Ashwagandha

Ashwagandha is a popular adaptogen that has been used for thousands of years to boost the body’s resilience to stress and relieve anxiety symptoms. (1) During menopause, when you’re likely feeling both to a higher degree, ashwagandha supplements may offer some relief. 

Sleep studies show ashwagandha may also treat insomnia and improve sleep quality by getting you to sleep more efficiently and with fewer interruptions. (2) This can make it easier to get up and go in the morning when you’ve been dealing with brain fog and fatigue.

B Vitamins

This group of vitamins plays an essential role in nervous system health, and deficiencies put you at a higher risk of cardiovascular disease and stroke. Poor heart health is linked to an earlier onset of menopause symptoms, so healthy levels of this one may slow down that process. (3)

B vitamins are also essential to mental and cognitive health, especially as we age. Low vitamin B6 and B12 intake have been linked to higher rates of dementia and Alzheimer’s disease. (4) B9, or folate, supports mood regulation and reduces the risk of depression during menopause. (5)

Together, B vitamins support cellular function and a healthy metabolism, which can help you maintain energy, mental clarity, weight loss, and emotional stability during this stage. 

Black Cohosh

Black cohosh, a North American herb from the buttercup family, is a popular menopause remedy for hot flashes. Although the science on this one has become mixed, it’s approved in Germany as a treatment for premenstrual syndrome (PMS) bloating and cramping, as well as menopause symptoms.

Some studies show it may have some benefit on joint pain and inflammation in rheumatoid arthritis and osteoarthritis patients, a solid benefit as women get older. (6) I’d recommend trying this one for 6 months or so to see if you feel any relief. 

LISTEN: Menstrual Cycle, Menopause & Hormone Replacement Therapy Myths & Truths | Esther Blum

Isoflavones

Which supplements are most effective for hot flashes during menopause? Isoflavones in soybeans, red clover, and alfalfa are phytoestrogens, which mimic or modulate the effects of estrogen. That makes them some of the most effective at reducing the frequency of hot flashes.

They do this by binding to estrogen receptors to help regulate hormone levels when they’re out of balance with progesterone, like during menopause.

Studies show these antioxidant compounds modulate hot flashes, support bone density, improve glycemic control, and positively affect systolic blood pressure. (7) You might see these as a soy supplement or a combination of different compounds in capsule or powder form.

If you’re sensitive to soy or worried about estrogen dominance, a potential side effect of consuming large quantities of soy, seek out isoflavones that aren’t derived from soy. 

Inositol

Inositol is a natural compound found in foods like fresh fruits, nuts, and beans. It’s known for its calming effects on the nervous system, so inositol for menopause may be helpful if you’re dealing with anxiety and depression as part of your symptoms. (8)

Research shows it may be supportive if you’re dealing with metabolic syndromes like type 2 diabetes on top of menopause. Inositol can help regulate insulin sensitivity, which can support better metabolic outcomes and help you manage weight gain. 

N-acetyl-cysteine (NAC) 

Women who use NAC for menopause report reduced stress and a better mood thanks to its effects on neurotransmitters that play a role in mood regulation. This precursor to glutathione is also important to immune function.

Studies show it reduces your risk of immune system-related diseases and infections as you age, which can dramatically improve your well-being and quality of life postmenopause. (9)

Taurine

Taurine is an amino acid essential to nervous system function and managing oxidative stress. Both are key to a balanced mood and reduced risk of anxiety, depression, and mood swings at perimenopause, menopause, and postmenopause.

Taurine also works as an antioxidant to combat oxidative stress and reduce inflammation, which is crucial for reducing the risk of heart disease and other inflammatory conditions as you age.

Relax your body and your mind with one scoop a day of Chill, a powdered drink mix full of hormone-healthy ingredients like taurine, magnesium, and L-theanine.

Korean Ginseng

This potent form of ginseng helps fight off hot flashes and reduce mood swings thanks to its effects on the body’s stress responses. (10) Its adaptogenic properties help your body deal with hormones in flux at menopause that trigger hot flashes and mood changes.  

