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The best menopause supplements according to experts

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While the symptoms of menopause vary from person to person, it can be a difficult time as your body is going through these significant changes. While awareness is growing in this key hormonal phase, there is still research needed on how to manage menopause. But with experts and studies available, we have a list of the best supplements for menopause to help you get the support you need.

Menopause and perimenopause symptoms

Although menopause is dated from the last menstrual period, most women experience symptoms in the five to ten years beforehand, as the number of egg follicles (which produce oestrogen and progesterone hormones) dwindles. During this time, many women will notice a spectrum of troublesome symptoms, including:

  • Anxiety
  • Hot flushes
  • Night sweats
  • Headaches
  • Tiredness
  • Mood swings
  • Joint and muscle aches and pains
  • Dry, thinning skin and hair
  • Vaginal dryness

Hormone replacement therapy (HRT) is one way that you can get support with these menopausal symptoms. Talk to your doctors about the pros and cons and whether this is a good fit for you.

However, if you are unable to don't wish to take prescribed HRT, there are other ways to help manage your symptoms. Through regular exercise, eating a balanced diet, and taking menopause supplements you can help keep your symptoms at bay.

Interestingly, a review of menopause treatments by the National Institute for Health and Care Excellence (NICE) concluded that menopause supplements such as isoflavones and black cohosh are more effective than placebo in treating hot flushes (but not better than prescribed HRT, which is as expected), so they are certainly worth considering.1

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Vitamins, minerals and plant oestrogens to support women through the menopause

  • Vitamin B6 to regulate hormonal activity, high dose of vitamin E
  • Calcium, magnesium and vitamin D for healthy bones
  • Phytoestrogens from soy and omega 3 from flax
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The best supplements for menopause

There is a wide range of supplements for menopause on the market, those which target all-round health, and those which help ease specific symptoms. To help you find the one for you, we've put together a list of our best menopause vitamins.

1. Black cohosh

Black cohosh is one of the best and most well-studied supplements for menopause. Also known as Cimicifuga racemose, it's a wildflower native to Canada and the USA. Its roots and underground stem (rhizome) are a traditional herbal medicine used to relieve menopausal symptoms, and it appears to work through a direct action on the brain.

Black cohosh extracts have been shown to lower levels of LH (luteinising hormone) to help normalize oestrogen-progesterone balance. It also affects the dilation of blood vessels, to relieve hot flushes and night sweats, and improves low libido, anxiety, mood swings and sleep quality.

The results from seven clinical trials involving over 1,000 women aged from 40 to 60 years found that black cohosh extracts produced a significant improvement in menopausal symptoms. On average, symptoms were reduced by over a quarter (26 per cent) compared to placebo.

This is an impressive result given that placebo itself was found to reduce the severity or frequency of hot flushes by 25 to 30 per cent within four weeks of treatment.2

Helping to manage a wide range of symptoms, this is one of the best supplements for menopause out there, just note not to use this one if you have liver problems.

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Traditional Herbal Medicine (THR) for menopause symptoms

  • Traditionally used to help relieve menopause symptoms such as hot flushes, night sweats and mood swings
  • Registered Traditional Herbal Medicine, regulated by the MHRA
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2. Soy isoflavones

Soy isoflavones are the natural compounds of soya bean plants, and these are a potent source of plant oestrogen. This compound helps to support women during menopause, helping to raise oestrogen levels to reduce hot flushes and menopausal sleep disturbances, and also has a beneficial effect on cholesterol, balance, and memory.

This menopausal supplement can also be found in soy foods and is a staple of south-east Asian diets. Women who follow an Asian diet report few, if any, menopausal symptoms. One reason is that their intake of isoflavone plant hormones is around fifty times higher than in the West.

Taking isoflavone supplements for menopause can reduce the frequency of hot flushes and their severity within 6 to 12 weeks.3 Overall, the results of 19 randomised controlled trials found that isoflavone extracts significantly reduced hot flushes by 39 per cent compared with placebo.4

Different women metabolise isoflavones in different ways, depending on the balance of bacteria within their large bowel. For example, those who possess good amounts of probiotic bacteria (think Lactobacilli and Bifidobacteria) can convert one soy isoflavone (daidzein) into a more powerful oestrogen called equol.

Therefore, those who can produce equol obtain more benefits from soy isoflavones than those who don't, so eat live bio yoghurt and/or take a probiotic supplement to help increase your equol production.

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  • 100mg soy extract per vegan tablet
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  • Added vitamin B6 to support and regulate hormonal activity
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3. Flaxseed

Flaxseed also contain isoflavones, and eat the seeds or taking flaxseed oil is one of the best supplements for menopause. This is because flaxseed is a good source of lignans, which can balance hormones. It can benefit in relieving some menopausal symptoms such as night sweats. But also, it's rich in ALA, the only omega 3 essentially fatty acid, meaning it can also help to maintain healthy blood and cholesterol levels.

