cycle, if pregnancy does not occur, both progesterone and estrogen levels drop, which signals for the blood vessels to pull away from the endometrium, causing it to die and slough off. This triggers the body to start bleeding. The cycle then restarts to create healthy tissue for the following month. The cycle is continuous-not an arc-with each one influencing the next; maintaining good communication between estrogen and progesterone ensures the cycle continues normally. This continuum means that sometimes balance happens over the course of more than one cycle (think of the "carry-over" minutes on your cell phone plan).

"The health and wellness of a woman's endocrine system is very much dependent on balanced hormonal function as one part of the network of efficient communication leading toward a more radiant, healthy, functioning body," said Dr. Mary Bove, ND, a member of the Scientific Advisory Board at Gaia Herbs.

There are many lifestyle factors that support a healthy menstrual cycle: - a balanced diet that provides an adequate amount of dietary fat - regular exercise at moderate levels to support a healthy fat-to-muscle ratio - a normal body weight - adequate sleep in a quiet, dark environment to support healthy levels of melatonin, a hormone that supports the circadian rhythm - normal levels of cortisol, a hormone produced by the adrenals that helps maintain a healthy stress response and blood sugar within normal ranges

In addition to the normal pathway of making cortisol from scratch, the adrenal glands can shunt progesterone away to produce this stress hormone. This happens because, in the totem pole of the endocrine system, the ovaries (as well as the testes in men) are on the bottom. Reproduction is not necessary for survival, but, for example, the adrenal and thyroid glands are.

In conjunction with the pituitary gland and the hypothalamus, the area of the brain that is responsible for the production of many hormones and links the nervous and endocrine systems, the adrenals form the HPA (hypothalamic-pituitary-adrenal) axis. (The endocrine system has an axis for each gland in the body to maintain proper communication.) The main function of the HPA axis is to support the body's response to normal stress. When the axis includes the ovaries, it is called the HPO axis. When the HPO axis is functioning normally-meaning that the brain, ovaries and adrenal glands are all communicating as usual-it supports healthy menstruation.

The normal function of the body's stress hormones, including cortisol, is to rise and fall quickly. They increase long enough to help get the body out of danger, then return to a low level. Though the levels fluctuate, this is considered normal functioning of those hormones. Supporting a healthy response to stress ensures the body is ready for those peaks and valleys, which also allows the adrenals to take the time needed to create cortisol versus taking it from the ovaries (in the form of progesterone) without notifying them. This also supports a healthy estrogen to progesterone ratio.

Herbal Support for Healthy Menstruation

A number of herbs have traditionally been used to support a healthy menstrual cycle.* Chaste Tree Berry and Red Clover help support normal reproductive hormone balance.* As such, Red Clover supports normal body temperature regulation and appropriate perspiration levels, by promoting the normal production of estrogen.* In turn, the support it provides for estrogen also promotes a healthy mood during the luteal phase of the menstrual cycle.* Chaste Tree Berry, which is also called Vitex, maintains the connection between the brain and the ovaries to facilitate production of progesterone.1*

Wild Oats and Schisandra promote a healthy mood and appropriate hunger levels.* These herbs provide overall tonifying support and nutrition for the body systems, and they possess antioxidant qualities.* Wild Oats and Schisandra can also help to maintain blood glucose already within normal ranges.*2,3

Adaptogenic herbs such as Ashwagandha, Rhodiola and Holy Basil promote a healthy response to stress.* By supporting the normal function of the adrenal glands (and their production of cortisol), the adrenals do not need to steal it from the progesterone made by ovaries.

Dandelion helps with healthy fluid elimination and supports the liver's breakdown of hormones.* By supporting that function of the liver, the body can maintain the normal hormonal balance, which in turn supports appropriate fluid levels.* Dandelion also supports the body's receptors for estrogen, progesterone and FSH, which promotes normal, efficient use of those hormones.4*

We hope this blog has demystified the body's hormones as they relate to normal menstruation.

Selected information in this blog, including sources cited, came from a webinar by Dr. Wendy Werner, MD, ABIHM, who is board certified in obstetrics and gynecology as well as in integrative holistic medicine. Dr. Werner is a member of the Gaia Herbs Scientific Advisory Board.

Dr. Mary Bove, ND, a member of the Scientific Advisory Board, reviewed and approved this content.

References:
1 Pharmacogn Rev. 2013 Jul-Dec; 7(14): 188-198.
2 Eur J Clin Nutr. 2013 Apr; 67(4):310-7
3 J Ethnopharmacol. 2008 Jul 23;118(2):183-212; J Ethnopharmacol. 2011 May 17;135(2):455-62
4 Int J Mol Med 2007 Sep;20(3):287-92

REFERENCES:

