Some people may wish to take supplements, such as black cohosh and vitamins, to relieve menopausal symptoms. However, there is little evidence that these supplements have a significant effect on symptoms of menopause.
This article discusses common supplements that people may use to manage menopause symptoms. It also discusses their effectiveness and potential side effects.
Sex and gender exist on spectrums. For the purposes of this article, we use “male” and “female” to refer to a person’s sex assigned at birth. We also match the gendered language used in the studies we reference in order to maintain accuracy. Learn more about sex and gender here.
Menopause is the clinical term for when a person’s estrogen levels drop and they stop menstruating. The age of menopause typically varies from 40 to 58 years of age, although people in the United States usually go through menopause around
However, menopause does not happen all at once. On average, it takes people about 4 years to transition into menopause. Perimenopause describes this transitional period. During this time, a person’s periods may change in:
- regularity
- duration
- heaviness
A person has reached menopause when they have not menstruated for 12 months.
Menopausal symptoms can develop during perimenopause and may include:
It is unclear exactly how many people experience symptoms. According to an older 2005 review of studies, roughly
The
It is important to remember that menopause supplements are not regulated by the Food and Drug Administration (FDA). Products may have proprietary blends, which means that the company does not list the amounts of the ingredients on the product packaging. Products may also contain active or inactive ingredients that the manufacturer does not list.
People should discuss taking supplements with a healthcare professional or a pharmacist. Some supplements may cause side effects and interact with prescription or nonprescription medications.
The following are some menopause supplements a person may use, alongside their effectiveness and any potential side effects.
Black cohosh is one of the
Native Americans have used this plant to treat conditions such as fever, cough, and irregular menstruation. European settlers also used black cohosh to support female reproductive health.
More recently, people may use black cohosh to treat menopausal symptoms such as:
- hot flashes
- night sweats
- vaginal dryness
- irritability
Originally, scientists thought that black cohosh worked like estrogen. More recent studies suggest that this herb works by mimicking the neurotransmitters:
- dopamine
- serotonin
- norepinephrine
However, there is
A research review from 2020 suggests that black cohosh may be effective for relieving menopausal symptoms, either alone or in combination with other herbs.
Side effects and safety
The
However, the Memorial Sloan Kettering Cancer Center warns that black cohosh may interact with the following medications:
- Tamoxifen: Black cohosh may interfere with the way tamoxifen works.
- Chemotherapy drugs: Black cohosh may increase the toxicity of the chemotherapy drugs doxorubicin and docetaxel.
- Cytochrome P450 3A4: This enzyme plays an important part in metabolizing medicines. Black cohosh may interact with drugs that this enzyme metabolizes.
- Simvastatin: Black cohosh may increase the side effects a person experiences with simvastatin.
It is important to note that, as the FDA does not regulate black cohosh, so it is difficult to know which ingredients a manufacturer uses for their product. Some products
The NIH states that, worldwide, there have been at least
The amount of black cohosh may also vary from supplement to supplement. This variance makes it more difficult to determine whether a person will experience side effects as a result of a higher dose.
Side effects from taking black cohosh may include:
- uterine bleeding
- breast pain
- musculoskeletal pain and discomfort
People who take larger doses may experience gastrointestinal effects such as bloating and cramping.
Less common side effects include:
Every person has levels of calcium in their body. Adult females have around
Vitamin D also plays a role in bone health. During menopause, a person’s bone density
The
The researchers found no difference in symptoms between the group that took supplements and the group that did not. Sleep disturbances, energy levels, and emotional well-being were similar between the two groups, leading the researchers to conclude that calcium and vitamin D supplements are unlikely to affect symptoms of menopause.
While taking vitamin D supplements may not be helpful in people with adequate levels, being deficient in vitamin D can negatively affect bone and heart health.
Research shows that a vitamin D deficiency could affect
That said, being deficient in vitamin D can negatively affect bone and heart health in people during and after menopause. A 2020 study found that high doses of vitamin D supplements after menopause were effective in improving vaginal pH and dryness.
Side effects and safety
Adult females should aim to ingest
Females 70 years or under should have
Not having enough calcium and vitamin D, or having too much, may cause side effects.
Calcium
Side effects of having too little calcium include:
- pins and needles feeling in the fingertips, toes, and lips
- muscle pains and cramps in the legs, feet, and stomach
- facial muscle twitches
- mood changes, such as depression, irritability, and anxiety
- fatigue
- rough and dry skin
- coarse hair and hair breakage
- easily broken fingernails
Side effects of having too much calcium, or hypercalcemia, include:
- vomiting
- drowsiness
- dehydration
- muscle spasms
- bone and joint pain
- irregular heartbeat
- high blood pressure
Vitamin D
Not having enough vitamin D can lead to bone conditions in adults and children. Children who do not have enough vitamin D may develop rickets, and adults may develop osteomalacia. These conditions can cause bone pain and lead to soft and weak bones.
Taking too many vitamin D supplements can lead to hypercalcemia.
