• Menopause
• Vitamins and Supplements

What Supplements Should You Take During Menopause?

Medically reviewed and edited by Kerri Louati, MS, RD, LD, CDE

Published: November 19, 2025
Updated: November 19, 2025
5 mins

Menopause and perimenopause bring significant hormonal changes that can trigger symptoms like hot flashes, night sweats, mood swings, fatigue, weight gain, sleep disturbances, and bone loss. While hormone therapy is an effective option for many women, others prefer a non-hormonal or combined approach. Evidence-based supplements can play an important role in supporting overall health, reducing symptoms, and protecting long-term wellbeing.

The Top 8 Supplements to Consider

Below is a comprehensive, research-informed review of the supplements most consistently shown to help women during perimenopause and menopause.

Vitamin D3

Vitamin D3 plays a central role in bone density, immune function, mood regulation, and metabolic health, which are all areas affected during menopausal transition. Declining estrogen accelerates bone loss, increasing the risk of osteoporosis. Adequate vitamin D3 supports calcium absorption, maintains bone strength, and may reduce fracture risk. Women with low vitamin D levels are also more likely to experience fatigue, low mood, and muscle pain. Many women entering midlife are deficient due to limited sun exposure or low dietary intake, making supplementation an essential part of menopausal health if blood levels are suboptimal.

Vitamin K2

Vitamin K2 (particularly the MK-7 and MK-4 forms) works synergistically with vitamin D3. While vitamin D increases calcium absorption, vitamin K2 directs calcium to bones and teeth while preventing it from accumulating in arteries. This dual action supports both skeletal integrity and cardiovascular health, two major concerns for postmenopausal women. Supplementing with D3 without adequate K2 may increase the risk of arterial calcification, which is why they are often recommended to take together.

Calcium

Calcium remains vital for maintaining bone density, especially as estrogen decline accelerates bone turnover. Ideally, calcium should come from food sources, but supplementation is appropriate when dietary intake is insufficient. Calcium works best when paired with vitamin D3 and K2 to support safe and effective bone mineralization. 

There are many different forms available, and they are not all equal. Consider choosing naturally occurring forms if able, such as algae or microcrystalline hydroxyapatite (MCHA). Ensuring adequate intake can reduce the risk of osteoporosis, fractures, and chronic bone loss that typically accelerate in the decade following menopause.

Magnesium (magnesium glycinate)

Magnesium influences more than 300 biochemical processes and is commonly low in women. During menopause, magnesium can help alleviate symptoms such as insomnia, anxiety, muscle tension, headaches, and constipation. Magnesium glycinate is one of the most absorbable and gentle forms, making it ideal for sleep and relaxation support. Adequate magnesium also works with vitamin D to improve bone density, insulin sensitivity, and overall metabolic health.

Omega-3 fatty acids (EPA & DHA)

Omega 3 fatty acids, particularly EPA and DHA, support inflammation balance, cardiovascular health, brain function, and mood regulation. These areas often shift during perimenopause and menopause as estrogen levels decline. A 2023 systematic review published in Nutrients found that omega 3 supplementation may help reduce the frequency and intensity of hot flashes in postmenopausal women and may also support mood and emotional well-being. 

Given the rise in cardiovascular risk after menopause and the common increase in inflammation and metabolic changes, maintaining adequate omega 3 intake can be an important part of a functional medicine approach to menopausal health.

B-complex vitamins

B vitamins (especially B6, B9/folate, and B12) play key roles in energy production, methylation, mood regulation, and neurological function. During menopause, B-complex supplements can support:

 • Reduced fatigue • Improved mood stability • Better stress resilience • Cognitive function

B vitamins also help regulate homocysteine levels, a cardiovascular risk marker that can rise during menopausal transition. Vegetarian or vegan women, or those with impaired absorption, may be especially likely to benefit from supplementation.

Melatonin

Melatonin is a naturally occurring hormone that helps regulate the sleep-wake cycle. During perimenopause and menopause, many women experience insomnia, early waking, or fragmented sleep due to shifting hormones, increased nighttime anxiety, and temperature regulation changes. 

Research shows that melatonin supplementation can improve sleep quality, decrease the time it takes to fall asleep, and support deeper, more restorative sleep in midlife women. Melatonin also has antioxidant properties and may support bone metabolism and mood regulation, which adds to its value during menopausal transition. Lower nightly melatonin production is common with age, making a supplement especially helpful for women struggling with sleep despite good sleep hygiene practices.

