Ashoka
FabaceaeSaraca asoca
Also known as: Saraca indica (syn.), Ashok, Sita Ashok
clinical_notes Clinical Summary
Ashoka (Saraca asoca) is known as the 'friend of women' in Ayurveda and has been used for millennia as a premier uterine tonic for menorrhagia, dysmenorrhea, uterine fibroids, and leucorrhea.
Its flavonoid- and tannin-rich bark provides hemostatic, astringent, anti-inflammatory, and uterine-tonifying actions—documented oxytocic activity in animal and isolated human uterine preparations.
Contraindicated in pregnancy.
A culturally and spiritually significant tree with classical formulations including Ashokarishta and Ashokagritha.
Pregnancy Safety
Contraindicated in pregnancy due to documented oxytocic activity stimulating uterine contractions. Gravid uterus is especially sensitive.
Lactation Safety
Limited specific data for lactation. Traditional postpartum use for uterine recovery in some Ayurvedic systems; however, saponin and tannin content warrants caution. Consult qualified practitioner.
warning Contraindications
- Pregnancy (contraindicated)Theoretical
- Hormone-sensitive cancers (estrogen receptor-positive breast cancer, endometrial cancer) (caution)Theoretical
- Constipation (caution)Theoretical
- Hypotension / concurrent antihypertensive therapy (caution)Theoretical
vital_signs Clinical Profile
Primary Indications
- check_circle menorrhagia (heavy menstrual bleeding)
- check_circle dysfunctional uterine bleeding
- check_circle dysmenorrhea (painful periods)
- check_circle leucorrhea (white vaginal discharge)
- check_circle uterine fibroids
- check_circle endometriosis-related bleeding
- check_circle pelvic inflammatory disease
- check_circle postpartum recovery
- check_circle hemorrhoids with bleeding
- check_circle skin disorders with bleeding
Therapeutic Actions
System Affinities
- check_circle female reproductive system
- check_circle uterus
- check_circle circulatory system
- check_circle skin
- check_circle kidney/urinary system
labs Active Constituents
flavonoids
tannins
saponins
glycosides
sterols
leucocyanidin
amyrin
ceryl alcohol
organic calcium compounds
history_edu Traditional Use
No TCM data available for this herb yet.
Traditional Uses Across Healing Systems
While many herbs lack controlled clinical trials, centuries of traditional practice across cultures provide valuable insight into their therapeutic applications.
Premier Ayurvedic herb known as the 'friend of women' (raktapradara nashini) for menorrhagia, dysmenorrhea, leucorrhea, dysfunctional uterine bleeding, uterine fibroids, endometriosis, and postnatal recovery. Classical indication in raktpradara (excessive menstrual bleeding).
Classical preparations include Ashokarishta (fermented uterine tonic), Ashoka ghrita, and Ashokakshara. Considered sacred in Hindu and Buddhist traditions—the tree under which Buddha was born and Sita waited in the Ramayana.
Applied in Unani tradition for uterine disorders, bleeding hemorrhoids, and dysmenorrhea. Recognized anti-hemorrhagic action.
Similar indications to Ayurveda with slight variations in processing.
Tribal and rural communities in India traditionally prepare a decoction of bark in cow's milk with sugar, taken preventively by women every 3 months for gynecological health. Seeds with betel leaf (pan) for amenorrhea.
Women also eat flower buds on Ashok Shasthi day as spiritual/preventive practice.
Used in Western integrative practice for menorrhagia, fibroids, and perimenopausal bleeding as a safer alternative to hormonal therapy. Standardized extracts increasingly available.
Often incorporated into women's herbal formulations alongside Shatavari and Chaste Tree.
spa Parts Used
flower
- diabetes-related complications
- dysentery
- hemorrhagic conditions
Traditionally eaten as preventive food on Ashok Shasthi day by women. Used in decoction for bleeding disorders.
seed
- dermatophytic fungal infections
- amenorrhea
Powdered seed traditionally mixed with betel vine (pan) for amenorrhea. External paste for skin conditions.
shield Safety
Contraindications — Evidence Basis
Pregnancy
Ashoka exhibits oxytocic action in rat and human isolated uterine preparations, stimulating the uterus and making contractions more frequent and prolonged. Estrogen-primed or gravid uterus is more sensitive.
