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The Best Supplements for Menopause and Perimenopause

Is there any evidence that supplements help with menopausal symptoms? Which supplements are best during the menopausal transition?

Many people prefer a non-hormonal approach to managing symptoms during the menopausal transition, but good quality evidence in this area about potential harms and benefits can be hard to come by.

Best Supplements for Perimenopause

LARA BRIDEN, naturopath

Dr Kelly Teagle recently interviewed Lara Briden, a Naturopath with 25 years’ experience in women’s health, on this very topic. To listen to their conversation REGISTER HERE FOR OUR FREE ON-DEMAND PODCAST

A Holistic Approach To Wellness in the Menopausal Transition

Rather than focusing on individual symptoms, Lara’s approach is more holistic.  “You don’t have to match a supplement to each symptom… supporting the same process with a few basic supplements can help with the whole lot.”

She likens the menopausal transition to a software update for the brain as it “recalibrates” itself to the hormonal changes occurring; this causes symptoms of the menopausal transition such as sleep disturbance, brain fog, flushes and night sweats.

“My approach is to support and stabilise brain health generally… The brain has a lot going on [at this time] and it just needs the right nutrients to be supported and stabilised while it… finds this new way of doing things.” 

Lara guides her clients in choosing nutrients that will supplement the brain and body’s changing needs at this time and help them to function better. One of her favourites is magnesium, which she says really helps with neurological symptoms caused by perimenopause, including sleep, mood, migraines, flushes and heart palpitations. In the podcast she discusses the best way of using magnesium and which added cofactors improve its effects.

Do Herbal Supplements Help Menopausal Symptoms?

Lara tends not to recommend herbal supplements, which can have many unforseen side effects and interactions with other drugs or supplements. It is also difficult to predict the effects of differently-manufactured preparations which have variable ingredients, dose delivery and physiological effects from product to product.

If you do want to try herbal supplements, spend some time beforehand researching which have evidence for both their effectiveness and safety, and ALWAYS consult your doctor before starting any new supplements. Even “natural” products can have potentially disastrous side-effects depending on your medical conditions and medications. For example, you must stop fish oils (which have blood-thinning effects) in the leadup to surgery.

WellFemme Founder Dr Kelly Teagle did this literature search to find which supplements have some reasonable evidence for their effectiveness:

Herbal Supplements for  Inflammation:

Herbal Supplements for Joint Aches and Pains

Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review

In summary, our findings indicate that food and nutritional interventions are considered beneficial in the treatment of pain and inflammatory conditions. For example, vegan and Mediterranean diets and the consumption of blueberry, strawberry, passion fruit peel extract, argan oil, fish oil (omega-3), olive oil, and undenatured type II collagen and vitamin D gel capsules reduce musculoskeletal pain, specifically in adults with osteoarthritis. Besides pain improvement, nutritional interventions, including the consumption of strawberry and vitamin D gel capsules, decrease the levels of several inflammatory markers including IL-6, IL-1β, and TNF-α.”

Herbal Supplements for Hot Flushes

Does scientific evidence support the use of non-prescription supplements for treatment of acute menopausal symptoms such as hot flushes?

“…evidence from a small number of placebo-controlled trials suggested that further research is warranted to test efficacy of red clover, soy, sage and black cohosh for treatment of hot flushes in menopausal women. To date, controlled trials do not support use of dong quai, evening primrose oil and ginseng for treatment of hot flushes.”

Other Hot flush treatments with insufficient evidence to recommend them: Wild yam cream, flaxseed, Maca, pollen extract, siberian rhubarb, licorice root, vitamin E.

The Australasian Menopause Society also has this wonderful factsheet about Complementary and Herbal Therapies for Hot Flushes.

Herbal Supplements for Mood Symptoms

Some supportive evidence for:

This review article found that there is “…evidence for the benefit of B vitamin supplementation in healthy and at-risk populations for stress, but not for depressive symptoms or anxiety. “

This review found evidence for the use of Vitex Agnus Castus (Chasteberry) for PMS symptoms and cyclical breast pain.

Supplements for Breast Pain

Lara says: ” I get good results with her patients with molecular iodine at a dose of 1-3 mg. But it is important to ensure you have a normal thyroid result and are negative for thyroid antibodies (aka TPO antibodies) before taking this high dose. For more information about iodine and breast health, see the American site Violet Daily. And know that a similar product is available in Australia as  “Molecular Iodine Colloid 3%” drops. But ALWAYS check with your doctor and get your thyroid levels checked first.”

Supplements for Sleep

“Valerian and kava have received the most research attention; both have decreased sleep onset time and promoted deeper sleep in small studies, and kava also shows anxiolytic effects. German chamomile, lavender, hops, lemon balm and passionflower are reputed to be mild sedatives but need much more experimental examination.” [Efficacy and Safety of Herbal Stimulants and Sedatives in Sleep Disorders]

Supplements for Vaginal Dryness

  • Vaginal moisturisers, eg. Replens® , Sylk®, YES VM®, Sliquid®
  • Oil or silicon-based lubricants for intra-vaginal sexual activity. Note that natural oils or oil-based lubricants shouldn’t be used with condoms, and silicon lubricants don’t play well with silicon-covered toys.
  • Lara recommends zinc, and refers clients to this vaginal health service.
  • Vaginal estrogen; we list this as a supplement even though it’s hormonal, due to overwhelming evidence about its effectiveness and safety. It is useful for a range of genito-urinary issues which tend to worsen and persist the longer someone is post-menopausal. It is often also used in women after breast cancer (but consult your oncologist first!)

You can also check out our Blog post and on-demand webinar about Intimacy and Menopause, or this excellent information sheet from the Australasian Menopause Society about Vulvovaginal Symptoms after Menopause.


Lara Briden is a naturopathic doctor with consulting rooms in Christchurch, New Zealand. She is the author of the Hormone Repair Manual: Every Woman’s Guide to Healthy Hormones After 40Find out more on her blog LaraBriden.com 

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