Supplements

No supplement has consistent, high-quality evidence for relieving hot flashes, and The Menopause Society’s 2023 position statement does not recommend supplements or herbal remedies for them. Where supplements earn a place in midlife is in filling real nutritional gaps, such as vitamin D or calcium when intake from food is low, or supporting a goal like building muscle. Because the FDA does not review supplements for safety or effectiveness before they are sold, how you choose a product matters as much as what you choose.

Where to start

Begin with do menopause supplements work?, which sums up the trials and explains why so many products seem to help. If you are considering a specific ingredient, the guides below take them one at a time; for magnesium, citrate vs glycinate compares the two most popular forms. Before you buy, read how to read a supplement label and third-party testing explained.

Popular supplements at a glance

Supplement	What women take it for	What the evidence shows	Read the guide
Black cohosh	Hot flashes	No better than placebo across 16 trials; rare reports of liver injury	Black cohosh
Ashwagandha	Stress, sleep, symptoms	One unreplicated 8-week trial in perimenopausal women; liver and thyroid cautions	Ashwagandha
Magnesium glycinate	Sleep, muscle symptoms	Modest sleep benefit, strongest when intake is low; not a sedative	Magnesium glycinate
Omega-3	Hot flashes, mood, heart	Did not reduce hot flashes, sleep problems or mood symptoms in MsFLASH	Omega-3
Vitamin D	Bone health	RDA is 600 IU a day through age 70; no benefit for hot flashes, mood or sleep	Vitamin D
Creatine	Muscle and strength	Adds lean mass when combined with resistance training, not on its own	Creatine for women over 40
Soy isoflavones	Hot flashes	A modest effect in some trials; not recommended as a treatment	Soy and phytoestrogens
Melatonin	Sleep	Not recommended for chronic insomnia; label doses are often inaccurate	Melatonin in perimenopause

How to choose, if you choose

The FDA does not approve supplement labels or products before sale, and in one lab analysis 17 of 30 immune supplements bought online had labels that did not match their contents. Proprietary blends list only a total weight, so you cannot tell how much of each ingredient you are getting; a single-ingredient product makes it easier to match the dose used in research. USP Verified and NSF marks confirm that a product contains what the label says and stays under contaminant limits, but not that it works, so confirm any mark in the certifier’s own online database.

Food comes first where it can: eating well in perimenopause covers protein, calcium and vitamin D from the plate.

When to see a clinician

Tell your clinician everything you take, especially if you use hormone therapy, antidepressants, thyroid medication or blood thinners. Stop a botanical and seek care if you develop abdominal pain, dark urine or yellowing of the skin or eyes. If hot flashes or poor sleep are what you are trying to fix, proven treatments exist; compare them in non-hormonal treatments for hot flashes and what is hormone therapy. The symptom check helps you prepare, and the directory lists clinicians near you.