NAD for Women: One Placebo-Controlled Trial, One Seven-Day Menopause Study, and Fertility Trials Still Unreported

"NAD for women" is a large search with a small answer. Supplement pages build the case from biology — NAD+ levels fall with age, oestrogen falls at menopause, eggs depend on healthy mitochondria — and then attach it to products. The question this page asks is narrower: what has actually been tested in women?

The answer is short enough to list in full. The comparison of the two main precursors is on our NAD vs NMN page; injectable NAD+ is covered on NAD injection benefits and NAD injection vs oral; figures used in trials are on our NAD dosage page; and Peptide Lexicon's NAD entry explains the molecule. Hormone-related peptide claims for this life stage are covered by Peptide Lexicon's peptides for menopause and, for training, MuscleLedger's peptides for women. Nothing here is a recommendation.

The census

Searches run on 28 October 2026. NMN = nicotinamide mononucleotide; NR = nicotinamide riboside.

The other 27 records in the randomised-trial search enrolled both sexes or were in specific diseases — COPD, peripheral artery disease, Werner syndrome, mild cognitive impairment, Friedreich's ataxia — and did not report women separately in their abstracts.

The one placebo-controlled trial: insulin sensitivity after menopause

Yoshino and colleagues (Washington University in St. Louis, Science, June 2021; NCT03151239) randomised 25 postmenopausal women aged 55 to 75 with prediabetes and overweight or obesity: 13 to NMN 250 mg a day, 12 to placebo, for about 10 weeks.

What changed on NMN and not on placebo:

• Insulin-stimulated glucose uptake, measured by the hyperinsulinaemic-euglycaemic clamp — the reference method.
• Insulin signalling in muscle (phosphorylation of AKT and mTOR in biopsies) and the expression of muscle-remodelling genes.
• NAD+ in blood cells (peripheral blood mononuclear cells).

What did not change in either group, per the paper's own text:

• Body composition — fat mass, lean mass, abdominal fat, liver fat.
• Blood pressure, fasting glucose, insulin, free fatty acids, blood lipids, adiponectin and leptin.
• NAD+ content in muscle itself — the tissue where the insulin effect was measured.

No adverse events were reported in either group. Two features matter for reading it. It is small and short — 13 women on the active capsule. And its authors carried interests the paper declares: one co-author receives a share of NMN patent-licensing fees, another is an inventor on an NMN patent application. The result is a well-measured signal in one narrow group of women, not evidence that NMN does anything for weight, energy or hormones.

The menopause study: seven days, no placebo

Holmes and colleagues (Frontiers in Aging, May 2026; NCT04841499) gave 40 women over 35 the nicotinamide riboside plus pterostilbene combination sold as Basis — 32 with menopause-transition symptoms and 8 without — for 7 days. The symptomatic group reported less frequent and less severe bloating, hot flushes and poor sleep against their own baseline, and urinary oestradiol relative to oestrone rose.

The design cannot separate those changes from expectation or from the passage of a week: it was open-label, with no placebo group, and the symptoms were self-reported. The paper's conflict-of-interest statement lists three of its seven authors as employed by Elysium Health, the company that sells the product. The registration lists the University of South Alabama as sponsor.

Fertility, ovarian reserve and PCOS: registered, not reported

The first three come from one hospital, Peking University Third Hospital. The completed PCOS trial finished nearly two years before this census with nothing posted to the registry and no linked publication in PubMed. Until any of these report, the case for NMN in fertility rests on animal work: a 2026 systematic review by Noh and colleagues at UCL included seven preclinical studies and no human trial, and concluded that "clinical trials are needed".

Pregnancy and breastfeeding

We found no trial of NMN, NR or NAD+ in pregnant or breastfeeding women. The registry records that mention pregnancy do so almost entirely in their exclusion criteria. This is an absence, not a reassurance: no study has measured what these products do in pregnancy, and none has measured whether they pass into breast milk. Our page on peptides and breastfeeding sets out how to read that kind of gap. Anyone pregnant, trying to conceive or breastfeeding should take the question to their obstetric clinician.

What is not established

• Any benefit of NAD+ precursors specific to women, beyond one 25-person insulin-sensitivity result.
• Whether women and men respond differently — no trial has compared them directly, and mixed-sex trials were mostly too small to analyse women separately.
• Effects on fertility, egg quality, PCOS or ovarian reserve in people.
• Effects on menopause symptoms under placebo control.
• Anything about NAD+ injections or patches in women: none of the women-only studies used them. Patches have no human study at all — see NAD patch.

Sources and dates

• Yoshino M et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science 2021;372(6547):1224–1229. doi:10.1126/science.abe9985 — full text via PMC8550608, read 28 October 2026; registry NCT03151239 read the same day.
• Holmes HE et al. Nicotinamide riboside and pterostilbene reduces frequency and severity of undesirable symptoms of the menopause transition: an open-label, pilot clinical trial. Front Aging 2026;7:1773667 — abstract and conflict-of-interest statement, read 28 October 2026.
• Noh H et al. NMN supplementation as a strategy to improve oocyte quality: a systematic review and transcriptomic analysis. J Assist Reprod Genet 2026;43(1):51–65 — abstract read 28 October 2026.
• ClinicalTrials.gov API v2: NCT05305677, NCT05485610, NCT06426355, NCT06950736, NCT07475208, NCT04841499 — read 28 October 2026.
• PubMed E-utilities searches as printed above, run 28 October 2026.