Hormone-sensitive cancers (estrogen receptor-positive breast cancer, endometrial cancer)
U-3107 (Ashoka-containing preparation) demonstrated estrogenic action in normal and ovariectomized rats; while some studies suggest anti-estrogenic activity, effects are hormone-state dependent.
Constipation
Astringent tannin-rich nature may worsen constipation; use with bowel-moving herbs (e.g., Triphala) if constipation is present.
Hypotension / concurrent antihypertensive therapy
Pentolinium bitartrate blocked Ashoka's oxytocic effect suggesting autonomic activity; theoretical blood pressure effects warrant monitoring.
Monitoring Parameters
Monitor during use, especially with prolonged or high-dose therapy.
Menstrual blood loss (volume, duration)
Track for 2-3 menstrual cyclesPrimary indication is menorrhagia—subjective and objective menstrual blood loss assessment confirms response.
flagThreshold: No improvement after 3 cycles or worsening: discontinue and investigate alternative cause
Hemoglobin / ferritin (if menorrhagia with anemia)
Baseline and every 3 monthsHeavy menstrual bleeding commonly causes iron deficiency anemia; response to treatment should include hemoglobin recovery.
flagThreshold: Hemoglobin failing to rise or falling: reassess diagnosis and treatment
Toxicity
Generally well-tolerated at traditional doses of 3-6g dried bark. LD50 and acute toxicity data limited but traditional use suggests wide safety margin.
Abdominal cramping, nausea, constipation (from tannin astringency); rare: allergic reactions.
Discontinue. Supportive hydration. Reduce dose if GI symptoms persist.
Adverse Effects
CYP Metabolism
Limited CYP450 interaction data. Flavonoids (quercetin, kaempferol) may modestly inhibit CYP3A4 and CYP2C9 at high doses. Clinical significance uncertain at therapeutic doses.
swap_horiz Interactions
Estradiol / Hormone Replacement Therapy
Class: Estrogen / HRT
Saraca asoca bark extract demonstrates anti-estrogenic activity by reducing serum estradiol levels and inhibiting estradiol-induced endometrial proliferation in rat models. Constituents including procyanidin B2, luteolin, quercetin and kaempferol compete at estrogen receptors and may interfere with pharmacologic estrogen activity.
Avoid concomitant use with exogenous estrogens (oral HRT, transdermal estradiol) in patients where full estrogenic effect is required (e.g., menopausal symptom control, osteoporosis prophylaxis). If co-administered, monitor for reduced therapeutic response and consider separating by 2-4 hours.
Tamoxifen
Class: Selective Estrogen Receptor Modulator (SERM)
Ashoka flowers contain phytoestrogens (β-sitosterol, luteolin, quercetin, kaempferol) with estrogenic potency demonstrated in ovariectomized rat models. Phytoestrogens may competitively bind estrogen receptors and theoretically interfere with tamoxifen's antagonist activity at ER in breast tissue, though clinical relevance is unproven.
Avoid Ashoka in breast cancer patients on tamoxifen or aromatase inhibitors due to theoretical competition at estrogen receptors and unknown net hormonal effect.
Combined Oral Contraceptives
Class: Hormonal contraceptives
Ashoka exerts both phytoestrogenic and anti-estrogenic effects depending on endogenous estrogen status (selective estrogen receptor modulation). When used with estrogen-based contraceptives, its anti-proliferative endometrial effect and receptor competition could theoretically reduce contraceptive efficacy or alter breakthrough bleeding patterns.
Counsel patients on combined hormonal contraceptives about possible changes in menstrual bleeding. Not a primary contraindication but avoid high-dose standardized extracts without clinician oversight.
Ferrous sulfate / Oral iron
Class: Iron supplement
Saraca asoca bark is tannin-rich (catechin, epicatechin, procyanidins). Tannins form insoluble complexes with non-heme iron in the gastrointestinal lumen, reducing iron absorption—a well-established pharmacologic effect of high-tannin botanicals.
