Up to 80% of women suffer from physical, mental, and emotional manifestations of hormonal imbalances. Signs and symptoms that indicate you may be struggling with hormonal imbalances include irregular menstrual cycles, heavy periods, premenstrual syndrome, infertility, hot flashes, weight gain, and hair loss. Functional medicine practitioners can help identify the root causes of hormonal dysregulation and implement an integrative treatment plan that gets hormones back on track. Maca has gained popularity for its ability to support hormonal health, especially when treating pesky symptoms related to the menopausal transition.

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Understanding Hormonal Imbalance and Menopause

The hypothalamic-pituitary-ovarian (HPO) axis orchestrates the release of sex hormones. The process begins with the hypothalamus secreting gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones, in turn, act on the ovaries, triggering the production of estrogen and progesterone. A negative feedback mechanism acts as a regulatory brake to prevent excessive hormone production. As estrogen levels rise, they exert negative feedback on the hypothalamus and pituitary gland, inhibiting the release of GnRH, LH, and FSH. This inhibition curtails further stimulation of the ovaries, preventing an unchecked surge in sex hormone secretion.

During the perimenopausal and menopausal periods, the HPO axis and its feedback loop undergo notable alterations. As ovarian function declines, there is a reduction in estrogen and progesterone production. The decreased hormone levels result in weakened negative feedback signals, increasing GnRH, LH, and FSH. The loss of negative feedback by sex hormones results in increased secretion of GnRH and a 3-to-4 and 4-to-18-fold increase in the concentrations of LH and FSH, respectively (2). (23) 

These hormonal shifts contribute to various physiological and psychological manifestations that women commonly experience during perimenopause and menopause. The most common symptoms of hormonal imbalance in this population include hot flashes, night sweats, vaginal dryness, mood swings, breast tenderness, frequent urination, sleep disturbances, and low libido. Hormonal changes during these periods also contribute to bone density loss (increasing the risk of osteoporosis), alterations in lipid metabolism (increasing the risk of cardiovascular issues), and thyroid dysfunction.

Maca Root: Profile and Historical Use

Maca root, scientifically known as Lepidium meyenii, is a cruciferous vegetable native to the Andes mountains of Peru. Renowned for its adaptogenic properties, maca has been traditionally used in indigenous medicine for over 2,000 years for its potential health benefits. Maca is used traditionally to enhance fertility and treat rheumatic, respiratory, and hematologic disorders. In the past 20 years, maca has skyrocketed in popularity due to its introduction into the mainstream natural health market as a natural fertility and libido booster. It is claimed that maca can support general hormonal health, improve mood, increase energy levels, and treat menopausal symptoms, erectile dysfunction, and benign prostatic hyperplasia. (3, 15) 

Maca root is commonly consumed in powdered form and often added to smoothies, juices, and soups (7). It is recognized for its rich nutritional profile, containing essential amino acids, fatty acids, fiber, vitamins, and minerals. Notably, maca is a source of vitamin C, copper, calcium, iron, potassium, and zinc. (19, 20)

Maca Root and Hormonal Regulation

Maca root is believed to influence the endocrine system and support hormonal health through various mechanisms despite not containing hormones. While the exact pathways are not fully elucidated, several proposed mechanisms offer insights into how maca may exert its effects:

Adaptogenic Properties 

Maca is classified as an adaptogen, a category of substances that may help the body adapt to stressors and maintain balance. Adaptogens modulate the body's response to stress via the hypothalamic-pituitary-adrenal (HPA) axis, which controls the body's cortisol response to stress. In doing so, they can reduce cortisol levels during stressful times. Research has found that higher stress levels are associated with more severe menopausal symptoms. 

Endocrine System Regulation

Maca may directly affect the endocrine system, particularly the hypothalamus and pituitary glands. Some research suggests that the alkaloids in maca root act on the hypothalamus and pituitary gland, thereby promoting the optimal functioning of the HPO axis and balancing its associated hormones (FSH, LH, estrogen, and progesterone). (28, 29) 

Nutrient Content

Inadequate intake of high-quality fatty acids, proteins, vitamins, and minerals contributes to hormonal imbalances. Maca root is rich in essential nutrients for maintaining a well-functioning endocrine system.

Maca Root for Menopausal Symptom Relief

Several scientific studies and clinical trials have explored the potential efficacy of maca root in alleviating menopausal symptoms. While the research on this topic is limited, the existing studies offer some insights into the effects of maca on menopausal symptoms. 