  • 1. Gustavo F. Gonzales, "Ethnobiology and Ethnopharmacology of Lepidium meyenii (Maca), a Plant from the Peruvian Highlands", Journal List Evid Based Complement Alternat Med v.2012; 2012 PMC3184420. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184420/
  • 2. Luis G Valerio Jr, Gustavo F Gonzales, "Toxicological aspects of the South American herbs cat's claw (Uncaria tomentosa) and Maca (Lepidium meyenii) : a critical synopsis", Toxicol Rev . 2005;24(1):11-35. doi: 10.2165/00139709-200524010-00002. PMID: 16042502. https://pubmed.ncbi.nlm.nih.gov/16042502/
  • 3. H. O. Meissner,1 P. Mrozikiewicz,2 T. Bobkiewicz-Kozlowska,3 A. Mscisz,2 B. Kedzia,2 A. Lowicka,2 H. Reich-Bilinska,4 W. Kapczynski,5 and I. Barchia6, "Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (I) Biochemical and Pharmacodynamic Study on Maca using Clinical Laboratory Model on Ovariectomized Rats", Journal List Int J Biomed Sci v.2(3); 2006 Sep PMC3614604. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614604/
  • 4. Eva Fries 1, Lucia Dettenborn, Clemens Kirschbaum, "The cortisol awakening response (CAR): facts and future directions", Int J Psychophysiol. 2009 Apr;72(1):67-73. doi: 10.1016/j.ijpsycho.2008.03.014.Epub 2008 Sep 30.. https://pubmed.ncbi.nlm.nih.gov/18854200/
  • 5. Nicolas C. Nicolaides 1, Alexandros N. Vgontzas 2, Ilia Kritikou 3, George Chrousos 4 Kenneth R Feingold 1, Bradley Anawalt 2, Alison Boyce 3, George Chrousos 4, Wouter W de Herder 5, Ketan Dhatariya 6, Kathleen Dungan 7, Jerome M Hershman 8, Johannes Hofland 9, Sanjay Kalra 10, Gregory Kaltsas 11, Christian Koch 12, Peter Kopp 13, Márta Korbonits 14, Christopher S Kovacs 15, Wendy Kuohung 16, Blandine Laferrère 17, Miles Levy 18, Elizabeth A McGee 19, Robert McLachlan 20, John E Morley 21, Maria New 22, Jonathan Purnell 23, Rakesh Sahay 24, Frederick Singer 25, Mark A Sperling 26, Constantine A Stratakis 27, Dace L Trence 28, Don P Wilson 29 , editors., "HPA Axis and Sleep", PMID: 25905298 Bookshelf ID: NBK279071. https://pubmed.ncbi.nlm.nih.gov/25905298/
  • 6. José Manuel Lozano Sánchez', Zoraida Axtle Serranol*, Julio Avilés Durán, Héctor Salvador Godoy Morales, Paola Berenice Merchand Álvarez, Ricardo Mera Mejía? Luis Felipe Montaño Estrada and Erika Patricia Rendón Huerta, "Peruvian Maca and Possible Impact on Fertility", Journal of Nutritional Health & Food Engineering. https://www.researchgate.net/profile/Jose-Manuel-Lozano-Sanchez/publication/317569911_Peruvian_Maca_and_Possible_Impact_on_Fertility/links/59494b03aca272a30c6cae11/Peruvian-Maca-and-Possible-Impact-on-Fertility.pdf
  • 7. A López-Fando 1, M P Gómez-Serranillos, I Iglesias, O Lock, U P Upamayta, M E Carretero, "Lepidium peruvianum chacon restores homeostasis impaired by restraint stress", Phytother Res . 2004 Jun;18(6):471-4. doi: 10.1002/ptr.1455.. https://pubmed.ncbi.nlm.nih.gov/15287072/
  • 8. Gustavo F. Gonzales *, "Ethnobiology and Ethnopharmacology of Lepidium meyenii (Maca), a Plant from the Peruvian Highlands", Evid Based Complement Alternat Med. 2012; 2012: 193496. Published online 2011 Oct 2. doi: 10.1155/2012/193496. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184420/
  • 9. José Manuel Lozano Sánchez', Zoraida Axtle Serranol*, Julio Avilés Durán, Héctor Salvador Godoy Morales, Paola Berenice Merchand Álvarez, Ricardo Mera Mejía? Luis Felipe Montaño Estrada and Erika Patricia Rendón Huerta, "Peruvian Maca and Possible Impact on Fertility", Journal of Nutritional Health & Food Engineering. https://www.researchgate.net/profile/Jose-Manuel-Lozano-Sanchez/publication/317569911_Peruvian_Maca_and_Possible_Impact_on_Fertility/links/59494b03aca272a30c6cae11/Peruvian-Maca-and-Possible-Impact-on-Fertility.pdf
  • 10. Maria Rosales-Hartshorn*, "Maca: Botanical Medicine from the Andes", Volume 1 : Issue 2 Article Ref. #: 1000AFTNSOJ1e001. https://www.openventio.org/Volume1-Issue2/Maca-Botanical-Medicine-from-the-Andes-AFTNSOJ-1-e001.pdf
  • 11. Natália da Silva Leitão Peres 1, Letícia Cabrera Parra Bortoluzzi, Leila Larisa Medeiros Marques, Maysa Formigoni, Renata Hernandez Barros Fuchs, Adriana Aparecida Droval, Flávia Aparecida Reitz Cardoso, "Medicinal effects of Peruvian maca (Lepidium meyenii): a review", Food Funct. 2020 Jan 29;11(1):83-92. doi: 10.1039/c9fo02732g.. https://pubmed.ncbi.nlm.nih.gov/31951246/
  • 12. Office of Communications, "How common is infertility?", Home- Health- A to Z List- Infertility and Fertility- About- How common is infertility?. https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common#f1
  • 13. ASRM, American Society for Reproductive Medicine., "In approximately 40 percent of infertile couples, the male partner is either the sole cause or a contributing cause of infertility", Home Infographic Gallery. https://www.reproductivefacts.org/resources/infographic-gallery/images/in-approximately-40-percent-of-infertile-couples-the-male-partner-is-either-the-sole-cause-or-a-contributing-cause-of-infertility/
  • 14. G F Gonzales 1, A Cordova, C Gonzales, A Chung, K Vega, A Villena, "Lepidium meyenii (Maca) improved semen parameters in adult men", Asian J Androl. 2001 Dec;3(4):301-3.. https://pubmed.ncbi.nlm.nih.gov/11753476/
  • 15. José Manuel Lozano Sánchez', Zoraida Axtle Serranol*, Julio Avilés Durán, Héctor Salvador Godoy Morales, Paola Berenice Merchand Álvarez, Ricardo Mera Mejía? Luis Felipe Montaño Estrada and Erika Patricia Rendón Huerta, "Peruvian Maca and Possible Impact on Fertility", DOI:10.15406/jnhfe.2017.06.00217. https://www.researchgate.net/publication/317569911_Peruvian_Maca_and_Possible_Impact_on_Fertility
  • 16. Daniel Nedresky; Gurdeep Singh., "Physiology, Luteinizing Hormone", Treasure Island (FL): StatPearls Publishing; 2022 Jan-.. https://www.ncbi.nlm.nih.gov/books/NBK539692/