Red clover is a legume that
People traditionally used red clover as a treatment for conditions such as:
- asthma
- whooping cough
- cancer
In recent times, people have used this supplement for:
- menopause symptoms
- osteoporosis
- high cholesterol
However, the NCCIH states that all studies investigating the effects of red clover on menopausal symptoms and bone density in menopausal females have had inconsistent results. There is not enough evidence to suggest red clover can effectively relieve symptoms of menopause.
Side effects and safety
The Memorial Sloan Kettering Cancer Center states that red clover can interact with the following medications:
- Anticoagulants: Red clover may increase the effects of these medications. However, more clinical research is needed.
- Cytochrome P450 enzymes: Red clover can inhibit some of these enzymes and may interact with medications that the enzymes metabolize.
- Methotrexate: Red clover may increase the toxicity of methotrexate, leading to severe vomiting and stomach pain.
Soy supplements commonly consist of soy protein, isoflavones, or a combination. People may use soy supplements
An older 2015 review of studies found that soy isoflavones can reduce the severity of hot flashes. However, the authors note that it took an average of 13.4 weeks for people to notice the effect of the soy isoflavones in comparison with 3.09 weeks when using estrogen hormone replacement therapy (HRT).
Medical professionals no longer use the term HRT and instead refer to this as menopausal hormone therapy (MHT).
Another small 2021 study found that hot flashes decreased by 79% from eating 1/2 cup of cooked soybeans for 12 weeks.
The
Side effects and safety
People who are allergic to soy should not use soy supplements or ingest food or beverages that contain soy.
The
The organization also warns that soy may alter the way the thyroid functions in people with an iodine deficiency. As soy contains compounds similar to estrogen, people who are pregnant or nursing should also contact a doctor before ingesting soy.
The most common side effect of ingesting soy is digestive upset. People may experience symptoms such as constipation and diarrhea.
Ginseng is another herbal supplement that people may use to relieve menopausal symptoms.
An older
A 2022 review also found ginseng to be helpful for reducing hot flashes and improving overall quality of life scores, though it pointed out the studies are small and more high quality research is necessary.
It is worth noting the review did not find a significant benefit for sexual arousal or vaginal health. There is also no research to support gensing’s ability to affect a person’s hormones.
Side effects and safety
Short-term oral use of ginseng for
- infants
- children
- those who are pregnant or nursing
People should contact a healthcare professional if they wish to take ginseng and are currently using medications such as calcium channel blockers, statins, or antidepressants. Ginseng may interact with these medications.
Some side effects of ginseng include:
- breast pain
- changes in menstruation
- increase in heart rate
- high or low blood pressure
- headache
- loss of appetite
St. John’s wort is a traditional European
Another small 2019 study found 80 postmenopausal women showed a reduction in hot flashes after taking between 270 mg and 300 mg of St. John’s wort 3 times a day for 2 months.
However, the
Side effects and safety
St. John’s wort can interact with
- antidepressants
- birth control pills
- cyclosporine, a medication that stops the body from rejecting donor organs
- heart medications such as digoxin and ivabradine
- HIV medications such as indinavir and nevirapine
- cancer medications such as irinotecan and imatinib
- warfarin
- statins such as simvastatin
This supplement can cause the following side effects:
Many supplements for menopause are available. Below we compare six supplements that may offer some relief.
| Daily dose | Active ingredients | Targeted symptoms | Quality testing | |
|---|---|---|---|---|
| NOW Black Cohosh | 1 to 2 capsules | black cohosh licorice root dong quai | hot flashes night sweats vaginal dryness irritability | tested in-house at ISO-certified labs |
| MegaFood Calcium & Magnesium | 3 tablets | calcium magnesium | bone health sleep mood digestive health | tested for pesticides |
| mindbodygreen Vitamin D3 Potency+ | 1 softgel | vitamin D3 flaxseed oil avocado oil extra virgin olive oil | bone health heart health | third-party tested for purity and potency |
| NOW Foods Red Clover | 2 capsules | red clover | hot flashes | third-party tested |
| Pure Encapsulations Panax Ginseng | 2 to 3 capsules | Asian ginseng | hot flashes | third-party tested for purity and potency |
| Bonafide Relizen | 2 tablets | Swedish flower pollen blend | hot flashes irritability fatigue | clinically-studied formulation |
Medical News Today selects supplements that meet the following criteria:
- Ingredients: MNT chooses products that contain high quality ingredients that have research to support their potential benefits for menopause.
- Dosage: MNT selects products that contain safe doses of active ingredients. When possible, we select products containing effective doses backed up by research.
- Quality: MNT chooses products that are third-party tested for purity and potency or rigorously tested in-house by reputable brands.
- Vetting: MNT selects supplements that its team of medical experts has vetted and approved.
Menopause is a natural stage in life, but it can cause symptoms that negatively affect a person’s quality of life. Some people may wish to use natural supplements. However, there is little evidence that these supplements are effective, and many studies deliver inconsistent results.
People should contact a healthcare professional for advice before taking any dietary supplements. Some supplements can interact with prescription and nonprescription medications and may cause additional side effects.