In a 2016 randomized, double-blind, placebo-controlled trial, researchers studied the effects of black and red maca extract on menopausal symptoms. One hundred seventy-five participants were given 3 grams of placebo, black, or red maca extract daily for 12 weeks. At the end of the trial period, participants in the maca groups experienced significant improvements in quality of life parameters compared to those taking placebo. Based on these results, researchers suggested that maca may be a viable option for managing menopausal discomfort. (21)

A 2006 study published in the International Journal of Biomedical Science explored the effects of maca on hormonal profiles and menopausal symptoms in postmenopausal women. Participants self-administered either two 500 mg capsules with pre-gelatinized organic maca (Maca-GO) or placebo powder twice daily with meals. After two months of supplementation, women taking Maca-GO had measurable increases in estradiol and bone density markers, reductions in FSH and cortisol, and relief of menopausal symptoms, particularly hot flashes and night sweats. (29)

In a clinical trial of postmenopausal women, 3.5 grams of powdered maca daily was shown to improve sexual dysfunction after six weeks. Dording et al. conducted a double-blind, placebo-controlled trial to investigate the efficacy of maca root in alleviating sexual dysfunction induced by SSRI/SNRI antidepressant medications in women. SSRIs are recommended as a first-line treatment for hot flashes in people who cannot take estrogen but commonly cause symptoms of sexual dysfunction as a side effect. The findings of this study support the notion that maca can be safely administered to women taking SSRIs and effectively increase libido. 

Some evidence suggests that maca root may help improve mood in postmenopausal women. In a small randomized placebo-controlled study, 29 Chinese postmenopausal women received 3.3 grams of maca or placebo daily for six weeks. Women taking maca experienced significant decreases in depression. 

Additional Health Benefits of Maca Root

In addition to alleviating menopausal symptoms, maca root may offer additional health benefits. 

The same study of Chinese postmenopausal women noted above also found that 3.3 grams of maca daily for 12 weeks lowered diastolic blood pressure in participants. This may be attributed to maca's ability to stimulate the secretion of nitric oxide, a potent vasodilatory signaling molecule (39). 

Maca is widely used to increase fertility in men and women. In women, maca is proposed to have potential benefits on reproductive health by balancing hormonal levels and optimizing the menstrual cycle through the mechanisms discussed earlier in this article. In men, maca may positively influence sperm production, motility, and quality. Findings of a small study conducted in 2009 also suggest that taking 2.4 grams of maca daily for 12 weeks may be beneficial for men with mild erectile dysfunction. 

Dosage and Administration

Maca root is widely available in powder, capsule, and liquid form and is commonly used by adults in doses of 1.5-3.5 grams daily for up to 16 weeks (19, 27).

Maca's powdered form is versatile and easily added to various foods and beverages. One of the easiest ways to incorporate maca into the diet is by adding a teaspoon of maca powder to smoothies. You may also consider sprinkling maca powder on oatmeal, yogurt, or cereal. Maca powder can be included in baking recipes such as muffins, pancake/waffle batter, cookies, or raw desserts. It blends well with the flavors of nuts, seeds, and chocolate.

Potential Interactions and Side Effects

Maca root is considered safe for most individuals; however, as with any dietary supplement, there is always potential for adverse side effects. Subjective reports of altered menstrual cycles, moodiness, abdominal cramps, and insomnia have been reported with maca use (26).  

There isn't enough reliable information to know if maca is safe to consume when pregnant and breastfeeding. Other populations, such as those with hormone-sensitive conditions, like endometriosis, uterine fibroids, and breast, uterine, or ovarian cancers, are generally advised to avoid maca extracts, as they may interfere with treatment. (27) 

Personalizing Maca Supplementation

​​Personalizing maca supplementation is critical due to the wide variability in individual health needs, symptoms, and medical histories. Maca can have different effects depending on existing health conditions and hormonal profiles. Consulting with knowledgeable healthcare professionals is important to guide personalized supplementation plans and tailor maca use for hormonal health. Functional medicine providers trained in botanical medicine consider factors like existing health conditions, potential medication interactions, and individual symptoms to ensure that maca supplementation aligns with their patients' health goals and minimizes the risk of unwanted side effects. 

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Maca Root for Hormonal Regulation and Menopausal Symptom Relief

In functional medicine, maca root is sometimes explored as a natural option for individuals seeking to support hormonal health, energy levels, and vitality. Research on maca is ongoing, and while some studies suggest potential benefits, more research is needed to understand its mechanisms and efficacy fully. As with any health-related decision, individuals are encouraged to make informed choices based on their unique health circumstances by consulting with healthcare providers when considering the incorporation of maca root or any other supplements into their wellness regimen.