The research on sexual function is more mixed, but studies on ginseng and estrogen dominance show it may have an effect on sex drive in postmenopausal women. (11) 

Maca

Maca root is a Peruvian plant traditionally used to balance hormone levels getting in the way of fertility, libido, and menopause symptoms like hot flashes, vaginal dryness, and fatigue. Researchers believe it’s an adaptogenic herb that helps your body deal with stress. (12)

You’ll find this one in capsule form or as a powder, but it can also be eaten as food by baking, roasting, boiling, or drying it. 

Magnesium

At least half of us aren’t getting enough magnesium in our diets, which can result in a cascade of symptoms affecting mood, memory, and stress management. (13) When hormones are in flux, low magnesium only exacerbates what you’re already feeling. 

Supplementing with magnesium may reduce anxiety and irritability, alleviate tension-causing headaches, and improve your sleep. Magnesium also supports bone health by helping your body absorb calcium. This is crucial as your risk of osteoporosis increases post-menopause. 

Diindolylmethane (DIM)

DIM has been found to block androgen hormones that may be the cause of thinning hair and mood swings. (14) It may also enhance estrogen metabolism, which is helpful for the hormone balance you want to keep during menopause. (15)

You can find DIM naturally in broccoli, kale, and other cruciferous veggies or as a combo supplement of DIM and ashwagandha for menopause.

L-Theanine

L-theanine is an amino acid known for calming effects that are particularly helpful for those with sleep issues or anxiety during menopause. (16) This happens because of its effect on mood-related neurotransmitters like gamma-aminobutyric acid (GABA), serotonin, and dopamine.

I want to pause here to highlight the importance of sleep as you manage your symptoms. A lack of sleep means your body doesn’t have time to heal, putting you at risk for a variety of conditions caused by oxidative stress. 

Milk Thistle

Can herbs help reduce menopause symptoms? Herbs, like milk thistle, for hot flashes are a common natural treatment that can significantly decrease the frequency and duration of your symptoms. (17) 

Silymarin, the herb's primary active ingredient, may also support liver function and, as a result, more balanced estrogen levels.

Your liver is responsible for breaking down excess estrogen in the body. It can’t do this when it’s overloaded with toxins and inflammation. Milk thistle can help restore liver cells, increasing their function so that the liver can break down any excess estrogen. (18)

Vitamin D

Vitamin D is essential to bone health, calcium absorption, and reducing your risk of osteoporosis and bone loss, a common issue as estrogen levels decline. (19) It also supports mood regulation, potentially reducing your risk of depression and mood swings. 

Vitamin D deficiency is one of the most common nutrient gaps I see in my functional medicine practice. That doesn’t just worsen the effects of menopause. It increases your risk of heart disease, diabetes, and depression. Vitamin D supplementation can get you back on track.

Omega-3 Fatty Acids

Omega-3s found in fatty fish, olive oil, and over-the-counter fish oil supplements are anti-inflammatories linked to better cognitive function, reduced joint pain, and lower cholesterol. Studies show they may reduce the frequency of night sweats to help you get your rest. (20)

They’re good for your brain, too. Boosting your intake of omega-3s enhances serotonin function, which can help reduce mood swings, anxiety, and depression as you move through menopause.

Probiotics

The gut-brain connection affects your hormone health, too. If your microbiome is out of balance, that can influence estrogen metabolism, immune function, and mental health. Probiotics can help.

A healthy microbiome can increase calcium absorption and reduce osteoporosis risk, lower breast cancer and endometriosis risk, and lower heart disease risk. (21) It can even reduce gum disease risk, which can be a problem when hormones change as we age.

The Takeaway

Should you take menopause supplements? An individualized approach is best when optimizing your hormone health, and your healthcare professional is where you should start if you want to manage your symptoms long-term.

As some of these dietary supplements mimic the effects of estrogen, talk to your healthcare provider if you’re taking medications for hormonal conditions or at a higher risk of breast cancer. 

In functional medicine, the goal is to get to the root of your symptoms to start the healing process. That can mean a hormonal imbalance in the case of menopause, but nutritional deficits, chronic stress, or inadequate sleep could exacerbate your symptoms.

If you’re ready to get to the bottom of your symptoms, schedule a consultation through one of the first telehealth clinics in the world that provides personalized functional medicine care.