  • 17. G F Gonzales 1, A Cordova, C Gonzales, A Chung, K Vega, A Villena, "Lepidium meyenii (Maca) improved semen parameters in adult men", Asian J Androl. 2001 Dec;3(4):301-3.. https://pubmed.ncbi.nlm.nih.gov/11753476/
  • 18. G F Gonzales, M Gasco, A Córdova, A Chung, J Rubio and L Villegas, "Effect of Lepidium meyenii (Maca) on spermatogenesis in male rats acutely exposed to high altitude (4340 m)", Instituto de Investigaciones de la Altura, and Departamento de Ciencias Biolo´gicas y Fisiolo´gicas Facultad de Ciencas y Filosofı´a, Universidad Peruana Cayetano Heredia, PO Box 1843, Lima, Peru (Requests for offprints should be addressed to G F Gonzales, Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, PO Box 1843, Lima, Peru; Email: iiad@upch.edu.pe). http://eplant.njau.edu.cn/maca/publication/Effect%20of%20Lepidium%20meyenii%20(Maca)%20on%20spermatogenesis%20in%20male%20rats%20acutely%20exposed%20to%20high%20altitude%20(4340%20m).pdf
  • 19. A López-Fando, M P Gómez-Serranillos, I Iglesias, O Lock, U P Upamayta, M E Carretero, "Lepidium peruvianum chacon restores homeostasis impaired by restraint stress", Phytother Res . 2004 Jun;18(6):471-4. doi: 10.1002/ptr.1455.. https://pubmed.ncbi.nlm.nih.gov/15287072/
  • 20. G. F. Gonzales,A. Córdova,K. Vega,A. Chung,A. Villena,C. Góñez,S. Castillo, "Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men", Journal of Andrology. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1439-0272.2002.00519.x
  • 21. Byung-Cheul Shin, Myeong Soo Lee, Eun Jin Yang, Hyun-Suk Lim, Edzard Ernst, "Maca (L. meyenii) for improving sexual function: a systematic review", BMC Complement Altern Med . 2010 Aug 6;10:44. doi: 10.1186/1472-6882-10-44.. https://pubmed.ncbi.nlm.nih.gov/20691074/
  • 22. José Manuel Lozano Sánchez, Zoraida Axtle, Julio Aviles, Héctor Salvador Godoy Morales, Paola Berenice Merchand Álvarez, Ricardo Mera Mejía, Luis Felipe Montaño Estrada, Erika Patricia Rendón Huerta, "Peruvian Maca and Possible Impact on Fertility", Journal of Nutritional Health & Food Engineering. https://www.researchgate.net/publication/317569911_Peruvian_Maca_and_Possible_Impact_on_Fertility
  • 23. Hongkang Zhu, Wenqian Xu, Ning Wang, Wenhao Jiang, Yuliang Cheng, Yahui Guo, Weirong Yao, Bin Hu, Peng Du and He Qian, "Anti-fatigue effect of Lepidium meyenii Walp. (Maca) on preventing mitochondria-mediated muscle damage and oxidative stress in vivo and vitro†", Journal of Food & Function. https://pubs.rsc.org/en/content/articlelanding/2021/fo/d1fo00383f/unauth
  • 24. Mark Stone, Alvin Ibarra, Marc Roller, Andrea Zangara, Emma Stevenson, "A pilot investigation into the effect of maca supplementation on physical activity and sexual desire in sportsmen", J Ethnopharmacol . 2009 Dec 10;126(3):574-6. doi: 10.1016/j.jep.2009.09.012. Epub 2009 Sep 23.. https://pubmed.ncbi.nlm.nih.gov/19781622/
  • 25. Gustavo F Gonzales, Sara Miranda, Jessica Nieto, Gilma Fernández, Sandra Yucra, Julio Rubio, Pedro Yi & Manuel Gasco, "Red maca (Lepidium meyenii) reduced prostate size in rats", Reprod Biol Endocrinol 3, 5 (2005). https://doi.org/10.1186/1477-7827-3-5. https://rbej.biomedcentral.com/articles/10.1186/1477-7827-3-5
  • 26. C Gonzales, J Leiva-Revilla, J Rubio, M Gasco, G F Gonzales, "Effect of red maca (Lepidium meyenii) on prostate zinc levels in rats with testosterone-induced prostatic hyperplasia", Andrologia . 2012 May;44 Suppl 1:362-9. doi: 10.1111/j.1439-0272.2011.01190.x. Epub 2011 Jul 18.. https://pubmed.ncbi.nlm.nih.gov/21762188/
  • 27. G. F. Gonzales,A. Córdova,K. Vega,A. Chung,A. Villena,C. Góñez,S. Castillo, "Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men", Journal of Andrology. https://onlinelibrary.wiley.com/doi/full/10.1046/j.1439-0272.2002.00519.x
  • 28. Y Ohta, N Kawate, T Inaba, H Morii, K Takahashi, H Tamada, "Feeding hydroalcoholic extract powder of Lepidium meyenii (maca) enhances testicular gene expression of 3β-hydroxysteroid dehydrogenase in rats", Andrologia . 2017 Dec;49(10). doi: 10.1111/and.12792. Epub 2017 Mar 6.. https://pubmed.ncbi.nlm.nih.gov/28261840/
  • 29. Ángel Rodríguez-Huamán, Sandra Casimiro-Gonzales, Jorge Antonio Chávez-Pérez, Carla Gonzales-Arimborgo, Richard Cisneros-Fernández, Luis Ángel Aguilar-Mendoza, Gustavo F Gonzales, "Antioxidant and neuroprotector effect of Lepidium meyenii (maca) methanol leaf extract against 6-hydroxy dopamine (6-OHDA)-induced toxicity in PC12 cells", Toxicol Mech Methods . 2017 May;27(4):279-285. doi: 10.1080/15376516.2016.1275908. Epub 2017 Jan 8.. https://pubmed.ncbi.nlm.nih.gov/28007001/
  • 30. Bárbara Teixeira, António Marques, Cristina Ramos, Maria Carmo Serrano, Olívia Matos, Nuno R Neng, José Nogueira, Jorge M. A. Saraiva, Maria Leonor Nunes, "Chemical composition and bioactivity of different oregano (Origanum vulgare) extracts and essential oil", Journal of the Science of Food and Agriculture 93(11) DOI:10.1002/jsfa.6089. https://www.researchgate.net/publication/236104725_Chemical_composition_and_bioactivity_of_different_oregano_Origanum_vulgare_extracts_and_essential_oil
  • 31. Wesam Kooti, Zahra Hasanzadeh-Noohi, Naim Sharafi-Ahvazi, Majid Asadi-Samani, Damoon Ashtary-Larky, "Phytochemistry, pharmacology, and therapeutic uses of black seed (Nigella sativa)", Chin J Nat Med . 2016 Oct;14(10):732-745. doi: 10.1016/S1875-5364(16)30088-7. Epub 2016 Oct 31.. https://pubmed.ncbi.nlm.nih.gov/28236403/
  • 32. Łukasz Łuczaj & Wojciech M Szymański, "Wild vascular plants gathered for consumption in the Polish countryside: a review.", Journal of Ethnobiology and Ethnomedicine volume 3, Article number: 17 (2007). https://ethnobiomed.biomedcentral.com/articles/10.1186/1746-4269-3-17
