Best Supplements for Perimenopause and Menopause: What the Research Shows

“Wait, is this perimenopause, or am I just tired? Why can’t I sleep? And why am I always hot?”

For many women in their 40s and 50s, hot flashes, 3 a.m. wake-ups, and changes in energy levels can be signs of perimenopause, the transition leading up to menopause. If these perimenopause symptoms sound familiar, you may be wondering what’s causing them and whether a supplement can help.

There are ingredients with promising research behind them, while others have limited evidence to support their claims. Understanding what the research says can help you make a more informed decision about which options are worth considering.

The best choice depends on your symptoms, health needs, and stage of menopause. This guide evaluates the evidence behind popular menopause supplements, the doses studied, and what to know before you buy.

 

What Is Perimenopause? Symptoms & Key Changes

Perimenopause is the transition your body goes through before menopause. 

According to the Office on Women’s Health, it often starts in your mid-to-late 40s and can last several years, though the timing and symptoms are different for everyone.

During perimenopause, estrogen and other hormone levels fluctuate. These changes can cause you to experience symptoms such as hot flashes, night sweats, trouble sleeping, mood changes, and irregular periods.

Menopause officially begins after you’ve gone 12 consecutive months without a period. After menopause, estrogen levels stay lower, which can speed up bone loss. Age-related changes in muscle mass can also make it harder to maintain strength as the years go by.

All of these changes are worth keeping in mind when choosing a supplement. An ingredient that helps with hot flashes or sleep might not do much for bone health or muscle maintenance. The best place to start is by looking at what each ingredient has been studied for and how it relates to your symptoms and health goals.

 

Do Perimenopause Supplements Actually Work?

Perimenopause supplements can help address certain nutritional needs and support specific aspects of health, such as bone health. Some ingredients have also been studied for symptoms like hot flashes and sleep disturbances, though results vary depending on the ingredient and the quality of the research.

The Menopause Society’s 2023 position statement on nonhormonal treatments didn’t recommend dietary supplements or herbal remedies for treating hot flashes and night sweats because the evidence available at the time wasn’t strong enough. Hormone therapy remains the most effective treatment for these symptoms, though it isn’t the right option for everyone.

Vitamins and minerals can help fill nutritional gaps, while certain botanical ingredients are being studied for their potential to ease menopause symptoms.

Two botanical ingredients with promising early research are SheVari4 and EstroG-100. 

In an 8-week, placebo-controlled trial involving 60 women, SheVari4 was associated with improvements in overall menopause symptom scores, including hot flashes and sleep quality (2026 clinical study). 

A separate 12-week trial involving 64 women found that EstroG-100 improved overall menopause symptom scores compared with a placebo, including insomnia (2012 clinical study). In a later trial, 70 postmenopausal women completed the final analysis. Researchers found that EstroG-100 reduced the frequency of moderate hot flashes compared with a placebo by week 3, with significant differences in mild, moderate, and severe hot flashes by week 6 (2024 clinical study).

These findings are encouraging, but the studies were relatively small, and further independent research is needed to help establish how reliably these ingredients work. 

 

Which Ingredients Have the Best Research for Perimenopause Symptoms?

The table below compares popular ingredients for perimenopause support based on the available research.

• Stronger: Good evidence for the specific use listed.
• Promising: Encouraging clinical findings, but more research is needed.
• Mixed: Studies have produced inconsistent results.
• Weak: Research hasn’t shown a convincing benefit for the intended use.

Evidence ratings reflect the specific use case listed, not every potential benefit of an ingredient or the effectiveness of a finished supplement.

Use these ratings as a starting point for a conversation with your doctor or pharmacist. For example, calcium has good evidence for meeting bone-health needs, but that doesn’t mean it treats hot flashes.

 

What Are the Best Supplements for Hot Flashes and Night Sweats?

Hot flashes and night sweats can disrupt sleep and make everyday activities uncomfortable. Dressing in layers you can easily remove, keeping your bedroom cool, and identifying personal triggers may help.

If you’re considering a supplement, these three ingredients come up frequently.

EstroG-100

EstroG-100 has some encouraging research for overall menopause symptoms.

It’s a blend of three plant extracts: Cynanchum wilfordii, Phlomis umbrosa, and Angelica gigas.

In a 2012 US trial involving 64 women, the average Kupperman index score, a measure of menopause symptoms, dropped from 29.5 to 11.3 over 12 weeks. The placebo group’s score fell from 29.2 to 23.7.

A 2022 Korean trial tested 514 mg per day. Women taking EstroG-100 had a greater improvement in their overall symptom scores than women taking a placebo after 12 weeks. Researchers didn’t find changes in estrogen, FSH, or the thickness of the uterine lining. 

There are a few limits to keep in mind. Both studies were relatively small and short, and the company behind the ingredient was involved in the research.

Black Cohosh

Black cohosh is a popular herbal ingredient in menopause supplements, particularly products marketed for hot flashes.

