10 Supplements That Ease Perimenopause Symptoms

Perimenopause: That time when your periods turn up inconveniently, like Amazon deliveries, your moods make landfall like extreme weather events, and your skin (including the skin in your nether regions that has never needed any help staying hydrated) requires Costco-sized buckets of moisturizer. Hormone therapy can certainly treat some of these symptoms, but can vitamins for perimenopause, or other types of perimenopause supplements also potentially help?

First off, a quick reminder that this whole perimenopause business is a natural stage of life, like puberty, but with more autonomy and much better haircuts. Yes, it’s an emotional ride and night sweats aren’t exactly helpful to getting a restful eight hours. But the changes our bodies are going through are expected, understandable, and, in fact, somewhat predictable.

This is where perimenopause supplements can be helpful, to make sure you’re getting all the nutrients you need. 

“The holistic approach definitely helps,” says Yves-Richard Dole, M.D., a board-certified obstetrician/gynecologist with Mercy Medical Center in Baltimore, Maryland. “Assessing someone’s intake of proper nutrition is important,” he says, especially as the changes taking place during perimenopause may actually affect our eating habits. Insomnia and mood issues like depression or anxiety can dampen or ramp up appetite and “women may start to eat differently because of the decrease in estrogen,” he says.

One big heads up: dietary supplements can play a role in keeping us healthy, but it’s far better to eat well and get your nutrients from real food if possible. Experts agree that supplements can’t replace a good, healthy, varied diet. 

That said, the interest, scientific research into, and demand for perimenopause and menopause supplements is growing, according to a research firm that tracks the industry—in 2023, supplements were 95 percent of this market. “Vitamin supplements are very important,” says Neha Lalani, M.D., a board-certified endocrinologist and obesity medicine specialist who practices at Bluebonnet Diabetes & Endocrinology, in Austin, Texas.

Some of the most touted supplements for perimenopause, like red clover and wild yam, aren’t backed by much research. However, there’s some evidence that certain vitamins and supplements can alleviate perimenopausal symptoms. Lalani stresses that their real value is in preserving health and helping our bodies function better while undergoing enormous change. 

So here are the vitamins that can help support your health through perimenopause-related changes, all to keep you healthier and happier for longer. 

About the Experts

Yves-Richard Dole, M.D., a general OB/GYN at Mercy Medical Center in Baltimore. 

Neha Lalani, M.D., an Austin-based board-certified endocrinologist and obesity medicine specialist practicing at Bluebonnet Diabetes & Endocrinology

1. Vitamin D for Calcium Absorption and Immune Health

Vitamin D promotes healthy functioning of muscles and the immune system, as well as food absorption. Some studies even show that vitamin D could impact mood (2, 3). Low levels of the vitamin are associated with depression, although researchers point out that there is no known direct link. 

According to the American College of Obstetricians and Gynecologists, about 4 in 10 women have mood symptoms during perimenopause similar to PMS; the organization reports that most studies agree that the risk of depression increases during the menopause transition (4).

Dosage: 15 mcg

Best food sources: Fish, dairy, mushroom

Suggested supplement: New Chapter

2. B Vitamins for Energy and Mental Sharpness

Just what won’t having an adequate amount of B vitamins do? They’re credited with helping prevent cognitive decline in women (5). They may help battle that pernicious perimenopausal symptom: tiredness. The science points to a deficiency of B12 causing fatigue, so experts posit that more of it can help fight fatigue in some women.

B Complex vitamins may also guard against breast cancer as well as help prevent cardiovascular disease, which can ramp up during menopause. 

Dosage: There are eight B vitamins, including riboflavin, folic acid, and B12, and you need different (albeit small) amounts of each of them.

Best food sources: Meat, eggs, dairy, legumes, fruit and veggies, whole grains

Suggested supplement: Nature Made’s B Complex

MANAGING MENOPAUSE

7 Signs Perimenopause is Finally Ending

8 Signs You Might Need Menopause Hormone Therapy

3. Vitamin E for Hot Flashes 

Newsflash for hot flashers: Taking a vitamin E supplement may help douse the flames, the Mayo Clinic reports. One study published in Complementary Therapies in Medicine determined that taking 200 IU (or roughly 134 mg) of vitamin E daily “significantly reduced” hot flashes in postmenopausal women after 8 weeks (6).  

Dosage: 15 mg

Best food sources: Spinach, avocado, sunflower seeds, and almonds

Suggested supplement: Kirkland Signature Vitamin E

4. Vitamin C for Brighter Skin and Stronger Bones

The “orange juice vitamin” does more than make your morning sunny. It’s also essential for the production of collagen (that lovely stuff in your face that makes your skin look plump and dewy, which we lose as we get older).  As an antioxidant, vitamin C may help prevent cardiovascular disease, which is underdiagnosed and undertreated in women. According to one source, women who consumed a high amount of vitamin C had a higher bone density (7).

Dosage: 75 mg

Best food sources: Tomatoes, peppers, and Brussels sprouts

Suggested supplement: Garden of Life Vitamin Code (or pick from these Vitamin C options)

5. Iron for Irregular Periods

During perimenopause, your periods might get wonky. Aside from being hard to prepare for (changing your tampon once an hour? No thanks), heavy blood loss can lead to iron deficiency. In addition to the usual iron deficiency symptoms—weakness, lack of energy, and lowered immune defense—one study suggests that during perimenopause, iron deficiency impairs cognitive function and lowers mood (8).

