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As a tea lover, I frequent health stores often, looking for new and delicious flavors. Recently, when I bought a box of rose tea, the cashier told me the tea contains adaptogens. Adaptogens? I thought. What are adaptogens?
Being a fairly skeptical person, I suspected it was just another meaningless buzzword that was created to market health foods. But when I began my research, I found out that adaptogens have been used for their anti-stress properties in traditional Ayurvedic medicine for centuries. While more studies on adaptogens are needed, the existing evidence on their chemical properties is very encouraging.
Here’s what you need to know about using adaptogens.

What are adaptogens?

Adaptogens is a term used to refer to plants that have an anti-stress affect on the body. They affect the central nervous system, and can have either a stimulating or a relaxing effect.
“Adaptogens are typically herbs or other plants that help the body handle stress. They act on the body’s production of the stress hormone, cortisol,” explains Sunny Brigham, MS, CNS, a board-certified clinical and integrative nutrition specialist. Brigham uses adaptogens with clients who experience anxiety and stress-related fatigue, as well as stress-induced irritable bowel syndrome (IBS).
While adaptogens are definitely trending at the moment, they’ve been used for a very long time in traditional Ayurvedic medicine. The first modern scientific trials on adaptogens were conducted during World War II in the Soviet Union, where researchers focused on whether adaptogens could help increase the stamina of military personnel. Over the next few decades, adaptogens became widely used by the USSR, where they played a part in the space exploration program, the Olympic games, and the Arctic and Antarctic expeditions.
Since then, adaptogens have become popular in the West, too, especially among natural healthcare practitioners.

What types of adaptogens are there?

There are many different adaptogens out there, and while all of them are associated with soothing stress, they all have their own particular benefits and drawbacks.
Fortunately, most of them are safe—but it’s still important that you speak to a qualified healthcare provider before you take them. Even though adaptogens can be bought without a prescription, they can interfere with the medications you’re currently taking, Brigham points out.
“Adaptogens are fairly safe but some [like rhodiola and ginseng] can be stimulating and should not be taken in the evening.” She goes on to say, “Others can interact with medications, such as ginseng. It’s important that individuals investigate their medication interactions before taking any herbal supplements.”

Here’s a brief guide to different types of adaptogens:

Ashwagandha

Ashwagandha, also known as Withania somnifera, is probably one of the more well-known and well-studied adaptogens. “Ashwagandha is best used for minor nervousness or anxiety related to increased stress. It may also be helpful with increasing concentration levels and boosting the immune system,” Brigham says. “Ashwagandha should not be used in pregnant or lactating women as it can have a mild sedative effect.” A review of human trials shows that ashwagandha is probably effective at regulating stress, but further studies are needed. Studies also suggest that the herb may have anti-inflammatory and antioxidant effects in addition to its anti-stress properties.

Cordyceps Mushrooms

Cordyceps mushrooms are particularly good for boosting the immune system, Brigham explains. “There is insufficient information available to determine if cordyceps are okay to be used in pregnancy. With this information, I probably would not use them in pregnant or lactating women.”
Brigham also says that she wouldn’t use cordyceps on people using blood thinning medication or those with immune disorders. “There is some evidence, in animal studies, that show cordyceps inhibit platelet aggregation, the clumping together of platelets to form blood clots around wounds,” Brigham explains. “If someone is on a blood thinning medication, taking cordyceps could cause further blood thinning and increase the chances of bleeding.”

Eleuthero

Joseph Feuerstein, MD, associate professor of clinical medicine at Columbia University and director of integrative medicine at Stamford Hospital, says eleuthero is good for fatigue related to excess exercise, so he recommends it to his active patients. “Eleuthero seems to be okay in pregnant women but should be used with caution in those with hypertension,” he adds.

Ginseng

“Ginseng can be slightly stimulating to help combat stress-related fatigue,” Brigham says. “It can also be used to help boost the immune system.” Ginseng seems to be safe for pregnant women. Studies have also suggested that ginseng improves male sexual functioning.