Phytoestrogens 

Phytoestrogens are plant compounds that have mild estrogen-like effects in the body. Rather than acting as hormones, they gently influence estrogen receptors and help bring more balance to the system. This can be especially helpful during perimenopause and menopause as estrogen levels fluctuate and begin to decline. They are especially helpful for women seeking non-hormonal options or who want to complement lifestyle or nutritional therapies.

Soy isoflavones: Soy contains isoflavones such as genistein and daidzein, which have the strongest research support among phytoestrogens. A 2024 systematic review found that soy isoflavones can significantly reduce hot flashes and night sweats while improving overall comfort during the menopausal transition. Women who naturally produce a helpful gut metabolite called equol may experience even greater symptom relief.

Red clover: Red clover also contains isoflavones, but in a slightly different form from soy. While research has varied, several studies show that red clover may reduce the frequency of hot flashes, support a calmer mood, and improve sleep quality. It is often well tolerated and can be a useful option for women who do not want or cannot consume soy.

Flaxseed lignans: Flaxseeds contain lignans that support healthy estrogen metabolism. Research shows that flaxseed can help reduce hot flashes, improve regularity and digestion, support cholesterol health, and promote a more balanced inflammatory response. Because flaxseed is a whole food, it’s an easy and safe first step for many women looking for natural symptom support.

Supplements to Use Cautiously During Menopause

Supplements can play a meaningful role in supporting women through the transition to menopause, but it is important to approach them with an understanding of bioindividuality and safety. Every woman metabolizes nutrients, herbs, and medications differently, and the hormonal shifts of midlife can change how the liver, gut, and nervous system respond to supplementation. 

Drug-nutrient interactions

Some supplements may interact with medications commonly used during this stage of life. 

• St. John’s Wort can interfere with how the liver processes antidepressants 

• Dong Quai may increase bleeding risk for women taking anticoagulants. 

Liver toxicity risks

Even supplements that are generally well tolerated, such as black cohosh or kava, can stress the liver in certain individuals, particularly when the product quality is poor or when multiple herbal blends are combined. 

Limited effectiveness

While commonly marketed for hormone support, Wild yam contains diosgenin, a compound that can be converted into steroids in the lab. However, the body cannot convert diosgenin into estrogen, rendering wild yam ineffective for menopausal symptom relief.

This does not mean these supplements must be avoided, but rather that they should be selected with care, sourced from reputable brands, and matched to a woman’s specific needs, health history, and medication use. An individualized approach recognizes that women respond uniquely to botanicals and nutrients, and that thoughtful guidance helps ensure supplements are both safe and effective.

Tips for Supplement Use During Menopause

• Consult a healthcare provider: Before starting any supplement, discuss it with your provider or dietitian, especially if you're on other medications.

• Choose quality products: Opt for supplements from reputable brands that undergo third-party testing.

• Integrate with lifestyle changes: Supplements should complement a balanced diet, regular exercise, and stress management techniques.

• Monitor your body's response: Keep track of any changes or side effects and report them to your healthcare provider or dietitian.

Where Can I Learn More About Relief from Symptoms of Menopause?

While supplements can offer support during menopause, they are not a cure-all. A balanced approach, including a nutritious diet, regular physical activity, and adequate sleep, is crucial for managing menopausal symptoms effectively.

Hormone replacement therapy (HRT) may also be an effective option for some women, helping to reduce hot flashes, improve sleep, and support bone health. The LifeMD Women’s Health Program offers personalized HRT plans, virtual consultations with licensed providers, and convenient access to lab testing and prescriptions – all tailored to your unique needs. 

Explore the program to see if HRT could be the right solution for managing your menopausal symptoms.

Kerri Louati, MS, RD, LD, CDE

Kerri Louati, MS, RD, LDN, CDE, is a registered dietitian and certified diabetes educator specializing in nutrition, integrative medicine, functional laboratory interpretations, and functional medicine. She is also the Director of Women's Health Clinical Operations at LifeMD. She previously served as the Director of Nutrition and Coaching with the telehealth platform Optimal Human Health MD.

Talk To A Doctor

How does LifeMD work?