  • 33. IKHLAS A. KHAN, EHAB A. ABOURASHED, "Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics.", John Wiley & Sons, Inc., Hoboken, New Jersey. https://naturalingredient.org/wp/wp-content/uploads/leungs-encyclopedia-of-common-natural-ingredients-3rd-edition.pdf
  • 34. Adom MB, Taher M, Mutalabisin MF, Amri MS, Abdul Kudos MB, Wan Sulaiman MWA, Sengupta P, Susanti D, "Chemical constituents and medical benefits of Plantago major.", Biomedecine & Pharmacotherapie, 10 Oct 2017, 96:348-360 DOI: 10.1016/j.biopha.2017.09.152 PMID: 29028587. https://europepmc.org/article/med/29028587#similar-articles
  • 35. ZOT Organic, "What is Licorice?", General Info. https://zotorganic.com/information/licorice/#:~:text=The%20plant%20is%20prized%20for,shrub%2C%20is%20officially%20a%20weed.
  • 36. Dalia Akramiene, Anatolijus Kondrotas, Janina Didziapetriene, Egidijus Kevelaitis, "Effects of beta-glucans on the immune system", Medicina (Kaunas) . 2007;43(8):597-606.. https://pubmed.ncbi.nlm.nih.gov/17895634/
  • 37. R C Rosen, "Prevalence and risk factors of sexual dysfunction in men and women", Curr Psychiatry Rep . 2000 Jun;2(3):189-95. doi: 10.1007/s11920-996-0006-2.. https://pubmed.ncbi.nlm.nih.gov/11122954/
  • 38. Natália da Silva Leitão Peres, Letícia Cabrera Parra Bortoluzzi, Leila Larisa Medeiros Marques, Maysa Formigoni, Renata Hernandez Barros Fuchs, Adriana Aparecida Droval, Flávia Aparecida Reitz Cardoso, "Medicinal effects of Peruvian maca (Lepidium meyenii): a review", Food Funct . 2020 Jan 29;11(1):83-92. doi: 10.1039/c9fo02732g.. https://pubmed.ncbi.nlm.nih.gov/31951246/
  • 39. Nicole A Brooks, Gisela Wilcox, Karen Z Walker, John F Ashton, Marc B Cox, Lily Stojanovska, "Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen content", Menopause . 2008 Nov-Dec;15(6):1157-62. doi: 10.1097/gme.0b013e3181732953.. https://pubmed.ncbi.nlm.nih.gov/18784609/
  • 40. Maria Rosales-Hartshorn*, "Maca: Botanical Medicine from the Andes", Adv Food Technol Nutr Sci Open J. 2015; 1(2): e1-e6. doi: 10.17140/AFTNSOJ-1-e001. https://www.openventio.org/Volume1-Issue2/Maca-Botanical-Medicine-from-the-Andes-AFTNSOJ-1-e001.pdf
  • 41. Sánchez JML, Serrano ZA, Durán JA, Morales HSG, Álvarez PBM (2017), "Peruvian Maca and Possible Impact on Fertility", J Nutr Health Food Eng 6(5): 00217. DOI: 10.15406/jnhfe.2017.06.00217. https://www.researchgate.net/profile/Jose-Manuel-Lozano-Sanchez/publication/317569911_Peruvian_Maca_and_Possible_Impact_on_Fertility/links/59494b03aca272a30c6cae11/Peruvian-Maca-and-Possible-Impact-on-Fertility.pdf
  • 42. Leila Mazaheri Nia, Mina Iravani, Parvin Abedi, Bahman Cheraghian, "Effect of Zinc on Testosterone Levels and Sexual Function of Postmenopausal Women: A Randomized Controlled Trial", J Sex Marital Ther . 2021;47(8):804-813. doi: 10.1080/0092623X.2021.1957732. Epub 2021 Jul 27.. https://pubmed.ncbi.nlm.nih.gov/34311679/
  • 43. G. F. Gonzales,A. Córdova,K. Vega,A. Chung,A. Villena,C. Góñez,S. Castillo, "Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men", Journal of Andrology. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1439-0272.2002.00519.x
  • 44. Byung-Cheul Shin 1, Myeong Soo Lee, Eun Jin Yang, Hyun-Suk Lim, Edzard Ernst, "Maca (L. meyenii) for improving sexual function: a systematic review", BMC Complement Altern Med . 2010 Aug 6;10:44. doi: 10.1186/1472-6882-10-44.. https://pubmed.ncbi.nlm.nih.gov/20691074/
  • 45. Ghanbarali Raeis Jalali, Jamshid Roozbeh, Azam Mohammadzadeh, Maryam Sharifian, Mohammad Mahdi Sagheb, Alireza Hamidian Jahromi, Sanaz Shabani, Fariborz Ghaffarpasand, Raha Afshariani, "Impact of oral zinc therapy on the level of sex hormones in male patients on hemodialysis", Ren Fail . 2010 May;32(4):417-9. doi: 10.3109/08860221003706958.. https://pubmed.ncbi.nlm.nih.gov/20446777/
  • 46. Tahoora Shomali, Mahnaz Taherianfard, Maryam Dalvand, Fatemeh Namazi, "Effect of pharmacological doses of niacin on testicular structure and function in normal and diabetic rats", Andrologia . 2018 Dec;50(10):e13142. doi: 10.1111/and.13142. Epub 2018 Sep 6.. https://pubmed.ncbi.nlm.nih.gov/30191583/
  • 47. Gonzales G. F., Cordova A., Gonzales C., Chung A., Vega K., Villena A., "Lepidium meyenii (Maca) improved semen parameters in adult men.", Asian Journal of Andrology. 2001;3(4):301–303.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411442/#B19
  • 48. Bogani P., Simonini F., Iriti M., et al., "Lepidium meyenii (Maca) does not exert direct androgenic activities.", Journal of Ethnopharmacology. 2006;104(3):415–417. doi: 10.1016/j.jep.2005.09.028.. ncbi.nlm.nih.gov/pmc/articles/PMC4411442/#B27
  • 49. Gonzalez G. F., Córdova A., Vega K., Chung A., Villena A., Góñez C., "Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing propeties, on serum reproductive hormone levels in adult healthy men.", Journal of Endocrinology. 2003;176(1):163–168. doi: 10.1677/joe.0.1760163.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411442/#B28
  • 50. Christina M. Dording , * Pamela J. Schettler, Elizabeth D. Dalton, Susannah R. Parkin, Rosemary S. W. Walker, Kara B. Fehling, Maurizio Fava, and David Mischoulon, "A Double-Blind Placebo-Controlled Trial of Maca Root as Treatment for Antidepressant-Induced Sexual Dysfunction in Women", Journal List Evid Based Complement Alternat Med v.2015; 2015 PMC4411442. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411442/
  • 51. Srikugan L., Sankaralingam A., McGowan B., "First case report of testosterone assay-interference in a female taking maca (Lepidium meyenii) BMJ Case Reports.", 2011 doi: 10.1136/bcr.01.2011.3781.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411442/#B26