Research results have been inconsistent. A 2023 review discussed by the National Center for Complementary and Integrative Health (NCCIH) found that black cohosh may help with overall menopause symptoms. The Menopause Society, however, considers the evidence insufficient to recommend it for hot flashes.

Safety is another consideration. There have been rare reports of liver injury, and some products tested in the past contained the wrong plant species.

If you’re considering black cohosh, talk with your doctor first, especially if you have liver problems or take prescription medication.

Soy Isoflavones and Red Clover

Soy isoflavones and red clover contain plant compounds called phytoestrogens. These compounds can interact with estrogen receptors, which is why they’re often marketed for menopause support.

The evidence is mixed.

According to NCCIH, soy isoflavones may offer a small reduction in hot flashes, but results vary across studies. Research on red clover has also produced inconsistent findings.

A Cochrane review covering 43 trials found no conclusive evidence that these supplements reliably reduce the frequency or severity of hot flashes.

Soy foods can still be part of a balanced diet. The evidence for taking concentrated supplements to manage menopause symptoms is less certain.

What About Omega-3?

Fish oil is another common recommendation for women going through menopause. It’s worth separating its general nutritional uses from claims about hot flashes.

The MsFLASH trial gave 355 women either 1.8 grams of omega-3 fatty acids per day or a placebo for 12 weeks. Researchers found no meaningful difference between the groups in hot flashes, sleep, or mood.

You may have other reasons to take omega-3s, depending on your diet and health needs. The evidence from this trial doesn’t support taking them specifically to reduce hot flashes.

 

Which Supplements Help With Sleep and Stress?

Waking up at 3 a.m. and struggling to fall back asleep can really wear you down. Hormonal changes, night sweats, stress, and other health factors can all play a role.

Magnesium and ashwagandha are 2 supplements commonly discussed for sleep and stress. Their evidence is different, and neither is a guaranteed fix for menopause-related sleep problems.

Magnesium

Your body needs magnesium for normal muscle and nerve function. It also plays a role in many other processes, including energy production.

Women over 30 need about 320 mg per day from all sources, according to the NIH Office of Dietary Supplements. Food sources include nuts, seeds, beans, whole grains, and leafy greens.

Magnesium supplements may be useful if you’re not getting enough through your diet. Some people also take them as part of an evening routine, although evidence that magnesium reliably improves sleep in otherwise healthy adults is limited.

The type of magnesium matters for tolerance. Magnesium glycinate is often easier on the stomach than magnesium oxide, though individual responses vary.

For adults, the upper limit for magnesium from supplements and medications is 350 mg per day. This limit doesn’t include magnesium naturally found in food. Higher supplemental amounts can cause diarrhea and other digestive problems.

If sleep is your main concern, you can also read our guide to supplements for deeper sleep.

Ashwagandha

Ashwagandha is a herb commonly used in supplements marketed for stress, sleep, and hormone support. Research in women going through menopause is still limited.

A 2021 study involving 100 women aged 45 to 55 found that those taking 600 mg per day for 8 weeks had better scores on a menopause symptom scale than the control group.

That’s an encouraging result, but one small study isn’t enough to establish how well the supplement works or how safe it is over the long term.

Ashwagandha also carries safety concerns. The NCCIH reports rare cases of liver injury and notes that it may interact with thyroid medications and sedatives. It may also be unsuitable for people with certain medical conditions.

Talk with your doctor before taking it, especially if you use prescription medication.

 

Which Supplements Support Bones and Muscle After 50?

Bone and muscle health deserve attention throughout adulthood, especially during and after menopause. Lower estrogen levels speed up bone loss, while aging can make it harder to maintain muscle mass and strength.

A few nutrients can help you meet your needs. They work best alongside a balanced diet and regular physical activity, including resistance training.

Calcium

Women aged 51 and older need 1,200 mg of calcium per day, according to the NIH Office of Dietary Supplements. That 1,200 mg target includes food and supplements combined.

Milk, yogurt, cheese, canned salmon with bones, certain leafy greens, and calcium-fortified foods all contribute. Check how much you’re getting from food before buying a supplement.

If your diet already provides enough calcium, taking extra will typically provide little benefit. The upper limit for women over 50 is 2,000 mg per day from all sources and more isn’t automatically better. Excessive calcium intake can cause problems.

Ask your healthcare provider whether you need a supplement based on your diet, health history, and bone-health needs.

Vitamin D

Vitamin D helps your body absorb calcium, making it important for bone health.

The recommended daily amount is 600 IU through age 70 and 800 IU for adults aged 71 and older.

Your needs may differ depending on your health and vitamin D status. A blood test can help your doctor determine whether you have low levels and whether supplementation makes sense.

Avoid taking high doses on your own. Too much vitamin D can raise calcium levels in your blood and cause health problems.

Creatine

Creatine is best known as a sports nutrition supplement, but it’s also being studied for its role in maintaining muscle and strength as we age.

A 2021 review found that postmenopausal women may benefit from creatine, particularly when combined with resistance training. The research suggests it can help support strength and muscle gains, although results vary by study.