Holy Basil

Also known as tulsi, holy basil has a mildly stimulating effect, says Brigham. This means it can be used to help combat stress-related fatigue. There’s a fair amount of scientific evidence to show that tulsi does, indeed, reduce stress. While Brigham says it’s fairly safe to use, it shouldn’t be used if you’re pregnant or lactating.

Passionflower

While many adaptogens are stimulating and shouldn’t be taken in the evening, passionflower has a very calming effect and thus can be taken before sleep, says Brigham. “Passionflower helps the hamster get off the wheel so our brains can relax and we can sleep,” she explains.

Reishi

Much like cordyceps in function, reishi is good for boosting the immune system, Brigham explains. Again, she cautions people against using it if they’re on blood thinning medication.

Rhodiola

Feuerstein says that he uses rhodiola to help with fatigue associated with low mood. Studies have shown that rhodiola might be effective at reducing symptoms of depression and easing mental fatigue, but those trials were small and more evidence is needed. Brigham notes that rhodiola should be avoided by people who have high blood pressure, nervous system disorders, or sleep issues. Brigham also says she wouldn’t give rhodiola to pregnant people.

Schisandra

Schisandra, while an adaptogen, is most commonly used to support the liver and digestive system, as it can reduce diarrhea. However, it can cause digestive issues in some people, Brigham explains. Namely, it can cause acid reflux, heartburn, and stomach pain.
Feuerstein emphasizes that you should consult a medical practitioner before using any adaptogen. “Much of the time, use of adaptogens is based on clinical experience of the practitioner,” he says. “It is important that you use them under the guidance of a medical professional so you get the right dose of the right herb made by a pharmaceutical-grade manufacturer to ensure quality and purity.”
While adaptogens are fairly safe and easy to obtain without a prescription, Brigham also notes that she wouldn’t give them to children. “They are pretty safe and many people use them. Kids are under more stress in school today than we ever were,” she notes. “I’d prefer, though, to teach them stress reduction techniques and proper sleep habits so they don’t need adaptogens.”

Is there a lack of scientific evidence on adaptogens?

While the scientific evidence on adaptogens is very encouraging, it’s also limited. You’ll notice that many of the herbs outlined by Brigham and Feuerstein need to be studied more to confirm their effectiveness.
Feuerstein agrees that there’s not enough evidence out there when it comes to adaptogens. Part of the reason is because studies into medicinal herbs aren’t well funded, he says, which means that the trials which have been done—although promising—are quite small.
“I do believe there is a lack of quality trials in reference to herbs today,” Brigham says. “There’s also a lack of peer-reviewed sources as well.” However, Brigham remains optimistic about the effects of adaptogens given the fact that they’ve been used by humans for centuries, and given her personal and professional experience with adaptogens.

How can I integrate adaptogens into my diet?

Adaptogens often come in form of tinctures, teas, or pills. They could also be eaten: For example, I use passionflower in my smoothies. Brigham says that most people don’t enjoy tinctures because they have an unpleasant taste, so many people opt for teas or pills instead. “Teas are great because you can make a combination of various adaptogens from bulk herbs,” she says. “The same can be said for pills. Most pill-form adaptogens are blends.”
Feuerstein says that he generally uses standardized herbal extracts in pill form to ensure quality. The clinical studies that are available use high doses, and those doses would be too high to add to a food or tea, he explains.
While your healthcare practitioner should be able to recommend a reputable brand, there are some great brands you can look out for, says Brigham. “My favorite sources for quality herbs or adaptogens are Gaia Herbs, Mountain Rose Herbs, Frontier Co-op, Oregon’s Wild Harvest, and Pacific Botanicals. There are ready-made supplements available as well, but the purchaser should ensure the source of the herbs [in them] is from a quality source,” says Brigham.
While there is a need for more scientific evidence, adaptogens might be worth trying if you struggle with stress, anxiety, and fatigue. Consider speaking to an integrative medical specialist if you’d like to use them: They’ll be able to ensure that you’re taking them safely, and they’ll help you choose the best kinds of adaptogens for your specific health concerns.