  • 52. Olivia Remes,Carol Brayne,Rianne van der Linde,Louise Lafortune, "A systematic review of reviews on the prevalence of anxiety disorders in adult populations", Journal of Brain and Behavior, 05 June 2016. https://onlinelibrary.wiley.com/doi/10.1002/brb3.497
  • 53. Rohit Verma, Yatan Pal Singh Balhara, and Chandra Shekhar Gupta, "Gender differences in stress response: Role of developmental and biological determinants", Journal List Ind Psychiatry J v.20(1); Jan-Jun 2011 PMC3425245. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425245/
  • 54. Mohammad Hossein Mirjalili, Elisabeth Moyano, Mercedes Bonfill, Rosa M Cusido, Javier Palazón, "Steroidal lactones from Withania somnifera, an ancient plant for novel medicine", Molecules . 2009 Jul 3;14(7):2373-93.. https://pubmed.ncbi.nlm.nih.gov/19633611/
  • 55. R C Rosen, "Prevalence and risk factors of sexual dysfunction in men and women", Curr Psychiatry Rep . 2000 Jun;2(3):189-95. DOI: 10.1007/s11920-996-0006-2.. https://pubmed.ncbi.nlm.nih.gov/11122954/
  • 56. Swati Dongre, Deepak Langade, Sauvik Bhattacharyya, "Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study", Biomed Res Int . 2015;2015:284154. doi: 10.1155/2015/284154.. https://pubmed.ncbi.nlm.nih.gov/26504795/
  • 57. UT NEWS, "Stress Hormone Blocks Testosterone’s Effects, Study Shows", Journal of Science and Technology. https://news.utexas.edu/2010/09/27/stress-hormone-blocks-testosterones-effects-study-shows/
  • 58. Rashad, N.M., Samir, G.M., "Prevalence, risks, and comorbidity of thyroid dysfunction: a cross-sectional epidemiological study", Egypt J Intern Med 31, 635–641 (2019). https://ejim.springeropen.com/articles/10.4103/ejim.ejim_22_19
  • 59. Cleveland Clinic, "Thyroid: What It Is, Function and Problems", Journal of Body Systems & Organs. https://my.clevelandclinic.org/health/body/23188-thyroid
  • 60. Sharma AK, Basu I, Singh S., "Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial", J Altern Complement Med. 2018 Mar;24(3):243-248. doi: 10.1089/acm.2017.0183. Epub 2017 Aug 22. PMID: 28829155.. https://pubmed.ncbi.nlm.nih.gov/28829155/
  • 61. Chandrasekhar K, Kapoor J, Anishetty S., "A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults", Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022. PMID: 23439798; PMCID: PMC3573577.. https://pubmed.ncbi.nlm.nih.gov/23439798/
  • 62. Stephens MA, Wand G., "Stress and the HPA axis: role of glucocorticoids in alcohol dependence", Alcohol Res. 2012;34(4):468-83. PMID: 23584113; PMCID: PMC3860380.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860380/
  • 63. Centers for Disease Control and Prevention, "1 in 3 adults don’t get enough sleep", CDC.gov. https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html
  • 64. Centers for Disease Control and Prevention, "Sleep and Sleep Disorders", CDC.gov. https://www.cdc.gov/sleep/data_statistics.html
  • 65. Krishnan V, Collop NA., "Gender differences in sleep disorders", Curr Opin Pulm Med. 2006 Nov;12(6):383-9. doi: 10.1097/01.mcp.0000245705.69440.6a. PMID: 17053485.. https://pubmed.ncbi.nlm.nih.gov/17053485/
  • 66. Danielle Pacheco, Ealena Callender, "Women and Sleep", Sleep Foundation. https://www.sleepfoundation.org/women-sleep
  • 67. Langade D, Thakare V, Kanchi S, Kelgane S., "Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study", J Ethnopharmacol. 2021 Jan 10;264:113276. doi: 10.1016/j.jep.2020.113276. Epub 2020 Aug 17. PMID: 32818573.. https://pubmed.ncbi.nlm.nih.gov/32818573/
  • 68. Abhijit Deshpande, Nushafreen Irani, Ratna Balkrishnan, Irin Rosanna Benny, "A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults", Sleep Medicine, Volume 72, 2020, Pages 28-36, ISSN 1389-9457,. https://www.sciencedirect.com/science/article/abs/pii/S1389945720301246
  • 69. Mahesh K. Kaushik, Sunil C. Kaul, Renu Wadhwa, Masashi Yanagisawa, Yoshihiro Urade, "Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction", plos.org DOI:10.1371/journal.pone.0172508. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172508#abstract0
  • 70. Auddy B, Hazra J, Mitra A, et al., "A standardized Withania Somnifera extract significantly reduces stress-related parameters in chronically stressed humans: a double-blind, randomized, placebo-controlled study", J Am Neutraceut Assoc 2008;11:50–6.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750292/#R20
  • 71. Andrade C, Aswath A, Chaturvedi SK, et al., "A double-blind, placebo-controlled evaluation of the anxiolytic efficacy ff an ethanolic extract of withania somnifera", Indian J Psychiatry 2000;42:295–301.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750292/#R18
  • 72. Fries E, Dettenborn L, Kirschbaum C., "The cortisol awakening response (CAR): facts and future directions", Int J Psychophysiol. 2009 Apr;72(1):67-73. doi: 10.1016/j.ijpsycho.2008.03.014. Epub 2008 Sep 30. PMID: 18854200.. https://pubmed.ncbi.nlm.nih.gov/18854200/
  • 73. Nicolas C. Nicolaides, Alexandros N. Vgontzas, Ilia Kritikou, George Chrousos Kenneth R Feingold, Bradley Anawalt, Alison Boyce, George Chrousos, Wouter W de Herder, Ketan Dhatariya, Kathleen Dungan, Jerome M Hershman, Johannes Hofland, Sanjay Kalra, Gregory Kaltsas, Christian Koch, Peter Kopp, Márta Korbonits, Christopher S Kovacs, Wendy Kuohung, Blandine Laferrère, Miles Levy, Elizabeth A McGee, Robert McLachlan, John E Morley, Maria New, Jonathan Purnell, Rakesh Sahay, Frederick Singer, Mark A Sperling, Constantine A Stratakis, Dace L Trence, Don P Wilson, "HPA Axis and Sleep", In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. 2020 Nov 24. PMID: 25905298 Bookshelf ID: NBK279071. https://pubmed.ncbi.nlm.nih.gov/25905298/
