How to choose supplements for menopause

When picking a supplement or multivitamin for menopause, consider the following factors:

• Intended use. Because most products are formulated to treat specific issues associated with menopause, consider your health needs and look for a supplement that contains ingredients intended to address the symptoms you’re experiencing.
• Quality ingredients. Look for supplements that have been tested for purity, strength, and safety, ideally by an independent lab or third-party organization.
• Dosage. In addition to the amounts of ingredients provided, consider how many capsules you’ll need to take each day.
• Budget. Be sure to evaluate your budget and check the price per serving to find a supplement that fits your needs.

You should speak with a healthcare professional before using any supplements to make sure it is the right choice for you.

How we chose

The supplements included in this article were selected based on the following criteria:

• Ingredients. Supplements contain vitamins, minerals, and herbal ingredients that have been shown to be beneficial specifically for menopause.
• Price. Each product provides a good value for the price.
• Quality. We prioritized products that are certified by third-party organizations such as NSF International and Underwriters Laboratories (UL).
• Vetting. All the products included have been vetted to ensure that they meet Healthline’s medical and business standards.
• Customer reviews. Each product has mostly positive customer reviews online.

Menopause supplements

There is no evidence that dietary supplements can relieve menopause symptoms, according to the National Center for Complementary and Integrative Health. Additionally, there is little research on the long-term safety of dietary supplements.

Learn more about natural remedies for menopause.

There are several supplements a person may take to help with symptoms related to menopause. Some of these supplements are effective, while others may cause side effects.

Black cohosh

Black cohosh is a common menopausal supplement.

This plant has been used by Native Americans to treat 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 thoughtTrusted Source

that black cohosh worked like estrogen. More recent

studiesTrusted Source

suggest that this herb works by mimicking the neurotransmitters:

• dopamine
• serotonin
• norepinephrine

There is no evidence to suggest that black cohosh has an effect on hormone levels in the body, including estradiol.

More recent studies suggest that black cohosh has no significant effect on menopause symptoms, though older studies claimed it may be effective. The authors of the newer studies say that more research needs to be conducted on this subject.

Learn more about black cohosh and menopause.

Side effects and safety

Although black cohosh does not interact with any medications, people should always ask a healthcare professional before taking any supplements to ensure it is safe to use with other medications.

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.

As the FDA does not regulate black cohosh, it is difficult to know which ingredients manufacturers use for their products. Some products may contain adulterants, which means manufacturers may substitute black cohosh for similar synthetic ingredients.

According to the NIH, there have been at least 83 worldwide cases of liver damage linked with black cohosh use. They say this may be partly due to adulterants and impurities, but there has been no independent analysis to confirm this link.

The amount of black cohosh in supplements can vary, which makes it difficult to predict if taking a higher dose will result in side effects.

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:

• dizziness
• nausea
• vomiting

Calcium and vitamin D

After menopause, females have only about 700 grams of calcium in their bodies. Every person has varying levels of calcium in their body. Adult females typically have around 1,200 grams (g)Trusted Source of calcium in their bodies, which generally remains consistent until estrogen levels drop during menopause. After menopause, females are left with only about 700 grams of calcium in their bodies.

Vitamin D affects bone health. Menopause causes a person's bone density to lower, which increases the risk for osteoporosis. Not getting enough calcium and vitamin D makes this condition more likely.

The Women’s Health Initiative Trial investigated the effects of calcium and vitamin D supplements on menopausal symptoms. The participants took 1000 mg of calcium and 400 international units (IU) of vitamin D during the course of the study, and the researchers followed up with the participants after an average of 5.7 years.

There was no difference in symptoms between the group that took supplements and the group that did not, leading the researchers to conclude that calcium and vitamin D supplements are unlikely to have an effect on symptoms of menopause.

Side effects and safety

The amount of calcium that females should aim to ingest per day differs depending on their age group. For those 50 years of age or younger, they should aim for 1,000 mg, and for those over 50, they should aim for 1,200 mg. The tolerable upper limit for calcium is 2,500 mg for those 50 years of age or younger, and 2,000 mg for those over 50.

Females aged 70 or younger need 600 IU of vitamin D, while those over 70 need 800 IU.

Having an inadequate or excessive amount of calcium and vitamin D can lead to negative consequences.

