Supplements for Perimenopause

Supplements are an essential part of an integrative approach to perimenopause. Around 70% of women, ages 40 to 60, use dietary supplements such as specific nutrients and herbs to help support and manage their health through the transition to menopause. Perimenopausal women take supplements to optimize nutrient status, reduce inflammation, and balance hormones.

However, not all supplements are created equal or have the research behind them for use in clinical practice. Today’s article will explore some of the supplements with clinical evidence and what to look for when choosing supplements for your perimenopausal journey and beyond. Keep reading to learn more about:

• What you need to know about perimenopause and menopause
• Why you should consider supplements during this hormonal transition
• What supplements might be supportive
• Supplement tips and best practices

Let’s dive in with this evidence-based approach!

What are Perimenopause and Menopause?

Perimenopause is the decline in ovarian function and reproductive capacity that leads to menopause, the one-year mark without a period. The average age of menopause is 51, but it’s normal to stop periods between the ages of 45 and 55. While menopause is just a one-day marker in time, perimenopause lasts much longer, years, or even a decade.

In perimenopause, estrogen levels fluctuate and then eventually decline. As ovulation becomes less frequent, progesterone does as well. These hormonal changes lead to symptoms such as hot flashes, mood changes, weight gain, vaginal dryness, brain fog, skin aging, irregular menstrual cycles, and others.

Perimenopause and menopause are also associated with an increased risk of chronic disease. Without the protective mechanisms of estrogen and progesterone, women are more at risk for insulin resistance, heart disease, cancer, osteoporosis, and dementia.

Perimenopause Care Plan

The good news is that perimenopause is a significant window of opportunity to create future health. Implementing nutrition and lifestyle behaviors during this time helps offset the metabolic changes during this transition. Supplements can be a helpful tool for supporting symptom management and lifelong health.

During perimenopause, supplements may help:

• Fill in nutrient gaps and optimize nutrition status
• Offset nutrient decline associated with aging and hormonal changes
• Decrease inflammation and manage oxidative stress
• Support perimenopausal symptoms, such as hot flashes or poor sleep
• Create a bridge for ovarian support until you’re ready for hormone replacement therapy
• Offer non-hormonal alternatives to hormone replacement therapy

Evidence-Based Supplements for Perimenopause

With so many supplements on the market, how do you know what will really work? Look at the research. Let’s explore some supplements with research supporting their use in perimenopause.

Omega-3s

In perimenopause, inflammation can increase, and women might see elevations in cholesterol levels and an increased risk for depression. Omega-3 fats (from fish) are naturally anti-inflammatory and support lipid balance, brain health, and mood. In postmenopausal women, low dietary intake of omega-3s is associated with increased rates of depression.

One recent systemic review suggests omega-3 fish oil supplements reduce depressive symptoms and show benefits for brain health in terms of mood and cognition after menopause.

We recommend an omega-3 supplement in the form of fish oil or krill oil for those who don’t eat much fish in their diet or need more to support inflammatory symptoms.

Magnesium

Magnesium is a critical mineral that supports over 300 biochemical reactions in the body, including metabolism, hormone balance, a healthy stress response, and more.

Even when eating good sources of magnesium, including leafy greens, avocados, and legumes, many women benefit from magnesium supplements during perimenopause because of low magnesium in agricultural soils and increased needs because of stress, toxins, and other factors.

As bone loss begins to accelerate in perimenopause, magnesium supplements may help. One review of 28 studies suggests magnesium supplementation supports bone mineral density and decreases fracture risk. Another review suggests magnesium supplementation supports perimenopausal symptoms, including painful periods, migraines, and PMS.

Magnesium supplements are very safe, even at high doses. We recommend chelated magnesium, such as magnesium glycinate.

Vitamin D

It’s well known that good vitamin D status is critical for bone health, which becomes critical in perimenopause and menopause. However, vitamin D is also involved in immunity, blood sugar regulation, and genetic expression. The risk of vitamin D deficiency increases with age and menopause.

Vitamin D deficiency may contribute to many of the adverse health risks associated with menopause, including insulin resistance, diabetes, heart disease, depression, cognitive impairment, and more. Therefore, it’s essential to optimize vitamin D levels in perimenopause and menopause form a disease prevention perspective.