  • 74. Bhattacharya SK, Bhattacharya A, Sairam K, Ghosal S., "Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an experimental study", Phytomedicine. 2000 Dec;7(6):463-9. doi: 10.1016/S0944-7113(00)80030-6. PMID: 11194174.. https://pubmed.ncbi.nlm.nih.gov/11194174/
  • 75. Gopal S, Ajgaonkar A, Kanchi P, Kaundinya A, Thakare V, Chauhan S, Langade D., "Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study", J Obstet Gynaecol Res. 2021 Dec;47(12):4414-4425. doi: 10.1111/jog.15030. Epub 2021 Sep 22. PMID: 34553463.. https://pubmed.ncbi.nlm.nih.gov/34553463/
  • 76. Chandrasekhar K, Kapoor J, Anishetty S., "A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults.", Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022. PMID: 23439798; PMCID: PMC3573577.. https://pubmed.ncbi.nlm.nih.gov/23439798/
  • 77. Khedgikar V, Kushwaha P, Gautam J, Verma A, Changkija B, Kumar A, Sharma S, Nagar GK, Singh D, Trivedi PK, Sangwan NS, Mishra PR, Trivedi R., "Withaferin A: a proteasomal inhibitor promotes healing after injury and exerts anabolic effect on osteoporotic bone", Cell Death Dis. 2013 Aug 22;4(8):e778. doi: 10.1038/cddis.2013.294. PMID: 23969857; PMCID: PMC3763455.. https://pubmed.ncbi.nlm.nih.gov/23969857/
  • 78. Sandi C., "Stress and cognition", Wiley Interdiscip Rev Cogn Sci. 2013 May;4(3):245-261. doi: 10.1002/wcs.1222. Epub 2013 Jan 22. PMID: 26304203.. https://pubmed.ncbi.nlm.nih.gov/26304203/
  • 79. Killgore WD., "Effects of sleep deprivation on cognition", Prog Brain Res. 2010;185:105-29. doi: 10.1016/B978-0-444-53702-7.00007-5. PMID: 21075236.. https://pubmed.ncbi.nlm.nih.gov/21075236/
  • 80. Ali SA, Begum T, Reza F., "Hormonal Influences on Cognitive Function", Malays J Med Sci. 2018 Jul;25(4):31-41. doi: 10.21315/mjms2018.25.4.3. Epub 2018 Aug 30. PMID: 30914845; PMCID: PMC6422548.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422548/
  • 81. Choudhary D, Bhattacharyya S, Bose S., "Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions", J Diet Suppl. 2017 Nov 2;14(6):599-612. doi: 10.1080/19390211.2017.1284970. Epub 2017 Feb 21. PMID: 28471731.. https://pubmed.ncbi.nlm.nih.gov/28471731/
  • 82. Dar NJ, MuzamilAhmad., "Neurodegenerative diseases and Withania somnifera (L.): An update.", J Ethnopharmacol. 2020 Jun 28;256:112769. doi: 10.1016/j.jep.2020.112769. Epub 2020 Mar 30. PMID: 32240781.. https://pubmed.ncbi.nlm.nih.gov/32240781/
  • 83. Bonilla DA, Moreno Y, Gho C, Petro JL, Odriozola-Martínez A, Kreider RB., "Effects of Ashwagandha (Withania somnifera) on Physical Performance: Systematic Review and Bayesian Meta-Analysis", J Funct Morphol Kinesiol. 2021 Feb 11;6(1):20. doi: 10.3390/jfmk6010020. PMID: 33670194; PMCID: PMC8006238.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006238/
  • 84. GRAHAM BINDER, "Researchers with the College of AGNR study nutrient-packed microgreens", College of Agriculture & Natural Resources, September 6, 2012. https://agnr.umd.edu/news/mighty-microgreens
  • 85. GAO, "While Levels in Clothing Generally Appear to Be Low, Allergic Contact Dermatitis Is a Health Issue for Some People", United States Government Accountability Office, Report to Congressional Committees, August 2010. https://www.gao.gov/assets/gao-10-875.pdf
  • 86. Dongre S, Langade D, Bhattacharyya S., "Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study.", Biomed Res Int. 2015;2015:284154. doi: 10.1155/2015/284154. Epub 2015 Oct 4. PMID: 26504795; PMCID: PMC4609357.. https://pubmed.ncbi.nlm.nih.gov/26504795/
  • 87. Chauhan, S, Srivastava, MK, Pathak, AK., "Effect of standardized root extract of ashwagandha (Withania somnifera) on well-being and sexual performance in adult males: a randomized controlled trial", Health Sci Rep. 2022; 5:e741. doi:10.1002/hsr2.741. https://onlinelibrary.wiley.com/doi/10.1002/hsr2.741
  • 88. Langade D, Thakare V, Kanchi S, Kelgane S., "Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study", J Ethnopharmacol. 2021 Jan 10;264:113276. doi: 10.1016/j.jep.2020.113276. Epub 2020 Aug 17. PMID: 32818573.. https://pubmed.ncbi.nlm.nih.gov/32818573/
  • 89. Abhijit Deshpande, Nushafreen Irani, Ratna Balkrishnan, Irin Rosanna Benny,, "A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults,", Sleep Medicine, Volume 72, 2020, Pages 28-36, ISSN 1389-9457, https://doi.org/10.1016/j.sleep.2020.03.012.. https://www.sciencedirect.com/science/article/abs/pii/S1389945720301246
  • 90. Bhattacharya SK, Bhattacharya A, Sairam K, Ghosal S, "Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an experimental study", Phytomedicine. 2000 Dec;7(6):463-9. doi: 10.1016/S0944-7113(00)80030-6. PMID: 11194174.. https://pubmed.ncbi.nlm.nih.gov/11194174/
  • 91. Rashad, N.M., Samir, G.M., "Prevalence, risks, and comorbidity of thyroid dysfunction: a cross-sectional epidemiological study", Egypt J Intern Med 31, 635–641 (2019). https://doi.org/10.4103/ejim.ejim_22_19. https://ejim.springeropen.com/articles/10.4103/ejim.ejim_22_19
  • 92. Durg S, Bavage S, Shivaram SB, "Withania somnifera (Indian ginseng) in diabetes mellitus: A systematic review and meta-analysis of scientific evidence from experimental research to clinical application", Phytother Res. 2020 May;34(5):1041-1059. doi: 10.1002/ptr.6589. Epub 2020 Jan 23. PMID: 31975514.. https://pubmed.ncbi.nlm.nih.gov/31975514/
  • 93. ASRM, American Society for Reproductive Medicine, "In approximately 40 percent of infertile couples, the male partner is either the sole cause or a contributing cause of infertility", Reproductivefacts.org/resources/infographic-gallery. https://www.reproductivefacts.org/resources/infographic-gallery/images/in-approximately-40-percent-of-infertile-couples-the-male-partner-is-either-the-sole-cause-or-a-contributing-cause-of-infertility/