Dosage: 18 mg before menopause, and 8 mg after. But if you have heavy periods or iron deficiency anemia, you may need more.

Best food sources: Meat, seafood, almonds, walnuts, sesame seeds, lentils, red kidney beans, and green leafy vegetables like spinach

Suggested supplement: NOW Foods Iron

6. Omega 3 for Hot Flashes and Heart Health

Omega-3s aren’t just good for heart health, which is at an elevated risk during perimenopause and after. Some research suggests that omega-3s might help alleviate vasomotor symptoms, including hot flashes and night sweats, alongside anxiety, depression, and sleep disturbances that many women deal with during menopause. While the research isn’t conclusive, one review did note that because omega-3 supplementation is so safe, it might be worth a try if you’re dealing with these symptoms (10).

Dosage: 1,000 mg

Best food sources: Fatty fish, such as salmon, tuna, sardines, mackerel, and herring, flaxseeds, walnuts, and chia seeds

Suggested supplement: Thorne Super EPA

7. Zinc to Boost Mood

If you’ve been feeling low, a simple zinc supplement might help. One study suggests that low levels of zinc may lead to lower gamma-aminobutyric acid (GABA) levels in the brain—a neurotransmitter that blocks specific signals to reduce fear, worry, and stress (13). Zinc supplementation can help raise GABA levels, improving symptoms of anxiety.

Dosage: 8 mg

Best food sources: Meat, fish, and seafood

Suggested supplement: Pure Encapsulations Zinc 15

Hormone Science

8 Signs You Might Need Menopause Hormone Therapy

Can I Take Progesterone Without Estrogen in Menopause?

8. Isoflavones (Soy) for Hot Flashes

Soy contains isoflavones, a group of plant-based chemicals called phytoestrogens which act like a weaker form of estrogen in the body. Since estrogen begins to wane during perimenopause, it makes sense that increasing your levels could help alleviate perimenopause symptoms.

Science agrees. A 2015 analysis of 10 studies found that plant isoflavones from soy and other sources reduced hot flashes by 11 percent (15). And a more recent review suggests that isoflavones can help reduce hot flashes, support bone mineral density, and improve systolic blood pressure and glycemic control (16).

Dosage: A standardized isoflavone dose has not been established, but a 2019 review suggests that 40 to 50 mg a day, split into two separate doses (16).

Best food sources: Edamame, tofu, tempeh, and soy milk.

Suggested supplement: NOW Foods Isoflavones

9. Black Cohosh for Hot Flashes and Night Sweats

Black cohosh for relief from menopause symptoms, including hot flashes, irritability, mood swings, and sleep disturbances, dates back to Native Americans. Today, many women swear by treatments like black cohosh extract or black cohosh tea for menopause relief.

That said, experts disagree about the safety and efficacy of black cohosh for treating menopause symptoms. Earlier research suggests black cohosh may help relieve hot flashes. However, the doses of black cohosh studied, extracts used, and length of clinical trials have been all over the place, leading to inconclusive evidence of whether black cohosh actually helps (17).

Dosage: Mount Sinai suggests 20 to 80mg per day, but because research is limited, it’s worth checking with a doc (18).

Best food sources: Black cohosh root tea

Suggested supplement: Remifemin

10. Calcium to Prevent Bone Loss

This is the headline nutrition message that every healthcare provider will stress: We need calcium, always, but especially in perimenopause. “Bone density is achieved in your mid-20s,” says Dole. “After that, it steadily decreases.” This is why some providers call calcium one of the best perimenopause supplements. 

Why does calcium start to dip during the menopause transition? You guessed it: Dropping estrogen levels. This “leads to a further decline in bone density,” he says, which raises the risk of osteoporosis. 

Osteoporosis is a “silent” disease—people experience no symptoms and may not know they’re at risk until they break a bone. “Unless you do a bone density scan you won’t realize what’s happening,” says Lalani.

Even if you don’t develop osteoporosis (8 million women suffer from it and 1 in 2 women over age 50 break a bone because of it), the strength and structure of bones can change, leading to weakness and fracture. If there’s not enough calcium in your diet, your bones will release their stored calcium to help the body function, making them even weaker. 

Calcium also helps the heart, muscles, and nerves work properly and, according to the Mayo Clinic, may also help protect against cancer, diabetes, and high blood pressure. 

Dosage: 1,200 mg daily divided into 250-500 mg doses

Best food sources: Dairy, dark green vegetables, fortified juices, and canned fish like salmon and sardines

Suggested supplement: Nature Made Calcium Carbonate

Should I Take a Perimenopause Multivitamin?

If you and your doctor decide it would be a good idea to supplement, you can take an all-in-one multivitamin and supplement the above nutrients that way. However, be sure to read the ingredient label and find out how much of each vitamin and mineral it contains (not all multivitamins have 100 percent of everything you need). 

Also, beware of the “pink tax,” whereby products aimed at women (such as multis that are marketed specifically for perimenopause or menopause) are often more expensive than those aimed at men. Check out multivitamins that are not marketed toward us perimenopausal queens—it could save you money.

What To Avoid

Unfortunately, caffeine and alcohol can worsen peri and post-menopausal symptoms, so it’s best to limit your intake. Both caffeine and alcohol can mess with cortisol, which can exacerbate hormone imbalances and interfere with sleep (19, 20).