Posted by Catherline Ng
on October 27, 2025
Aging isn’t always marked by wrinkles. It often begins with subtle signs—taking longer to recover after a late night, noticing skincare products seem less effective, or realizing that sleep and emotions are harder to balance.
These small changes may share one biological clue: a decline in NAD+, a molecule essential for cellular energy and repair. After around age 35, NAD+ levels start to drop significantly. For women, this reduction can quietly affect ovarian function, skin vitality, metabolism, and sleep.
Why NAD+ Decline Affects Women More Deeply
NAD+ fuels and repairs cells. It supports nearly every essential biological process, including energy metabolism, DNA repair, and circadian rhythm regulation. When NAD+ levels are high, cells operate efficiently and maintain vitality.
For women, NAD+ plays an especially important role because oocytes (egg cells) are among the body’s most energy-demanding cells. Their development and ovulation rely on mitochondria, which depend on NAD+ to generate energy.
- Each mature egg contains over 200,000 mitochondria, each requiring NAD+ for continuous energy production.
As NAD+ levels decrease:
- Energy supply to oocytes becomes limited.
- Follicle development may slow, and ovarian function can weaken.
- Hormone balance becomes more fragile.
A Nature Aging study suggests that early ovarian aging is closely linked to declining NAD+ metabolism.
Animal research further shows that NAD+ levels drop more sharply in ovaries than in the liver or heart. In women over 35, follicular fluid often contains higher levels of CD38, an enzyme that consumes NAD+, indicating increased metabolic stress in ovarian tissue.
A MedComm study found a strong positive correlation between serum NAD+ levels and ovarian reserve function. In a model of premature ovarian failure, NAD+ supplementation increased follicle numbers and improved hormone secretion.
NAD+ Influences Multiple Body Systems
The decline of NAD+ extends beyond the ovaries. It signals a broader slowdown across multiple body systems, affecting:
- Energy production and mitochondrial function.
- Redox balance and antioxidant capacity.
- Cellular renewal and repair efficiency.
While the ovaries are among the most energy-demanding organs, other tissues—such as the skin, nervous system, and metabolic organs—also show reduced performance as NAD+ decreases.
Supporting Skin Renewal and Repair
Everyday stressors such as UV exposure, pollution, and lack of sleep cause DNA damage, collagen breakdown, and a weakened skin barrier. NAD+ is a key component in the skin’s ability to repair these damages.
Research suggests that NAD+ supplementation can help:
- Decrease oxidative stress and inflammation.
- Reduce UV-induced DNA damage.
- Strengthen the skin’s protective barrier.
Together, these actions help preserve elasticity and maintain a more youthful appearance.
Regulating Sleep Rhythms
Sleep patterns are governed by the body’s internal clock—a network of circadian genes such as CLOCK, BMAL1, PER, and CRY that operate on a 24-hour rhythm.
The protein SIRT1, which depends on NAD+, plays a central role in this system. When NAD+ levels are sufficient, SIRT1 deacetylates CLOCK and BMAL1, stabilizing the expression of circadian genes.
In short, NAD+ acts as the molecular “key” that enables SIRT1 to regulate sleep and wake cycles, helping maintain consistent, restorative rest.
Stabilizing Energy Metabolism
In metabolic health, insulin sensitivity is a critical factor. When NAD+ declines:
- Mitochondrial function weakens.
- Cellular response to insulin drops.
- Glucose utilization becomes less efficient—leading to fat buildup and metabolic imbalance.
A Cell Metabolism study found that restoring NAD+ enhances metabolic efficiency and improves insulin sensitivity. This allows cells to switch flexibly between burning sugar and burning fat, preventing metabolic stagnation and supporting long-term energy balance.
Living with Better NAD+ Balance
Ultimately, NAD+ is not limited to a single function—it supports overall vitality in women. Maintaining healthy NAD+ levels helps coordinate energy, hormonal balance, metabolism, sleep, and skin repair. Sustaining this balance can promote resilience and a more graceful aging process.
3 Things You Can Do Today (with Evidence Grades)
- Prioritize quality sleep (7–9 hours per night)
Good sleep helps regulate NAD+ metabolism and enhances SIRT1 activity, supporting circadian balance.
Evidence Level: A — Supported by multiple clinical and molecular studies. - Engage in regular moderate exercise
Activities like brisk walking, cycling, or yoga improve mitochondrial function and naturally increase NAD+ synthesis.
Evidence Level: A — Consistently supported in human and animal studies. - Eat foods rich in NAD+ precursors
Include sources of niacin, tryptophan, or nicotinamide riboside such as fish, poultry, peanuts, and mushrooms to support NAD+ production.
Evidence Level: B — Backed by metabolic and nutritional research.
References
1. Yang, Q., Chen, W., Cong, L., et al. (2024). NADase CD38 is a key determinant of ovarian aging. Nature Aging, 4(1), 110–128.
2. Xie, N., Zhang, L., Gao, W., et al. (2020). NAD+ metabolism: pathophysiologic mechanisms and therapeutic potential. Signal Transduction and Targeted Therapy, 5(1), 227.
3. Li, L., Zhou, X., Liu, W., Chen, Z., Xiao, X., & Deng, G. (2024). Supplementation with NAD+ and its precursors: A rescue of female reproductive diseases. Biochemistry and Biophysics Reports, 38, 101715.
4. Liang, J., Huang, F., Hao, X., et al. (2024). Nicotinamide mononucleotide supplementation rescues mitochondrial and energy metabolism functions and ameliorates inflammatory states in the ovaries of aging mice. MedComm, 5(10), e727.
5. Li, M., et al. (2023). NAD+ administration profoundly decreases UVC-induced skin damage by attenuating oxidative stress, inflammation, DNA damage, and apoptosis. International Journal of Physiology, Pathophysiology and Pharmacology, 13(2), 41–49.
6. Cantó, C., et al. (2012). The NAD+ precursor nicotinamide riboside enhances oxidative metabolism and protects against high-fat diet-induced obesity. Cell Metabolism, 15(6), 838–847.
Educational content only; not medical advice. Follow your product label and consult a healthcare professional as needed (especially if pregnant/nursing, managing conditions, or taking medications).