  • 94. Tiwari S, Gupta SK, Pathak AK, "A double-blind, randomized, placebo-controlled trial on the effect of Ashwagandha (Withania somnifera dunal.) root extract in improving cardiorespiratory endurance and recovery in healthy athletic adults", J Ethnopharmacol. 2021 May 23;272:113929. doi: 10.1016/j.jep.2021.113929. Epub 2021 Feb 15. PMID: 33600918.. https://pubmed.ncbi.nlm.nih.gov/33600918/
  • 95. Chandrasekhar K, Kapoor J, Anishetty S, "A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults", Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022. PMID: 23439798; PMCID: PMC3573577. https://pubmed.ncbi.nlm.nih.gov/23439798/
  • 96. Mirjalili MH, Moyano E, Bonfill M, Cusido RM, Palazón J, "Steroidal lactones from Withania somnifera, an ancient plant for novel medicine", Molecules. 2009 Jul 3;14(7):2373-93. doi: 10.3390/molecules14072373. PMID: 19633611; PMCID: PMC6255378. https://pubmed.ncbi.nlm.nih.gov/19633611/
  • 97. Carnegie Mellon University, "Stress Contributes To Range Of Chronic Diseases, Review Shows", ScienceDaily. ScienceDaily, 10 October 2007. https://www.sciencedaily.com/releases/2007/10/071009164122.htm
  • 98. Bremner JD, "Does stress damage the brain?", Biol Psychiatry. 1999 Apr 1;45(7):797-805. doi: 10.1016/s0006-3223(99)00009-8. PMID: 10202566. https://pubmed.ncbi.nlm.nih.gov/10202566/
  • 99. Kalmbach DA, Anderson JR, Drake CL, "The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders", J Sleep Res. 2018 Dec;27(6):e12710. doi: 10.1111/jsr.12710. Epub 2018 May 24. PMID: 29797753; PMCID: PMC7045300. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045300/
  • 100. National Institutes of Health, "Poor Sleep Linked With Higher Blood Sugar", newsinhealth.nih.gov/Health Capsule/ July 2022. https://newsinhealth.nih.gov/2020/07/poor-sleep-linked-higher-blood-sugar
  • 101. Winston D, Maimes S, "Adaptogens: Herbs for Strength, Stamina, and Stress Relief", Rochester: Inner Traditions/Bear & Co. Vol. 48. Rochester: Inner Traditions/Bear & Co; 2007; p. 53. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6979308/#REF8
  • 102. Bhatnagar M, Sharma D, Salvi M, "Neuroprotective effects of Withania somnifera dunal.: A possible mechanism", Neurochem Res. 2009 Nov;34(11):1975-83. doi: 10.1007/s11064-009-9987-7. Epub 2009 May 15. PMID: 19444606. https://pubmed.ncbi.nlm.nih.gov/19444606/
  • 103. Salve J, Pate S, Debnath K, Langade D, "Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study", Cureus. 2019 Dec 25;11(12):e6466. doi: 10.7759/cureus.6466. PMID: 32021735; PMCID: PMC6979308. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6979308/
  • 104. Gopukumar, K.Thanawala, S. Somepalli, V. Rao Sathyanaryana, T. S. Thamatam, V.B. Chauhan, S., "Efficacy and Safety of Ashwagandha Root Extract on Cognitive Functions in Healthy, Stressed Adults: A Randomized, Double-Blind, Placebo-Controlled Study", Evidence-Based Complementary and Alternative Medicine/ Volume 2021/Article ID 8254344. https://www.hindawi.com/journals/ecam/2021/8254344/
  • 105. Choudhary D, Bhattacharyya S, Bose S., "Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions", J Diet Suppl. 2017 Nov 2;14(6):599-612. doi: 10.1080/19390211.2017.1284970. Epub 2017 Feb 21. PMID: 28471731. https://pubmed.ncbi.nlm.nih.gov/28471731/
  • 106. Dar NJ, MuzamilAhmad, "Neurodegenerative diseases and Withania somnifera (L.): An update", J Ethnopharmacol. 2020 Jun 28;256:112769. doi: 10.1016/j.jep.2020.112769. Epub 2020 Mar 30. PMID: 32240781. https://pubmed.ncbi.nlm.nih.gov/32240781/
  • 107. LULU XIE, HONGYI KANG, QIWU XU, MICHAEL J. CHEN, YONGHONG LIAO, MEENAKSHISUNDARAM THIYAGARAJAN, JOHN O’DONNELL, DANIEL J. CHRISTENSEN, CHARLES NICHOLSON, JEFFREY J. ILIFF, TAKAHIRO TAKANO, RASHID DEANE, AND MAIKEN NEDERGAARD, "Sleep Drives Metabolite Clearance from the Adult Brain", SCIENCE 18 Oct 2013 Vol 342, Issue 6156 pp. 373-377 DOI: 10.1126/science.1241224. https://www.science.org/doi/10.1126/science.1241224
  • 108. Bhatnagar M, Sharma D, Salvi M, "Neuroprotective effects of Withania somnifera dunal.: A possible mechanism", Neurochem Res. 2009 Nov;34(11):1975-83. doi: 10.1007/s11064-009-9987-7. Epub 2009 May 15. PMID: 19444606. https://pubmed.ncbi.nlm.nih.gov/19444606/
  • 109. Baker C, Kirby JB, O'Connor J, Lindsay KG, Hutchins A, Harris M, "The Perceived Impact of Ashwagandha on Stress, Sleep Quality, Energy, and Mental Clarity for College Students: Qualitative Analysis of a Double-Blind Randomized Control Trial", J Med Food. 2022 Aug 18. doi: 10.1089/jmf.2022.0042. Epub ahead of print. PMID: 35984870. https://pubmed.ncbi.nlm.nih.gov/35984870/
  • 110. Nayely Leyva-López, et al, "Essential Oils of Oregano: Biological Activity beyond Their Antimicrobial Properties", https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152729/
  • 111. S. Santoya et al, "Supercritical carbon dioxide extraction of compounds with antimicrobial activity from Origanum vulgare L.: determination of optimal extraction parameters", https://pubmed.ncbi.nlm.nih.gov/16496578/
  • 112. Snigdha Sacena et al, "Evaluation of Systemic Oxidative Stress in Patients with Premature Canities and Correlation of Severity of Hair Graying with the Degree of Redox Imbalance", https://pubmed.ncbi.nlm.nih.gov/32549695/
  • 113. Yunes Panahi et al, "Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial", https://pubmed.ncbi.nlm.nih.gov/25842469/
  • 114. Stephen C Barker & Phillip M Altman, "An ex vivo, assessor blind, randomised, parallel group, comparative efficacy trial of the ovicidal activity of three pediculicides after a single application - melaleuca oil and lavender oil, eucalyptus oil and lemon tea tree oil, and a "suffocation" pediculicide", https://bmcdermatol.biomedcentral.com/articles/10.1186/1471-5945-11-14
