The best menopause supplements for 2024

Many menopausal women are opting for supplements over HRT for their symptoms. So what’s out there, and how do you know which ones to buy?

Around one third of the entire UK female population is currently perimenopausal or menopausal, according to the NHS. Of those estimated 13 million people, the lucky ones might sail through the menopause transition without being troubled by the many recognised symptoms of the menopause, which includes hot flushes, night sweats, anxiety and brain fog. Unfortunately, this isn’t the case for many. 
Increasingly, women are turning to hormone replacement therapy (HRT), with the number of prescriptions increasing by 29 per cent in 2022/23. However, not everyone can take HRT – and many don’t want to. As a result, the global menopause supplement industry is expected to reach $22.7 billion by 2028 as more women seek out alternatives to prescribed medications. 
Jump to:
There are a number of different supplements which claim to treat different menopausal ailments, from hot flushes to aches and pains and problem periods. For this reason, it can be hard to know which supplement to choose – and if they’re likely to work. “It is hard to find good evidence for supplements,” admits Dr Sohère Roked, a GP and functional medicine and hormone doctor. “The reason for that is that most big trials are paid for by pharmaceutical companies who have less interest in studying alternative remedies.”
Dr Louise Newson, a GP and menopause specialist, says: “The market for menopause-related supplements is huge, but I always urge caution in seeing herbal medicines as a cure-all for menopause. If you are thinking about taking supplements, look beyond the marketing and think about your health in a holistic way, focusing on the key areas of bone, heart and brain health, as falling hormone levels can all have a detrimental effect on these.”
“If you are experiencing what you believe to be symptoms of the perimenopause or menopause, your first port of call should be a healthcare professional,” says Dr Newson. “Menopause-related symptoms are due to low hormones rather than being low on certain vitamins and minerals, and HRT is usually the first-line treatment to manage menopause-related symptoms, and it also has benefits for your long-term health.”
Nevertheless, Dr Newson does see the value in supplementation and says, “In addition to vitamin D and magnesium, I personally take fish oil for my joints and a good quality probiotic – our mood, immunity, stress and energy levels can all be impacted when our gut microbiome isn’t balanced.”
One note of caution: tempting as it is to take a pick and mix approach to supplementation, Charlotte Faure Green, a registered nutritionist, recommends checking with a doctor or pharmacist as some supplements aren’t suitable for everyone, and there can be contraindications and interactions with prescription drugs. 
Here are the supplements that our experts recommend for the most common perimenopause and menopause symptoms.
Best for: Bone health
How does it work? Age-related bone loss begins in our 40s and accelerates post-menopause. Studies show that vitamin D supplementation can prevent osteoporosis and reduce the risk of fractures. 
Dr Newson says: “During perimenopause and menopause, your bone density starts to decrease. This can make your bones weaker, less pliable and therefore more susceptible to breaking and developing osteoporosis. The primary benefit of having enough vitamin D is for the health and strength of your bones. It helps your body to absorb and use calcium, which gives them their strength and hardness.”
Faure Green adds: “Vitamin K2, combined with D, directs calcium to the bones and prevents its accumulation in soft tissues. Together they may help reduce the risk of fractures and improve bone density.”
Best for: Hormonal balance
How does it work? There’s evidence that vitamin B6 can help to alleviate the symptoms associated with premenstrual syndrome (PMS), while vitamin B12 can help to fight fatigue and boost mood. 
Dr Roked says: “B vitamins help you process both your female hormones and stress hormones, especially folate, which helps with  mood, energy, hormonal balance and metabolism.” 
Best for: Overall wellbeing
How does it work? These multivitamin and mineral supplements typically contain a mix of ingredients to tackle a range of perimenopause and menopause symptoms. Limited research suggests that they can help to improve quality of life during the menopause transition. 
Faure Green says: “Most women would benefit from a good quality multivitamin and mineral that is designed for women at this stage of their life. Ensure it has good levels of B vitamins for brain function, and other nutrients such as vitamin A, E, zinc, and selenium for antioxidant assistance. Dosages will differ from brand to brand, but all tend to be on the lower end, veering away from true therapeutic doses – more of a safety net dose.”
