Understanding Supplement Use During Perimenopause and Menopause
Article written by Dr Emma Ginns: British Menopause Society Registered Specialist, GP and Accredited Lifestyle Medicine Physician. Co-founder, Lemala Health. February 2026
This information is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personal guidance.
IN THIS ARTICLE, WE DISCUSS THE MOST COMMONLY CONSIDERED SUPPLEMENTS, DURING PERIMENOPAUSE AND MENOPAUSE.
During menopause consultations, we are often asked about supplements and herbal remedies. While hormone replacement therapy (HRT), alongside diet and lifestyle changes, remains the most effective way to manage menopausal symptoms, many women are keen to explore alternative or additional approaches.
Why Would I Consider Taking Supplements?
During perimenopause and menopause, declining oestrogen can affect many systems in the body.
As well as causing the common symptoms of menopause, this hormonal change can impact bone density, muscle mass, cardiovascular health, mood, sleep and our metabolic health.
Some nutrients are vital for bone health, immune function, energy production and maintaining cognitive and mental well being.
It is always preferable to obtain nutrients from a balanced and varied diet, but for some women due to dietary patterns, absorption issues, lifestyle factors or increased requirements, targeted supplementation may be helpful.
Our Approach at Lemala Health:
During our Specialist Menopause consultations we:
Discuss HRT (MHT) and lifestyle measures as the cornerstone of managing symptomatic hormone changes, with supplements as an adjunct when appropriate.
Focus on diet first and use supplements to fill specific gaps rather than as a main treatment.
Order relevant blood tests (e.g. vitamin D, iron status, B12) to guide personalised recommendations.
Review all current medications and health conditions to avoid interactions.
What supplements might be helpful?
Below, we’ve outlined the nutrients and supplements we’re most often asked about in clinic. Wherever possible, we encourage getting these from food first, with supplements considered if intake or levels are low.
Vitamin D and Calcium:
Vitamin D is essential for calcium absorption, bone health, immune function and mental wellbeing.
In the UK, sunlight exposure is insufficient for Vitamin D synthesis for much of the year, and most adults will benefit from supplementation.
A standard dose of vitamin D is 10-20mcg (400-800iu) daily.
Blood testing of vitamin D can be useful initially, routine ongoing monitoring is not usually required.
Calcium is essential for bone health, and is best obtained via food.
Calcium rich foods include:
Milk, yoghurt and cheese
Fortified plant milks (eg. Soya, Almond, Oat)
Tinned fish with edible bones (sardines, salmon)
Leafy green vegetables (eg. Kale, brocolli)
Tofu (made with calcium sulphate)
Fortified breakfast cereals
Sesame seeds and tahini
Magnesium:
Magnesium plays a role in many important processes in the body, including:
Nervous system regulation
Sleep quality
Muscle function
Energy metabolism
Magnesium intake is often sub-optimal in Western diets.
Foods rich in magnesium include:
Nuts and seeds, such as almonds and pumpkin seeds
Wholegrains
Dark leafy green vegetables
Legumes (for example lentils, chickpeas and beans)
Dark chocolate
Buying a magnesium supplement can feel so confusing, as there are many different types available.
When asked, we generally recommend choosing a good-quality supplement. You can try a blend of magnesium salts or, if sleep and anxiety are the main symptoms, magnesium glycinate can be helpful.
A three months trial is reasonable. If you haven’t noticed any benefit by then, for most women it would be sensible to stop.
Omega-3 Fatty Acids (EPA and DHA):
As we age, our risk of cardiovascular disease increases, and omega-3 fatty acids play an important role in supporting heart health, as well as brain function and mood.
There is good evidence to support adequate omega-3 intake for cardiovascular health, and for many women this is an important part of improving long-term health during and after the menopause.
Where possible, we recommend aiming to obtain omega-3s through the diet first.
Good food sources include:
Oily fish such as salmon, mackerel and sardines
Flaxseeds and chia seeds
Walnuts
Many Western diets are relatively high in pro-inflammatory omega-6 fatty acids and lower in omega-3s. For this reason, increasing omega-3 intake through food, while reducing excess omega-6-rich ultra-processed foods, is generally preferred.
For women who eat little or no oily fish, or who struggle to meet recommended intake, omega-3 supplementation can be a sensible and evidence-based option. When choosing a supplement, we encourage considering product quality and sustainability, such as responsibly sourced fish oils or algae-based alternatives.
B Vitamins:
B vitamins play an important role in energy production, nervous system function, and brain health, and can influence mood, concentration and fatigue.
For most women, a varied, balanced diet will provide adequate B vitamins.
Good food sources include:
Wholegrains
Eggs
Dairy products
Meat and fish
Leafy green vegetables and legumes
Deficiencies, particularly of vitamin B12 and vitamin B6, can contribute to symptoms such as low energy, brain fog and changes in mood.
Vitamin B12 absorption can decline with age, and deficiency is more common in women following plant-based diets or those taking acid-suppressing medication. Alcohol intake can also affect the absorption and metabolism of several B vitamins, particularly B1, B6 and folate.