Before I became an egg donor, I had a lot of questions about the process: What does egg donation entail? Are there any long-term health effects of donating your eggs? What should I know before I donate?
I googled it, but unfortunately there’s a lot of confusion and misinformation out there. This is probably because egg donation is often stigmatized. I read a lot of information online, but I wanted to know more. After all, it was a big decision.
I wanted to hear about egg donation from real donors—not just fertility specialists and egg donation agencies. Unfortunately, because of all the moralizing that surrounds egg donation, few egg donors really talk about their experiences.
So here I am, a three-time egg donor, telling you about my personal experience with egg donation as well as the scientific research behind the process. If you’re considering egg donation—or want to understand what the process is like for a donor—read on to find out what you need to know.

Who can become an egg donor?

Firstly, you’re probably wondering whether you fit the criteria for donation.
Generally speaking, egg donors are between the age of 18 and 35, although this can vary depending on the clinic you want to work with. You have to have a low chance of passing on genetic diseases. In addition to fitting specified health criteria, a potential donor will also have to undergo a scan and blood tests to ensure they’re qualified to donate.
If you have certain reproductive conditions, like endometriosis, it might not be advisable to donate eggs, even if a clinic would allow you to do so. “For women with endometriosis, there is evidence that ovarian reserve may be lower and procedural risks slightly higher if they have ovarian cysts,” says Rashmi Kudesia, MD of CCRM. Kudesia is board-certified in reproductive endocrinology and infertility by the American Board of Obstetricians and Gynecologists.
If you check all the boxes for becoming an egg donor, remember that certain characteristics—like having an education beyond high school, such as a college degree—can also make you more appealing to prospective recipients. Fitting the criteria is one thing, but you’ll still need to be matched to potential parents. This can take a while after you sign up and depends on how many potential parents the agency works with and your personal characteristics. It took me around eight months to be matched.

What exactly happens during the egg donation process?

Once a potential donor applies—either with a clinic or an egg donation agency—they wait to be matched with potential recipients (also known as intending parents or IPs). Once matched, the donors will undergo some blood tests and scans, says Kelly Rodgers, a five-time egg donor and egg-donation coordinator with Extraordinary Conceptions. The screening process involves a trans-vaginal ultrasound and a follicular count. The follicles are the small sacs in the ovaries where the eggs develop, and it’s important that donors have a healthy number of follicles—a number that needs to be determined by a donor and their healthcare provider.
If all is well, Rodgers says, contracts will be drafted and signed. The donor will go on to have hormone injections once a day for the next 10 days, give or take, with the dosage depending on their personal biology and determined by a fertility specialist.
“These medications are typically self-administered—which is not as hard as it sounds—via very skinny needles right under the skin, typically in the lower abdomen or outer thigh,” Kudesia explains. The medication contains synthetic versions of naturally occurring hormones called follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are used by the body to promote ovulation during the menstrual cycle.
“While on medications, donors will have a handful of monitoring appointments to see how her body is responding to the the medication and, if necessary, travel to the intended parent’s clinic for about seven to 10 days leading up to the egg retrieval,” Rodgers says. This could include more trans-vaginal ultrasounds and blood tests. The scans will help fertility specialists determine when to schedule the retrieval, which is also known as an egg pick-up. The retrieval is a non-invasive surgery, meaning it doesn’t involve cutting into your body. Instead, an implement is inserted through the vagina and a needle enters the ovary. The eggs are retrieved through this needle. You’ll either be under general anesthetic or a deep sedation, so you aren’t able to feel anything during the retrieval.
There might be a mild discomfort when you wake up, but generally it isn’t painful. You should be discharged on the same day, after which you should go home and rest. You’ll get your period within the next ten days after the retrieval. After this, you’ll probably be more fertile than usual. Following one full menstrual cycle, your fertility will be back to normal according to Rodgers.
After your retrieval, the donated eggs will be fertilized and placed in either a surrogate’s uterus or the uterus of the female IP.