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

If you don't have enough vitamin D, you're at risk for developing bone conditions like rickets (in children) and osteomalacia (in adults). These problems cause pain and make bones weak and soft.

If you take too many vitamin D supplements, you may develop hypercalcemia.

Red clover

They can act like estrogen in some tissues and like a chemical that blocks estrogen in other tissues. Red clover is a legume that contains isoflavones. Isoflavones are compounds that are similar to the hormone estrogen. They can act like estrogen in some tissues and like a chemical that blocks estrogen in other tissues.

Red clover was traditionally used 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

There is not enough evidence to suggest that red clover can effectively relieve symptoms of menopause, according to the NCCIHTrusted Source. All studies investigating the effects of red clover on menopausal symptoms and bone density in menopausal females have had inconsistent results.

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

Some studies suggest that soy spuements may treatTrusted Source hot flashes and night sweats, but more research is needed. Soy supplements are commonly consumed in the form of soy protein, isoflavones, or a combination. People may use soy supplements to relieve menopausal symptoms, regulate blood pressure, and improve cholesterol levels, as well as to improve bone health and memory. Some studies suggest that soy supplements may help to reduce hot flashes and night sweats, but further research is necessary to confirm these findings.

Learn more about soy.

Soy isoflavones can help to reduce the severity of hot flashes, but it takes a while to notice the effects. In 2015, a review of studies found 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).

The National Center for Complementary and Integrative Health says that soy isoflavones may help with bone health during menopause, but the evidence is not clear.

Side effects and safety

If you are allergic to soy, you should not take soy supplements or eat anything that contains soy.

The National Center for Complementary and Integrative Health (NCCIH) states that there is not enough evidence to verify the long-term safety of soy protein and isoflavone supplements.

The organization additionally warns not to consume soy if there is an iodine deficiency as it may have an effect on the thyroid. They go on to say that soy contains compounds that are similar to estrogen and so expectant mothers or those who are breastfeeding should speak to a doctor before consuming soy.

The most common side effect from eating soy is having an upset stomach. People may experience symptoms such as constipation and diarrhea.

Ginseng

Ginseng is an herbal supplement that people may use to relieve menopausal symptoms.

Learn more about ginseng.

According to a 2016 systematic reviewTrusted Source, there is a high risk of bias in many studies investigating the effectiveness of ginseng on menopause symptoms.

The authors note that ginseng may have a positive effect on:

• sexual function
• arousal
• total hot flash scores recorded by the participants

However, there is no evidence that this supplement affects:

• hot flash frequency
• a person’s hormones
• the thickness of the endometrium

Side effects and safety

Short-term oral use of ginseng for

up to 6 monthsTrusted Source

is usually safe for most people. However, experts may not recommend the use of ginseng in:

• infants
• children
• those who are pregnant or breastfeeding

If you currently take calcium channel blockers, statins, or antidepressants and wish to take ginseng as well, you should contact a healthcare professional, as 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

St. John's wort is a traditional European herbal remedy that has been used to treat a variety of conditions, such as depression and menopause symptoms.

Learn more about St. John’s wort.

A previous study found that St. John's wort supplements may help alleviate hot flashes. In this study, 100 women were divided into two groups, with one group taking the supplement and the other taking a placebo. After 4 weeks, there was no significant difference in the number of hot flashes reported by the participants. However, after 8 weeks, the group taking the supplement reported fewer hot flashes.

St. John's wort may not be an effective treatment for menopausal symptoms, according to the NCCIHTrusted Source.

Side effects and safety

St. John’s wort can interact with

various medicationsTrusted Source

, causing them to be less effective. An incomplete list of medications that this supplement can interact with includes:

• antidepressants
• birth control pills
• cyclosporine, a medication that stops the body from rejecting donor organs
• heart medications such as digoxin and ivabradine
• HIV drugs 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:

• sensitivity to sunlight
• insomnia
• anxiety
• fatigue
• headache
• dizziness
• dry mouth

Summary

Menopause is a normal part of a woman's life, but it can cause symptoms that have a negative impact on her quality of life. Some people may want to try natural supplements as a way to ease these symptoms. However, there is little evidence that these supplements actually work, and many studies have conflicting results.

Before taking any dietary supplements, people should check with a healthcare professional to see if there are any possible side effects or interactions.