  • 115. C Hay et al, "Randomized trial of aromatherapy. Successful treatment for alopecia areata", https://pubmed.ncbi.nlm.nih.gov/9828867/
  • 116. "Synaptic Pruning", https://www.sciencedirect.com/topics/veterinary-science-and-veterinary-medicine/synaptic-pruning
  • 117. CeJpeK, K, "“Antioxidant Activity in Variously Prepared Elderberry Foods and Supplements.”", Czech J. Food Sci. Vol. 27, 2009, Special Issue. https://www.agriculturejournals.cz/publicFiles/07578.pdf
  • 118. Porter RS, Bode RF, "A Review of the Antiviral Properties of Black Elder (Sambucus nigra L.) Products", Phytother Res. 2017 Apr;31(4):533-554. doi: 10.1002/ptr.5782. Epub 2017 Feb 15. PMID: 28198157..
  • 119. Deepak Langade, Subodh Kanchi, Jaising Salve, Khokan Debnath, and Dhruv Ambegaokar, "Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study", Cureus. 2019 Sep; 11(9): e5797. Published online 2019 Sep 28. doi: 10.7759/cureus.5797 PMCID: PMC6827862PMID: 31728244. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827862/
  • 120. Mohammad Hossein Mirjalili, Elisabeth Moyano, Mercedes Bonfill, Rosa M Cusido, Javier Palazón, "Steroidal lactones from Withania somnifera, an ancient plant for novel medicine", Molecules. 2009 Jul 3;14(7):2373-93. doi: 10.3390/molecules14072373.. https://pubmed.ncbi.nlm.nih.gov/19633611/
  • 121. Deepak Langade, Subodh Kanchi, Jaising Salve, Khokan Debnath, Dhruv Ambegaokar, "Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study", Cureus . 2019 Sep 28;11(9):e5797. doi: 10.7759/cureus.5797.. https://pubmed.ncbi.nlm.nih.gov/31728244/
  • 122. Biswajit Auddy, PhD1; Jayaram Hazra, PhD2; Achintya Mitra, MD2; Bruce Abedon, PhD3; Shibnath Ghosal, PhD1, "A Standardized Withania Somnifera Extract Significantly Reduces Stress-Related Parameters in Chronically Stressed Humans: A Double-Blind, Randomized, Placebo-Controlled Study", JANA Vol 11, No.1 2008. https://blog.priceplow.com/wp-content/uploads/2014/08/withania_review.pdf
  • 123. K Chandrasekhar, Jyoti Kapoor, Sridhar Anishetty, "A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults", Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022.. https://pubmed.ncbi.nlm.nih.gov/23439798/
  • 124. Deepak Langade, Vaishali Thakare, Subodh Kanchi, Sunil Kelgane, "Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study", Randomized Controlled Trial J Ethnopharmacol. 2021 Jan 10;264:113276.. https://pubmed.ncbi.nlm.nih.gov/32818573/
  • 125. Abhijit Deshpandea, Nushafreen Irania, Ratna BalkrishnanaIrin, Rosanna Bennyb, "A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults", Sleep Medicine Volume 72, August 2020, Pages 28-36. https://www.sciencedirect.com/science/article/abs/pii/S1389945720301246
  • 126. Mahesh K. Kaushik ,Sunil C. Kaul, Renu Wadhwa,Masashi Yanagisawa, Yoshihiro Urade, "Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction", Published: February 16, 2017 https://doi.org/10.1371/journal.pone.0172508. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172508
  • 127. Mahesh K. Kaushik ,Sunil C. Kaul, Renu Wadhwa,Masashi Yanagisawa, Yoshihiro Urade, "Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction", Published: February 16, 2017 https://doi.org/10.1371/journal.pone.0172508. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172508
  • 128. Adrian L. Lopresti, PhD,a,b,∗ Stephen J. Smith, MA,a,b Hakeemudin Malvi, MBBS, MD,c and Rahul Kodgule, MBBSd, "An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract", Medicine (Baltimore). 2019 Sep; 98(37): e17186. Published online 2019 Sep 13. doi: 10.1097/MD.0000000000017186. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750292/#R20
  • 129. Adrian L. Lopresti, PhD,a,b,∗ Stephen J. Smith, MA,a,b Hakeemudin Malvi, MBBS, MD,c and Rahul Kodgule, MBBSd, "An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract", Medicine (Baltimore). 2019 Sep; 98(37): e17186. Published online 2019 Sep 13. doi: 10.1097/MD.0000000000017186. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750292/#R18
  • 130. Nicolas C. Nicolaides, Alexandros N. Vgontzas, Ilia Kritikou, George Chrousos Kenneth R Feingold, Bradley Anawalt, Alison Boyce, George Chrousos, Wouter W de Herder, Ketan Dhatariya, Kathleen Dungan, Jerome M Hershman, Johannes Hofland, Sanjay Kalra, Gregory Kaltsas, Christian Koch, Peter Kopp, Márta Korbonits, Christopher S Kovacs, Wendy Kuohung, Blandine Laferrère, Miles Levy, Elizabeth A McGee, Robert McLachlan, John E Morley, Maria New, Jonathan Purnell, Rakesh Sahay, Frederick Singer, Mark A Sperling, Constantine A Stratakis, Dace L Tren, Don P Wilson, editors., "HPA Axis and Sleep", In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. 2020 Nov 24.. https://pubmed.ncbi.nlm.nih.gov/25905298/
  • 131. Eva Fries, Lucia Dettenborn, Clemens Kirschbaum, "The cortisol awakening response (CAR): facts and future directions", Int J Psychophysiol. 2009 Apr;72(1):67-73. doi: 10.1016/j.ijpsycho.2008.03.014. Epub 2008 Sep 30.. https://pubmed.ncbi.nlm.nih.gov/18854200/
  • 132. Nicolas C. Nicolaides, Alexandros N. Vgontzas, Ilia Kritikou, George Chrousos Kenneth R Feingold, Bradley Anawalt, Alison Boyce, George Chrousos, Wouter W de Herder, Ketan Dhatariya, Kathleen Dungan, Jerome M Hershman, Johannes Hofland, Sanjay Kalra, Gregory Kaltsas, Christian Koch, Peter Kopp, Márta Korbonits, Christopher S Kovacs, Wendy Kuohung, Blandine Laferrère, Miles Levy, Elizabeth A McGee, Robert McLachlan, John E Morley, Maria New, Jonathan Purnell, Rakesh Sahay, Frederick Singer, Mark A Sperling, Constantine A Stratakis, Dace L Tren, Don P Wilson, editors., "HPA Axis and Sleep", In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. 2020 Nov 24.. https://pubmed.ncbi.nlm.nih.gov/25905298/