Perimenopause—otherwise known as the wild rollercoaster ride leading up to menopause—can feel daunting. It usually kicks off in your 40s (sometimes even late 30s), and will bring along a bunch of changes, thanks to shifting hormones. The good news? You’re not alone, and there are some well-studied supplements that may help mitigate the symptoms. Let’s dive into what perimenopause is all about, what symptoms to expect, and what science-backed ingredients could help you feel more like yourself again.

What Is Perimenopause?

Perimenopause is the transitional phase before menopause, which is defined as 12 months without a period. During this time, your estrogen levels start fluctuating, which can throw your body and mood a little out of norm. Some symptoms that are typical during perimenopause include hot flashes, mood swings, irregular periods, sleep disturbances and low libido.1

Hormone replacement therapy (HRT) is still a go-to option for many practitioners and patients alike, but if you’re looking for a more natural alternative to alleviate symptoms, there are some promising supplements out there.

Can Supplements Help?

Several supplements have been studied for their potential benefits in helping perimenopausal discomforts. It’s essential to consult with a health care provider before starting any new supplement regimen. Other points to consider prior to investing in a supplement routine are quality and patience. Unlike HRT, supplements can take about three months to see any results, and supplements that come from a trusted company who follow good manufacturing practices are always best.

A few supplements that have research backing their effects on perimenopausal women include…

Black Cohosh: Black cohosh has been used for decades to help with menopausal symptoms, especially hot flashes and night sweats. A review study found that black cohosh can be more effective than a placebo in easing those dreaded heat surges.2

Red Clover: This plant is rich in isoflavones—plant-based compounds that act similarly to estrogen in the body. Some studies suggest that red clover can reduce the frequency of hot flashes. One meta-analysis backed that up, although researchers still want more data to confirm the full effect.3

Evening Primrose Oil: Evening primrose oil contains GLA (gamma-linolenic acid), an omega-6 fatty acid that may help with hot flashes and night sweats. One study found this to be true in women experiencing menopause, which is promising for those who are in perimenopause.4

Saffron: Yes, the same spice that is used in your famous paella may be helpful in reducing perimenopause symptoms! Saffron has been shown in some early research to help with mood swings and depressive symptoms, which are common in perimenopause. One study noted significant improvements in mood after saffron supplementation.5

Probiotic + Red Clover: There is some interesting science around pairing probiotics with red clover to reduce vasomotor symptoms because of declining estrogen levels. The idea is that probiotics help your body absorb and use the plant estrogens from the red clover more effectively. One study found that this combo might work well to reduce hot flashes and other symptoms that may be associated with menopause.6

Other Factors to Consider

Outside of supplementation, lifestyle factors can also help mitigate hormonal shifts before and during menopause! Here are a few other points to consider, alongside your supplement routine:

• Eat Well: Choose whole foods as often as you can. When foods are minimally processed, they are usually higher in fiber, healthy fats and protein which all support a healthy body and mind.

• Move Your Body: Exercise can help with mood regulation, energy and sleep—all things that may be disturbed during perimenopause.

• Sleep Smarter: Have a consistent sleep and stress-relief routine. This can help regulate our nervous system—which is in overdrive from hormonal shifts!

• Practice Mindfulness: Alongside sleep and stress-relief, having intentional mindfulness activities including yoga, journaling, deep breathing or nature walks can also help with mood and sleep.

Whether you choose to try supplements, adjust your lifestyle, or explore medical options, what matters most is finding what makes you feel good in your own skin. Your body may be changing, but that doesn’t mean you have to lose your balance. With the right tools and a little self-care, you’ve got everything you need to thrive through this transition!

References:

1 Mayo Clinic- diseases and conditions- perimenopause. Mayo Clinic. www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 Published May 25, 2023.

2 Hedaoo K, Badge AK, Tiwade YR, et al. Exploring the Efficacy and Safety of Black Cohosh (Cimicifuga racemosa) in Menopausal Symptom Management. Journal of Mid-life Health 15(1):p 5-11, Jan–Mar 2024. | DOI: 10.4103/jmh.jmh_242_23.

3 Kanadys W, Barańska A, Błaszczuk A, et al. Evaluation of Clinical Meaningfulness of Red Clover (Trifolium pratense L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021 Apr 11;13(4):1258. doi: 10.3390/nu13041258. PMID: 33920485; PMCID: PMC8069620.

4 Kazemi F, Masoumi SZ, Shayan A, Oshvandi K. The Effect of Evening Primrose Oil Capsule on Hot Flashes and Night Sweats in Postmenopausal Women: A Single-Blind Randomized Controlled Trial. J Menopausal Med. 2021 Apr;27(1):8-14. doi: 10.6118/jmm.20033. PMID: 33942584; PMCID: PMC8102809.

5 Jackson PA, Forster J, Khan J, et al. Effects of Saffron Extract Supplementation on Mood, Well-Being, and Response to a Psychosocial Stressor in Healthy Adults: A Randomized, Double-Blind, Parallel Group, Clinical Trial. Front Nutr. 2021 Feb 1;7:606124. doi: 10.3389/fnut.2020.606124. PMID: 33598475; PMCID: PMC7882499.

6 Lambert MNT, Thorup AC, Hansen ESS, Jeppesen PB. Combined Red Clover isoflavones and probiotics potently reduce menopausal vasomotor symptoms. PLoS ONE. 2017 June 7; 12(6): e0176590. https://doi.org/10.1371/journal.pone.0176590.

Dr. Nicole Avena is an associate professor of neuroscience at Mount Sinai School of Medicine in New York, NY, and a visiting professor of health psychology at Princeton University in New Jersey. She is a research neuroscientist and expert in the fields of nutrition, diet and addiction, with a special focus on nutrition during early life and pregnancy, and women’s health. In addition to more than 100 peer-reviewed scholarly publications, Dr. Avena has written several popular books, including Why Diets Fail: Because You’re Addicted to Sugar, What to Eat When You’re Pregnant, What to Feed Your Baby and Toddler and What to Eat When You Want to Get Pregnant. Her latest book, Sugarless, was released in December 2023. She frequently appears as a science expert in the media, including regular appearances on Good Day NY, The Doctors, and the former Dr. Oz Show, as well as many news programs.