What are the short-term health effects of egg donation?

The most concerning issue when it comes to egg donation is ovarian hyperstimulation syndrome, or OHSS. It occurs when the medication used to facilitate egg retrieval elevates your estrogen levels, says Kudesia. “Because these levels induce water to be drawn out of your bloodstream into the abdomen, severe OHSS can cause bloating and swelling, nausea and vomiting, low urine output, and a risk of blood clots,” she explains. In some severe cases, the donor might have to be hospitalized and given IV fluids. They might also need excess abdominal fluids to be removed.
Kudesia points out that egg donors only have a 1 to 2 percent chance of developing a serious case of OHSS. “Though anyone who has a robust response to ovarian stimulation may have a few rough days around the time of their egg retrieval, it is quite rare to see a severe OHSS case these days,” she notes.

How can egg donation impact my future fertility? Can it impact my health?

Here’s where things become a bit more controversial: While many experts deem egg donation to be safe judging from the current research, many donors would like more long-term studies on egg donation. Many donors go on to have their own children, but at present there aren’t any long-term studies that have monitored the impacts of egg donation on donor health.
Raquel Cool, co-founder of We Are Egg Donors, a global forum for egg donors, is one of the people advocating for more studies. Cool is currently working on a book compiling personal accounts from donors as well as data on their retrievals. “We are big advocates for more research on donor health,” she says. “We’d like more transparency on how eggs are retrieved, how many overstimulate and to what extent of severity, and finally, how egg donation impacts our health down the line. There have been no long-term studies on donor health outcomes.”
On the other hand, Kudesia feels the research that’s currently available is a firm enough indicator that there aren’t any long-term effects of donation. “Though we do not have registries or long-term cohort studies to specifically report on egg donors, we nonetheless have a lot of scientific data from which to extrapolate long-term effects,” she says. Kudesia points out that the egg donation process mirrors the first half of an IVF cycle. It involves the same medication and retrieval process as IVF patients undergo, and IVF has been around since the ’70s, which is one of the reasons she considers egg donation to be safe.
“Multiple scientific papers, following tens of thousands of women for up to 30 years after IVF, have established the long-term safety of the procedure for moms and babies,” she says. Those studies haven’t found any long-term risks of ovarian or breast cancer, for example, Kudesia says
The studies that look specifically at egg donors also haven’t found any risks of egg donation, Kudesia says. “I would echo the statement of the American Society for Reproductive Medicine, which is that though there is no evidence of long-term risk.” She goes on to say, “Prudence suggests that women be informed of the possible risks, and limit the number of times they donate to six cycles.” She adds that fertility clinics must take precautions to avoid OHSS. “Though I would be thrilled to see more specific literature on this topic, what exists is very reassuring to me for women and clinics following the guidelines.”
Before donating, it’s important not only to understand the research or lack of research on the long-term medical effects of donation, but also the emotional impact it may have on you as a donor.

What are the emotional impacts of being an egg donor?

Many potential donors are curious about how egg donation will affect them on an emotional level. Of course, this is a difficult question to answer because the process affects everyone differently.
Kudesia states that donors need to be mentally prepared to donate their eggs. “All donors meet with a mental health professional to make sure they’ve thought through the possible ramifications of possibly having genetic offspring out in the world,” she explains. “If, after that discussion, you have any reservations at all, I would not recommend donating.”
My personal experience with egg donation has been emotionally rewarding. I’ve never regretted my choice, and I feel great about my decision to donate. However, not everyone has the same experience.
Some people experience remorse about not having a relationship with their offspring, for example. You might not get pregnant with or birth the child, but in terms of DNA, the child is biologically yours. In that sense, it can be difficult to know they exist without being able to contact them. Most donors I know, myself included, aren’t bothered by this, but it’s something you have to consider before donating.
Another aspect to consider is whether you’d want an open, semi-open, or totally anonymous donation. Certain clinics and egg donation agencies only facilitate anonymous donations, while others facilitate open donations, semi-open donations, or a mixture of the two. This is usually stated quite clearly on their websites. Personally, I’ve done one anonymous donation and two open donations, where I’m still in contact with the recipient families.