For this reason, we usually recommend checking levels before supplementing, and focusing on targeted supplementation only where a deficiency or increased requirement is identified.
Creatine:
Creatine has been getting a lot of attention recently, particularly in conversations about muscle strength, healthy ageing and cognitive performance.
Creatine is a naturally occurring compound involved in muscle energy production. Muscle mass and strength naturally decline with age and around the menopause, and there is growing evidence that creatine may help support muscle strength and physical performance, particularly when combined with regular resistance or strength training.
Some emerging research also suggests potential benefits for bone health and cognitive function in midlife and older adults, although menopause-specific data is still limited.
Food sources of creatine include:
Red meat
Poultry
Fish
Vegetarians and vegans tend to have lower baseline creatine intake, which may partly explain why some people notice clearer benefits from supplementation.
Low-dose creatine supplementation (for example 3–5 g daily) is generally considered safe for most people, based on longstanding data. However, it is not something everyone needs, and benefits are most likely in those who are already engaging in strength or resistance training.
We recommend discussing creatine with your clinician, particularly if you have kidney disease or other medical conditions.
Collagen:
Collagen supplements are everywhere at the moment, often promoted for skin, joint and bone health. Collagen production naturally declines with age, and oestrogen appears to play a role in collagen synthesis, which helps explain why interest in collagen increases around the menopause.
The evidence for collagen supplements is modest. Some women do notice improvements in skin elasticity, nail strength or joint comfort, but this isn’t universal, and collagen isn’t something everyone needs.
Any potential benefits seem more likely when collagen intake is supported by adequate overall protein and vitamin C, which the body needs to produce collagen.
Foods that support collagen production include:
Protein-rich foods such as meat, fish, eggs and legumes
Vitamin C–rich foods including citrus fruits, berries and peppers
Bone broth and slow-cooked meats
Collagen supplements are generally considered safe, but are certainly not essential. A time-limited trial may be reasonable, and then continue only if it is making an obvious difference.
Probiotics & Gut Health:
Interest in probiotics for gut and vaginal health is growing, and some products are marketed specifically for the menopause transition.
However, solid clinical evidence for symptom relief is still limited, and research is ongoing.
For most women, focusing on a varied, plant-rich diet will provide many health benefits, including a wide range of natural prebiotic foods that support gut health.
Phytoestrogens (Soy Isoflavones & Red Clover):
Phytoestrogens are plant compounds that have weak oestrogen-like activity in the body.
Research into soy isoflavones and red clover shows mixed results for symptoms such as hot flushes as well as for bone health. Some women report a modest benefit, while others notice little or no difference.
These supplements are generally well tolerated, but it’s sensible to discuss them with your clinician before starting. Women who are undergoing treatment for cancer, or who have a history of hormone-sensitive cancer, should always seek specialist advice before considering phytoestrogen supplements, as some may interact with cancer treatments.
Herbal Remedies (Black Cohosh and St John’s Wort):
Some herbal remedies, such as black cohosh and St John’s Wort, are often mentioned in discussions about menopause.
The evidence for the benefit of black cohosh is inconsistent, and there are ongoing concerns about product variability and long-term safety. For these reasons, it is not something we would recommend in clinical practice.
St John’s Wort has been studied for low mood and may be effective for some people. However, it has significant interactions with many commonly prescribed medications, including antidepressants, hormonal treatments and other drugs. For this reason, it is not generally recommended during perimenopause or menopause without medical advice.
If you are considering any herbal remedy, it’s important to discuss this with your clinician to ensure it is safe and appropriate for you, and does not interact with other treatments.
Evidence and Safety:
In the UK, supplements are regulated as foods rather than medicines, and health claims are restricted unless supported by strong evidence.
Despite the popularity of many over-the-counter “menopause support” products, robust clinical evidence is limited for many. That said, some women do benefit from selected, targeted supplementation, particularly where intake is low or requirements are increased.
It’s also important to remember that supplements are not risk-free. Things to consider include:
Interactions with medications (for example blood thinners, antidepressants and thyroid medication)
Effects in hormone-sensitive conditions, including breast and gynaecological cancers
Variable quality and regulation - supplements are not regulated as strictly as medicines
Some herbal products can affect liver enzymes or clotting
For these reasons, we recommend discussing supplements with your clinician, especially if you take regular medication or have underlying health conditions.
Practical Tips for Choosing Supplements
Look for products that clearly list ingredients and doses
Choose reputable UK or EU suppliers, ideally with third-party testing
Be cautious of products making bold claims about treating or curing menopause symptoms
Keep a simple symptom diary to help you judge whether something is actually helping
Summary
Supplements can play a role in supporting health during perimenopause and menopause, particularly for bone, cardiovascular and general nutritional health but they are not a substitute for evidence-based hormone therapy or lifestyle measures where these are indicated.
The evidence varies widely between nutrients and herbal products, and safety should always come first. Personalised advice, and testing where appropriate, can help guide sensible and targeted use.
Always discuss supplements with your clinician, especially if you are taking medications or have underlying health conditions.