5 Vitamins & 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.

There’s some evidence that certain vitamins can act on perimenopausal symptoms but Lalani stresses their real value is to help with 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. 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. 

How much calcium do you need? 

Women aged 51 and older should aim for 1,200 mg daily, through food and supplements (if your doctor says you need them.) This should ideally be divided into 250-500 mg doses, because, the higher the dose of calcium taken at one time, the less it’s absorbed, according to the Cleveland Clinic.  More isn’t better, either—don’t go over 2,000 mg a day. 

Best sources of calcium

Good food sources include dairy (obviously) but also dark green vegetables (there is more calcium in uncooked versus cooked veggies), fortified juices, and canned fish like salmon and sardines. By adding a glass of fortified orange juice at breakfast, snacking on yogurt with a sprinkling of chia seeds, nibbling on a bit of cheese, and piling your plate with dark green vegetables at dinner you’ll get your daily requirement, or very close to it. 

What to look for in a supplement

If you and your doctor think you could use a supplement, pick one that suits your schedule. Most calcium carbonate supplements should be taken with a meal for maximum benefit and is less pricey than calcium citrate. 

Calcium citrate supplements, on the other hand, are more easily absorbed and can be taken anytime, with food or without. However, calcium citrate contains only 21% calcium so you need to take more of it to get the same amount of calcium (1). Nature Made Calcium Carbonate is third-party tested and comes as 600 mg per tablet, which prevents you from taking too much at one time. It also contains half your daily recommended amount of vitamin D, which helps your body absorb the calcium.

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2. Vitamin D for Calcium Absorption and Immune Health

Vitamin D is the Ginger Rogers to calcium’s Fred Astaire: a perfect pairing. That’s because Vitamin D helps the body absorb the calcium we get from food. “Vitamin D and calcium work better in concert,” says Dole.

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

A small study showed that vitamin D improved mood in women with type 2 diabetes (3). 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). The vitamin’s multifactorial benefits are why you’ll almost always find it in the supplement stacks of longevity nerds like Peter Attia.

How much Vitamin D do you need? 

Women up to age 70 need 15 mcg of vitamin D per day. It’s not easy to get that amount from food only, which is why doctors often recommend taking a vitamin D supplement for perimenopause.

Best sources of Vitamin D

Good food sources of vitamin D, according to the National Institutes of Health, include fish like tuna, salmon and sardines, fortified dairy, and mushrooms. If you’re adding a vitamin D supplement for menopause or perimenopause, try this one from New Chapter. It’s NSF certified, organic and you can take it whenever, according to the company, not only with meals like most calcium carbonate supplements. It has more vitamin D than you really need,  but it’s still a safe amount (the upper limit that is considered safe is 100 mcg).

3. 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, according to Mount Sinai Medicine; more research is needed. 

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

How much vitamin B do you need? 

There are eight B vitamins, including riboflavin, folic acid and B12, and you need different (albeit small) amounts of each of them. While these are all water-soluble (meaning you pee them out if you take in more than your body can use) going way overboard on one or another is a bad idea, according to the Mayo Clinic. Way too much B12, for instance, can upset your stomach or make you feel tired or tingly; too much B6 can make you lose muscle control, have skin lesions, and other nasty symptoms. 

Best sources for vitamin B

Again, this depends on which vitamin B you’re talking about. Most people can get all their B vitamins by eating a well-rounded diet, including fish and other animal proteins, legumes, fruit and veggies, and whole grains, according to the Cleveland Clinic. 

The exceptions: vegans and vegetarians may want to take a B12 supplement, and people who are pregnant or trying to become pregnant (which can happen during perimenopause!) may want to supplement with folate. 

Nature Made’s B Complex is a perimenopause supplement that has close to the recommended amounts of all eight of the B vitamins, so your risk of taking too much is very small (other brands offer megadoses).

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4. 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).  

How much Vitamin E do you need? 

Aim for 15 mg. The upper limit for adults is 1,000 mg, and taking too much may cause bleeding, according to the NIH.

H3 Best ways to get vitamin E 

Foods that are rich in vitamin E include spinach, avocado, sunflower seeds, and almonds. It’s not easy to find a third-party tested vitamin E supplement that also comes in a dosage as low as 180 mg, but Kirkland Signature Vitamin E  ticks this box. While that amount is more than you need each day, many supplements come in more than double that dosage, so to avoid overdoing it, this one is a good choice.

5. Vitamin C for Brighter Skin and Stronger Bones

The “orange juice vitamin” does more than make our 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. And according to one source, women who consumed a high amount of vitamin C had higher bone density (7).

How much vitamin C do you need? 

Women should get 75mg daily. Taking too much can cause stomach upset and other issues.

Best ways to get Vitamin C

In addition to citrus fruits, good sources of vitamin C include vegetables like tomatoes, peppers and brussels sprouts. According to the National Institutes of Health, “Consuming five varied servings of fruits and vegetables a day can provide more than 200 mg of vitamin C.”

If you prefer a vitamin C supplement for your perimenopause symptoms, Garden of LIfe Vitamin Code is third-party-tested, gluten-free and certified organic. Though there are many strong Vitamin C options on the market.

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, but be sure to read the ingredient label and find out how much it contains of the various vitamins and minerals (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.