Separate oral iron from Ashoka decoctions/capsules by at least 2 hours. Particularly relevant when Ashoka is prescribed for menorrhagia-associated iron deficiency anemia.
Metformin / Sulfonylureas
Class: Oral antidiabetic agents
Ethanolic extracts of S. asoca have demonstrated hypoglycemic, hypolipidemic and antioxidant activity in experimental models, likely via flavonoid-mediated improvements in insulin sensitivity (kaempferol reduces fasting blood glucose and enhances insulin sensitivity).
Monitor fasting glucose when initiating Ashoka in patients on antidiabetic medications; dose adjustment rarely needed but awareness of additive glycemic lowering is prudent.
NSAIDs (ibuprofen, naproxen)
Class: Non-steroidal anti-inflammatory drugs
S. asoca extract reduces LPS-induced COX-2 expression in rat uterus and demonstrates anti-inflammatory activity comparable to NSAIDs in carrageenan paw-edema models. Potentially additive with NSAIDs for dysmenorrhea but with different mechanisms.
No dose adjustment required. May allow lower NSAID doses for menstrual pain. No bleeding risk documented.
hub Combinations
Synergistic pairings can enhance therapeutic outcomes, while knowing suitable substitutes helps when specific herbs are unavailable or contraindicated.
No combination data available yet.
science Studies
Investigating potent cardioprotective compounds as ACE inhibitors in Saraca asoca
Systematic ReviewThis systematic review synthesized available in vivo, in vitro, and computational evidence to assess the cardioprotective potential of bioactive compounds in Saraca asoca, focusing on their capacity to act as angiotensin-converting enzyme (ACE) inhibitors. The authors catalogued multiple cardiovascular-relevant mechanisms, including antioxidant, free radical scavenging, anti-inflammatory, and lipid-lowering activities spanning various parts of the plant. Key phytochemicals — including flavonoids, tannins, and phenolics — were highlighted for their demonstrated ability to modulate ACE activity and reduce oxidative stress in cardiac tissue in existing experimental studies. The review concluded that while S. asoca is primarily known as a women's uterine tonic, its rich bioactive profile warrants dedicated investigation as a cardioprotective botanical agent.
Phytochemical-Based Study of Ethanolic Extract of Saraca asoca in Letrozole-Induced Polycystic Ovarian Syndrome in Female Adult Rats
In VivoThis in vivo study evaluated the ethanolic extract of Saraca asoca (EESA) in a letrozole-induced PCOS rat model, with HPLC identifying key bioactive compounds including kaempferol, rutin, and epicatechin. Treatment with EESA at 200, 400, and 600 mg/kg over five weeks dose-dependently reduced body weight gain, normalized the estrous cycle, and reduced cystic follicle counts in ovarian histology compared to the disease control group. Hormonal profiling showed EESA significantly lowered elevated testosterone and LH while increasing FSH, estradiol, progesterone, and prolactin, closely mirroring the positive control metformin. Antioxidant enzyme levels (SOD, CAT, GSH) were restored and lipid peroxidation marker MDA was reduced, indicating EESA also counters PCOS-associated oxidative stress. The authors concluded that EESA has therapeutic potential for managing PCOS by restoring hormonal profiles and improving ovarian morphology in a dose-dependent manner.
medication Dosing
decoction
3-6 g dried bark (in 240 mL water reduced to 60 mL)
BID
Classical kashaya dosing; can be prepared in cow's milk for traditional administration
capsule
500-1000 mg bark powder or extract
BID-TID
Standardized extracts increasingly available; take with meals
powder
1-3 g bark powder
BID
Classical Ayurvedic churna; taken with warm water or milk
tincture
15-30 mL of fermented Ashokarishta
BID after meals
Ashokarishta is a fermented medicinal wine (~5-10% alcohol) widely used for menorrhagia and uterine disorders
Disclaimer: This information is largely AI-generated and reviewed by human experts at Evara Health. It is intended for educational and clinical reference purposes only and should not replace professional medical advice.
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