Because it’s challenging to get enough vitamin D from food and safe sun exposure, vitamin D supplements can help fill in the gaps. We recommend asking your healthcare provider to test your vitamin D and supplement accordingly to maintain optimal levels.

Collagen

Collagen is the primary structural protein in the body and supports bones, joints, skin, digestion, and more. With age, collagen breaks down more quickly, and the body isn’t as efficient in replacing it. The loss of collagen in perimenopause and menopause is associated with wrinkles, skin aging, and bone loss.

Supplementing collagen peptides helps provide the amino acids the body needs to support healthy collagen levels. Research suggests that collagen peptide supplements help improve bone mineral density in postmenopausal women. A meta-analysis points to skin benefits, too; collagen supplements reduce wrinkles while improving skin elasticity and hydration.

Collagen peptides are easily incorporated into hot or cold beverages and baked goods.

Probiotics

Perimenopause and menopause are associated with gut microbiome changes that affect hormone balance, nutrient absorption, metabolic health, bone health, and more. Research suggests that probiotic supplements help prevent dysbiosis (gut microbiome imbalances) and protect the estrobolome (the part of the gut microbiome involved in estrogen metabolism).

Further, the gut microbiome informs the vaginal microbiome. With the loss of estrogen in perimenopause, women are more at risk for urinary tract and vaginal infections and genitourinary syndrome of menopause.

Perimenopause is an excellent time for microbiome testing and increasing gut and vaginal health with fermented foods, prebiotic foods, and probiotic supplements.

Resveratrol

Resveratrol is a polyphenol found in red wine, red grapes, and peanuts. While drinking red wine in perimenopause can disrupt estrogen metabolism and sleep, you can get a therapeutic dose of resveratrol through supplements.

Research suggests resveratrol supplements in postmenopausal women:

• Increases bone mineral density
• Improves insulin sensitivity
• Improves blood flow
• Slows cognitive changes associated with age

Look for resveratrol in the form of trans-resveratrol for best results.

Phytoestrogens

Phytoestrogens are plant compounds that bind to estrogen receptors in the body and have a lot of research to support their use for perimenopausal symptoms. You can increase phytoestrogens by adding organic soy (tofu, tempeh, edamame) to your diet or using specific herbs.

One phytoestrogen herb, black cohosh, has a long history of use for perimenopausal symptoms. Black cohosh has a favorable safety profile for use in reducing vasomotor symptoms (hot flashes and night sweats). It may also support perimenopause or menopause-related depression.

Read more about phytoestrogens in Phytoestrogens for Perimenopause.

DHEA

DHEA (dehydroepiandrosterone) is a steroid hormone made by the adrenal glands and ovaries.

It’s the precursor to testosterone and estrogen. DHEA declines with age, and supplementation can help support healthy aging.

In perimenopause and menopause, DHEA may be a consideration for women with low levels and associated symptoms, including:

• Hypoactive sexual disorders and low libido
• Depression and anxiety
• Fertility in perimenopausal women trying to conceive
• Obesity and insulin resistance

Although DHEA is available over the counter, it is a hormone, and we recommend working with a skilled practitioner for guidance, dosing, and monitoring.

Melatonin

Production of melatonin, the sleep hormone, declines in perimenopause and postmenopause, during which sleep issues are a common concern. In fact, insomnia is one of the most common complaints of women during the premenopausal transition as progesterone levels fall.

Melatonin supplements are safe and well tolerated and support several sleep disturbance patterns. You can consider supplementation along with other sleep hygiene and supportive measures.

Supplement Tips and Best Practices

The supplements discussed in this article are just the tip of the iceberg regarding perimenopause support. Please work with your TārāMD provider and team for personalized supplement guidance based on your symptoms, lab tests, and health goals.

Please note that some supplements can interact with medications or may not be indicated for those with certain medical conditions. Please always discuss new supplements with your healthcare provider or pharmacist.

Finally, supplements are poorly regulated and there are many low-quality supplements on the market, which can be potentially dangerous due to inconsistent dosing or contamination with heavy metals or other toxins. At TārāMD, we always recommend vetted practitioner brands that undergo third-party testing for quality and purity. Read more about the quality supplements we offer here.

If you are experiencing symptoms of perimenopause, you are not alone. Many lifestyle tools, including supplements, can help you optimize your health and feel better throughout this transition. Additionally, supporting your health today lays a solid foundation for health and longevity in your later decades.

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