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4. Sage leaf

Another natural plant oestrogen, sage has been used for thousands of years for a wide range of conditions, including menopause. Known as the perfect complement to black cohosh, sage leaf extracts contain several antioxidant polyphenols and essential oils which, together, have astringent and perspiration-inhibiting properties. It is traditionally used to relieve menopausal hot flushes and night sweats, although whether its actions are due to the presence of plant oestrogens, or an ability to stimulate natural oestrogen production, remains unclear.

Sage is also used to boost memory and concentration through an ability to inhibit cholinesterase, an enzyme that deactivates some neurotransmitters in the brain.

A study involving 69 women who had experienced menopausal symptoms for at least a year, and who had at least five flushes a day, found that sage leaf extracts reduced the frequency of mild hot flushes by 46 per cent, moderate flushes by 62 per cent, severe flushes by 79 per cent and stopped very severe flushes altogether.

The intensity of flushes overall was halved within four weeks and reduced by 64 per cent within eight weeks.5

Pair it with a black cohosh supplement, or take it by itself, either way this is one of the best menopause supplements to help with hot flashes and night sweats.

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5. Evening primrose oil

Evening primrose oil (EPO) is a rich source of GLA: an essential fatty acid that helps to improve dry itchy skin and has a beneficial effect on calcium and hormone metabolism. With menopause, this supplement can maintain hormonal balance and support women's health, and protects cells from oxidative stress, which can aid the hot flushes and dry skin that occur due to menopause.

Some GLA is incorporated into cell membranes, making them more flexible so that skin becomes noticeably softer and better hydrated within a few days. Some GLA is also converted into hormone-like substances known as series 1 prostaglandins, which relax blood vessels to improve blood flow to the skin, decrease inflammation to reduce redness, and improve nerve function to reduce itching and discomfort.

Regarding reducing the severity of hot flushes and dry skin at menopause, a study of perimenopausal women found that those who took EPO had significantly less severe hot flushes than those who took placebo.6

If you are struggling with dry skin or hot flushes, taking this menopause vitamin may help you.

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6. Starflower oil

Similar to evening primrose oil, this menopause supplement also has the GLA (Gamma-Linolenic Acid) which can help to balance hormone levels. Starflower oil, also known as borage oil, is pressed from the seeds of the Starflower plant and the omega 6 fatty acid has several benefits. From helping soothe mood swings, breast tenderness and skin changes, it can also help with heart health, weight loss, eye health, and joint pain and stiffness.

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7. Sea buckthorn oil

Sea buckthorn oil contains high levels of omega-7 fatty acids and is also rich in omega 9s and powerful antioxidants such as carotenoids and vitamin E.

Helping to improve hair and skin quality as well as reducing dryness throughout the body, including eczema, dry eyes, dry hair and vaginal dryness, sea buckthorn oil is considered to be one of the best menopause supplements.

A study involving 98 postmenopausal women experiencing vaginal dryness, itching or burning found that sea buckthorn oil was significantly more effective than placebo in relieving symptoms. These findings were supported by a significantly better rate of improvement in the integrity of vaginal epithelium.7

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8. Milk Thistle

This menopausal supplement uses milk thistle, which is a natural herb member of the sunflower family, and helps to support hormonal balance through the liver. Combined with calcium and vitamin B it can help aid the normal function of digestive enzymes as well as reduce tiredness and fatigue. Helping with hot flushes, as well as reducing feelings of anxiety and depression, it's no wonder why milk thistle is one the best supplements for menopause. Read more about The Effects Of milk thistle on menopause.

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Milk thistle extract with B vitamins, calcium and choline to support your digestive system and liver function

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  • Added B vitamins reduce fatigue
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9. Royal Jelly

Produced by worker bees as a source of nutrition for the queen, royal jelly contains proteins, fatty acids, B vitamins, minerals and trace elements. Taking this menopause supplement will support your energy levels and protect your cells from oxidative stress. Studies have shown that royal jelly can support menopausal symptoms such as fatigue and hot flashes, but further research is needed to confirm the effects.

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10. Magnesium

Magnesium is a mineral needed for over 700 enzymes to work properly, so is involved in just about every metabolic reaction, including the production of energy and the synthesis of hormones.

Lack of magnesium contributes to many common problems such as insomnia, fatigue, weakness, muscle cramps and constipation. Low magnesium intakes are also associated with a raised blood pressure and poor glucose tolerance.

Magnesium also regulates the movement of calcium in and out of bone cells, and is important for the prevention of osteoporosis in post-menopausal women.8 In fact, studies show that women with osteoporosis have significantly lower magnesium levels than similar women without osteoporosis, and that both men and women with the lowest magnesium and potassium intakes had a greater risk of hip fracture.9, 10

Taking magnesium supplements for two years has been shown to increase bone mineral density and prevent bone fractures in menopausal women.11 Whether you are increasing bone mineral density, or trying to help manage common menopause symptoms like insomnia, fatigue or weakness, taking this menopause supplement may help. Adding magnesium flakes into a bath can also help relax and promote a good night's sleep.

