Supplements for Perimenopause and Menopause Symptoms

Perimenopause and menopause bring huge changes to your body, mostly caused by shifting hormones. This hormonal shift can manifest in symptoms like hot flashes and night sweats, along with sleep issues, mood changes, and faster bone density loss. While Hormone Replacement Therapy (HRT) remains the primary medical intervention, it's not an option for some people, based on their medical history or personal preferences.

Some women turn to dietary supplements for symptom management. We'll explore some of those options below. Please keep in mind that it's imperative to speak with a trusted healthcare provider before adding, changing, or switching any medications or supplements.

Phytoestrogens and isoflavones

Phytoestrogens, including soy-derived isoflavones and red clover, are plant-based compounds. Their structure is similar to human estrogen. They bind to estrogen receptors, which can increase the levels of estrogen in your body.

Clinical research shows that phytoestrogens may offer some benefit for specific symptoms.¹ A systematic review and meta-analysis showed that phytoestrogen intake was associated with a reduction in daily hot flashes and a slight improvement in vaginal dryness scores compared to placebos.¹

Black cohosh

Black cohosh is among the most popular herbal remedies used for hot flash relief. Unlike phytoestrogens, it does not increase the estrogen in your body. Instead, it may help to regulate serotonin and dopamine in your brain. ²2

However, a broader Cochrane systematic review showed that consistent effectiveness can vary.²

Vitamin D and calcium for bone health

Beyond symptom relief, menopause increases long-term risk for osteoporosis. This is in part because lower estrogen affects how calcium is absorbed in your gut, and the hormonal changes speed up the breakdown of your bones. ³

Vitamin D and calcium supplements can help prevent bone loss. Eating foods rich in calcium and vitamin D such as canned fish with bones, dairy products, and fortified plant-based milks are good options in addition to over-the-counter supplements.³

Safety and clinical considerations

While over-the-counter supplements can be a helpful option, they need careful oversight from your healthcare provider.

Supplements don't have the same regulations pharmaceutical drugs have, so it can lead to variation in quality.
Additionally, certain herbal extracts, including black cohosh, have rare reports of liver toxicity, so it requires careful monitoring.²

Additionally, high-dose phytoestrogens or herbal formulations may interfere with hormone-sensitive conditions or medications, including anticoagulant drugs and tamoxifen.

Consulting your healthcare provider is essential to create a supplement protocol that works for you.