Bone health is a separate question. In a 2-year trial involving 237 postmenopausal women, creatine didn’t improve bone density, but researchers did report improvements in hip structure and walking speed.

For a closer look at the research, read our guide to what happens when women start taking creatine, including where CreaTone may fit in your daily routine.

Protein

Protein helps maintain muscle, supports recovery, and gives your body the building blocks it needs for everyday repair.

As you get older, getting enough protein becomes increasingly important for maintaining muscle and strength. Experts recommend that adults over 65 aim for about 1.0 to 1.2 grams of protein per kilogram of body weight each day.

For a 150-pound woman, that’s roughly 68 to 82 grams of protein per day.

You can get protein from foods like eggs, Greek yogurt, beans, fish, chicken, and lean meat. A protein shake can also help you meet your daily needs when you’re short on time or struggle to get enough protein through meals.

Your ideal protein intake depends on your age, activity level, health, and goals. A doctor or registered dietitian can help you determine an appropriate target, especially if you have kidney disease or another condition that affects protein intake.

 

How Do You Choose a Menopause Supplement You Can Trust?

A few checks can help you separate products with clear labels and quality testing from those that leave you guessing.

1. Read the Supplement Facts Panel

Start with the back of the bottle. The Supplement Facts panel should list the ingredients and their amounts per serving.

Be cautious with proprietary blends. These can list several ingredients together without telling you how much of each one is included.

Our guide to reading a Supplement Facts label explains what to look for.

2. Compare the Dose With the Research

The amount of an ingredient matters. If a study tested 514 mg of an ingredient per day, a product containing 50 mg hasn’t been shown to produce the same results.

Check the serving size, too. A label may list the amount per serving, but that serving could require several capsules.

3. Look for Independent Third-Party Testing

Independent third-party testing can help verify a supplement’s identity, potency, and purity. It can also help identify potential contaminants and confirm that a product meets certain quality standards. Keep in mind that testing verifies product quality, not effectiveness. A third-party tested supplement isn’t guaranteed to relieve hot flashes, improve sleep, or ease other perimenopause symptoms. 

4. Introduce One Supplement at a Time

If you start 3 supplements on the same day, you’ll have a hard time figuring out which one helped or caused a side effect.

Keep a simple symptom log for a couple of weeks before starting a new product. Record things like hot flashes, sleep quality, and energy. Continue tracking after you start, and follow up with your healthcare provider if symptoms persist or worsen.

A little patience can help you make a better decision about whether a product deserves a place in your routine.

5. Check Whether Your HSA or FSA Applies

Some supplements may qualify for HSA or FSA reimbursement when specific requirements are met. Eligibility depends on the product, your plan, and applicable rules.

Check before purchasing, and read our guide to using HSA or FSA funds for supplements for more information.

 

A Closer Look at BrickHouse Nutrition Level

BrickHouse Nutrition Level is a hormone-free daily supplement designed to support women through perimenopause and menopause. Its formula features two botanicals that have been studied in women: EstroG-100, a blend of three root extracts, and SheVari4, an extract of shatavari root. Each daily serving provides 514 mg of EstroG-100 and 100 mg of SheVari4, matching the amounts used in clinical studies. The formula also includes chaste tree berry, rose hip, Pycnogenol pine bark extract, and a blend of vitamins and minerals.

The clinical studies on these ingredients lasted 8 to 12 weeks, so BrickHouse recommends taking Level daily for at least 90 days to give it a fair trial. Some women may notice changes in sleep or hot flashes within the first month, while others may need more time or may not notice a meaningful difference. Individual results vary, and the research on these ingredients is still developing.

Level isn’t a replacement for hormone therapy or medical care. It may not be suitable for everyone, including women who are pregnant or nursing or those with hormone-sensitive conditions. If you take prescription medication, check with your healthcare provider before adding Level to your routine.

 

Frequently Asked Questions

Can You Take Menopause Supplements During Perimenopause?

Yes, some supplements can be used during perimenopause, depending on your needs and health history. For example, the 2012 EstroG-100 trial included women in perimenopause.

Choose supplements based on the specific symptom or nutritional need you’re trying to address.

How Long Do Menopause Supplements Take to Work?

It depends on the ingredient and the symptom you’re trying to address. Many trials for menopause symptoms run for 8 to 12 weeks to see the full effects. If you and your doctor decide to try a supplement, track your symptoms and set a time to review whether it’s helping. 

Are Menopause Supplements Safe?

Many supplements are well-tolerated by healthy adults when used appropriately, but safety depends on the ingredient, dose, medications, and individual health conditions. Choose products with clear labels and independent quality testing. Check with your doctor or pharmacist before adding anything new, especially if you take prescription medication.

Can Menopause Supplements Cause Weight Gain?

The trials discussed in this guide don’t point to weight gain as a common finding. Weight can change during the menopause transition for several reasons, including shifts in body composition, sleep, activity, and hormones. Maintaining muscle through adequate protein and regular strength training can help support your long-term health.