Best for: Insomnia
How does it work? Research indicates that magnesium can improve duration of sleep and reduce insomnia and early-morning awakening. It is believed to work by decreasing levels of the stress hormone cortisol.
Dr Newson says: “Lots of women I speak to struggle with sleep during menopause, which can be due to anxiety or physical symptoms like night sweats and needing the toilet. 
“If sleep is an issue, a good quality magnesium supplement can be beneficial: magnesium activates the parasympathetic nervous system, the system responsible for getting you calm and relaxed to help prepare your body for sleep. It also regulates the hormone melatonin, which guides sleep-wake cycles in your body.”
Best for: Cognitive function
How does it work? Studies show that fish oil supplementation can improve blood circulation in the brain and help improve memory and mental performance. 
Faure Green says: “Fish oils containing EPA and DHA, have been studied for their potential benefits in brain health, amongst many other systems. Research suggests that omega-3 supplementation may help the neurological symptoms in perimenopause by supporting cognitive function and reducing inflammation.”
Best for: Heavy periods
How does it work? Many women experience heavy periods and flooding during perimenopause. This is because lower levels of the hormone progesterone causes the uterine lining to build up, leading to heavy bleeding. Losing a lot of blood can lead to iron deficiency anaemia. 
Dr Newson says: “Girls and women of reproductive age are particularly at risk of developing iron-deficiency anaemia, especially if they have heavy periods. If you are concerned that you may be anaemic (symptoms can include fatigue, shortness of breath, cold hands and feet and brittle nails) you should see a healthcare professional: diagnosing iron deficiency anaemia usually requires a blood test and is usually treated with iron tablets and by eating iron-rich foods.”
Best for: Temperature regulation
How does it work? One of the best-known menopause supplements, studies indicate that sage supplements can reduce the overall severity of menopausal symptoms, particularly night sweats and hot flushes. 
Faure Green says: “Sage contains compounds that may help regulate body temperature and reduce the frequency and severity of hot flushes.”
Best for: Hot flushes and night sweats 
How do they work? There’s growing evidence that isoflavone supplements such as red clover and black cohosh can bind to oestrogen receptors in the body and reduce hot flushes – one of the most common symptoms of menopause. 
Dr Louise Newson says: “The Nice menopause guidelines state that isoflavones and black cohosh may help relieve hot flushes and night sweats. Both contain plant phytoestrogens, which are plant-derived compounds that have a similar structure to human oestrogen, but it’s worth remembering they don’t have the same potency as the oestrogen produced by your body, so will not have the same effect.”
Best for: Urinary tract infections (UTIs)
How does it work? Oestrogen supports the growth of beneficial bacteria in the urinary tract, which helps protect against the overgrowth of harmful bacteria. After menopause, low levels of oestrogen can disrupt this balance, making women more susceptible to UTIs. Early research indicates that probiotic supplementation can be helpful. 
Faure Green says: “Probiotics containing different Lactobacillus strains may help restore the balance of beneficial bacteria in the urinary tract, reducing the risk of UTIs. Look for a probiotic supplement specifically formulated for women’s urogenital health.”
Best for: Anxiety and stress
How does it work? A number of small studies indicate that ashwagandha can help to ease stress, anxiety and depression and improve insomnia. 
Dr Roked says: “This is a herb that’s known as an ‘adaptogen’ because it helps you adapt to the amount of cortisol in your system. If levels are too high it helps bring them down and if they are too low it helps to bring them up. Perimenopause and menopause are very stressful so if you’ve having surges of cortisol because you’re feeling very stressed or forgetting things, this will help. As a result, this can help with your mood or improve your perspective on your flushes. Some people find it useful at night because it helps with sleep.”
Best for: Vaginal dryness
How does it work? Research indicates that sea buckthorn can improve vaginal health and relieve symptoms of atrophy, such as dryness, soreness, burning and itching. 
Faure Green says: “Sea buckthorn oil contains omega-7 fatty acids, which may help support vaginal health and reduce vaginal dryness. Sea buckthorn oil supplements can be ingested, usually alongside other omegas in a complex, or applied using vaginal moisturisers or lubricants.”
Recommended