Ashwagandha (Withania somnifera)
is one of the most renowned and revered medicinal plant in the Indian Ayurvedic system of medicine. Ashwagandha Rasayanas (tonics) are used for curing a wide variety of chronic ailments and to improve fertility in men and women, and to treat impotence in men. Results from animal studies indicate that Ashwagandha stimulates GnRH release from the hypothalamus, and consequently through the hypothalamic-pituitary-gonadal axis increases the levels of luteinizing hormone (LH) and follicular stimulating hormone (FSH). The modulation or rectification of imbalance in testicular (testosterone) and ovarian (estrogen and progesterone) hormones leads to the improvement in male and female fertility, respectively. However, Ashwagandha must not be used during pregnancy because it may cause miscarriage or premature delivery, and may harm the fetus. Ashwagandha ingredients may pass into breast milk and pose risk to the nursing infant, therefore, breast-feeding while using Ashwagandha medication is not recommended. The quest for developing new products of Ashwagandha’s bio-active molecules (ginsenosides, withanolide, withanoside, withaferin) for treating neurodegenerative maladies (depression, epilepsy, Alzheimer’s disease, Parkinson’s disease) is continuing. Unfortunately, no large scale randomized, well-designed, double-blind, and placebo-controlled clinical trials have been done with calibrated dosages of Ashwagandha formulations to evaluate their long-term safety and efficacy. Because of the possibility of adverse clinical interactions of Ashwagandha with synthetic drugs, simultaneous oral administration of Ashwagandha and pharmaceuticals should be avoided. The focus of this review is to highlight the reversal of male/female infertility, alleviation of postmenopausal symptoms, and treatment of neurological disorders with Ashwagandha products.