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11. St John's wort

St John's wort is a well-known traditional herbal medicine used to treat low mood, anxiety or mild depression. The vibrant yellow petals have numerous pinpoint glands that contain a fluorescent red dye, which has substances such as hypericin and hyperforin. These have a natural antidepressant action and can also help those during menopause.

St John's wort extracts lift mood by prolonging the action of a wide range of neurotransmitters in the brain including serotonin, noradrenaline, dopamine, gamma-aminobutyric acid (GABA) and L-glutamate to even out mood swings.12

As well as improving low mood and smoothing any mood swings, St John's wort can also improve low sex drive, which often accompanies menopause. After three months of taking supplements, 60 per cent of women with a low libido became interested in sex again. Eighty-two per cent also suffered less irritability, anxiety, low mood, hot flushes, sweating and disturbed sleep.

Before the trial, 60 per cent said that they were too exhausted for sex. At the end of the trial, none of them felt that way. They also reported increased self-esteem, as well as a marked increase in self-confidence and self-respect.13Combining it with black cohosh makes this one of the best vitamins for menopause.

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Traditional herbal medicine used for relief of low moods and mild anxiety

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Best menopause supplements for skin, nails and hair

If you are struggling with dry skin, dry hair or brittle nails because of menopause, there are a few ways to help. Some of the supplements we've mentioned already can help with skin, such as evening primrose oil. Starflower oil, and sea buckthorn oil.

While those are worth a try, we have a range of menopause skincare products which may help as well. From collagen boosting skin serums, body and face wash, toners, creams, even shampoo and conditioner. You can also combine your new skincare regime with the best menopause supplement for skin, hair and nails. Both contain a range of vitamin and minerals that you need in order to combat these changes due to menopause.

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Combat the effects of lower oestrogen levels on the skin

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Menopause vitamins and supplements

Know that during perimenopause or menopause your symptoms might be hard to manage, but taking a supplement can help you. Here at Healthspan we have a wide range of menopause supplements which can help aid your symptoms from hot flushes, fatigue, headaches, mood swings and anxiety, aches and pains, as well as dry skin and hair. Before taking a supplement, make sure you talk to your doctor and make sure it's the best one for you, as some may interact with medicines you are currently taking, and others may cause reactions.

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1 Sarri, G., Pedder, H., Dias, S., Guo, Y., & Lumsden, M. A. (2017). Vasomotor symptoms resulting from natural menopause: a systematic review and network meta-analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause. BJOG: an international journal of obstetrics and gynaecology, 124(10), 1514–1523.
2 Shams, T., Setia, M. S., Hemmings, R., McCusker, J., Sewitch, M., & Ciampi, A. (2010). Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis. Alternative therapies in health and medicine, 16(1), 36–44.
3 Taku, K., Melby, M. K., Kronenberg, F., Kurzer, M. S., & Messina, M. (2012). Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials. Menopause, 19(7), 776–790.
4 Bolaños, R., Del Castillo, A., & Francia, J. (2010). Soy isoflavones versus placebo in the treatment of climacteric vasomotor symptoms: systematic review and meta-analysis. Menopause 7(3), 660–666.
5 Bommer, S., Klein, P., & Suter, A. (2011). First time proof of sage's tolerability and efficacy in menopausal women with hot flushes.Advances in therapy, 28(6), 490–500.
6 Farzaneh, F., Fatehi, S., Sohrabi, M. R., & Alizadeh, K. (2013). The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial. Archives of gynecology and obstetrics, 288(5), 1075–1079.
7 Larmo, P. S., Yang, B., Hyssälä, J., Kallio, H. P., & Erkkola, R. (2014). Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: a randomized, double-blind, placebo-controlled study. Maturitas, 79(3), 316–321.
8 Zheng, J., Mao, X., Ling, J., He, Q., Quan, J., & Jiang, H. (2014). Association between serum level of magnesium and postmenopausal osteoporosis: a meta-analysis. Biological trace element research, 159(1-3), 8–14.
9 Odabasi, E., Turan, M., Aydin, A., Akay, C., & Kutlu, M. (2008). Magnesium, zinc, copper, manganese, and selenium levels in postmenopausal women with osteoporosis. Can magnesium play a key role in osteoporosis? Annals of the Academy of Medicine, Singapore, 37(7), 564–567.
10 Hayhoe, R. P., Lentjes, M. A., Luben, R. N., Khaw, K. T., & Welch, A. A. (2015). Dietary magnesium and potassium intakes and circulating magnesium are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the EPIC-Norfolk cohort study. The American journal of clinical nutrition, 102(2), 376–384.
11 Sojka, J. E., & Weaver, C. M. (1995). Magnesium supplementation and osteoporosis. Nutrition reviews, 53(3), 71–74.
12 Müller W. E. (2003). Current St John's wort research from mode of action to clinical efficacy. Pharmacological research, 47(2), 101–109.
13 Grube, B., Walper, A., & Wheatley, D. (1999). St. John's Wort extract: efficacy for menopausal symptoms of psychological origin. Advances in therapy, 16(4), 177–186.