Could I be paid for egg donation?

According to international law, you’re not allowed to sell your eggs because they’re bodily tissues, but you can be compensated for your time since you might lose out on other forms of income while donating. More often than not, you’ll have to take time off work or studying and your personal life to become an egg donor.
Rodgers notes that the time commitment is something every donor needs to understand. “While the donation itself, in which you are on medication and undergoing the egg retrieval, is roughly two weeks, the medical screening process and legal contract finalization can add approximately six weeks time.” If you travel overseas to donate, as I did, it can be even more time-consuming.
In addition to compensation, you shouldn’t be expected to pay any medical expenses associated with the donation as those should be covered by the egg recipients. This usually includes covering any emergency expenses in case you have any health complications, like OHSS. Your contract should include the exact details of what is covered by the agency or recipients. If an agency asks for any money up front, be wary.
Also note that in some places, including the U.S., you might be taxed on any funds you receive in compensation for donating. In other places, like Australia, donors aren’t usually compensated at all according to Cool. If you’re curious about compensation, speak directly to the agency or clinic you’d like to sign with.

How do I know which egg donation agency or clinic to sign with?

While many agencies and clinics genuinely care about their egg donors, others might not treat their donors well. This is why it’s important to do a background check before signing up.
Cool notes that according to accounts by donors shared on We Are Egg Donors, there is a notable difference between the way donors in the U.S. are treated compared to donors in other countries. “Unfortunately, in the U.S. we see more instances in which higher numbers of eggs are retrieved, more cases of OHSS, greater challenges with withdrawing consent, and women feeling like they are being treated more like a number than a patient,” Cool says.
Your chances of getting OHSS are higher if more eggs are retrieved, since a higher egg count is usually associated with a higher amount of follicle-stimulating medication. As such, a clinic might overstimulate donors to get more eggs—at the price of the donor’s health. “High numbers are becoming so normalized within the industry that we see experienced donors rejected for subsequent cycles, or questioned about their medical records because they are considered ‘low producers’—yet their past cycle figures are between five and 20 [eggs], which is considered a safe and optimal range,” Cool says.
“Some clinics offer their clients (that is, the egg recipients) a cost savings option: a ‘shared cycle,’ in which a donor is stimulated to produce eggs—in one cycle—for two or three recipients rather than one,” Cool explains. This incentivizes clinics to over-stimulate donors so that they can collect more eggs for each of their clients. This is why carefully vetting agencies and clinics is important.
“I would do my best to vet agencies or clinics through word of mouth or reviews,” says Kudesia. “A clinic is perhaps the easier setup to vet, as all success rates are publicly reported and available online. Picking a clinic with high volume and success rates might help ensure that their methods prioritize patient safety and experience rather than trying to maximize egg number at any cost,” she adds. Kudesia also suggests you discuss the process with the agency or clinic before signing up, including the strategies they use to minimize your chances of getting OHSS. “Getting detailed, compassionate answers to these questions would be reassuring. Being rushed or pushed into donating should be immediate red flags,” she says.
When I donated my eggs, I was very well prepared: I researched a lot beforehand, I asked plenty of questions, and I thought about the emotional impact of donating before I did it. For those reasons, I felt confident in my decision and the people caring for me during the retrieval procedures.
Your generosity as an egg donor can mean the world to someone who wants to start a family, but it’s important that you’re well informed about the entire process before you start this journey.
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