While every woman goes through perimenopause, not every woman experiences it in the same way. Symptoms of perimenopause start for most females in their mid-40s, but they can also start years earlier or not until their 50s. Some women have severe symptoms, and others have only mild ones. If you’re wondering how to manage perimenopause symptoms, you’re not alone. A wide range of herbal supplements promise relief, but many questions remain as to their safety or effectiveness.
Always consult with your provider before taking any supplements. Doing so is crucial for preventing any adverse reactions and receiving safe, personalized treatment.
What Is Perimenopause?
Menopause is defined as the lack of a menstrual period for an entire 12 months. Once that occurs, women are officially considered menopausal, with no further menstrual cycles for the rest of their lives. The years preceding that change are called perimenopause.
Most women start perimenopause in their 40s. It usually lasts around four years, though it can last for only a short time or stretch for up to a decade.
Symptoms of Perimenopause
During perimenopause, your estrogen and other hormone levels may vary wildly. This fluctuation causes several symptoms in many women, such as:
- Abnormal spotting or bleeding between periods
- Hot flashes
- Irregular periods
- Memory loss or brain fog
- Mood swings
- Night sweats
- Trouble sleeping
- Vaginal dryness
- Weight gain
Some women may experience only mild or occasional symptoms. But others face years of symptoms that negatively affect their quality of life. Estrogen loss can also affect bone health, increasing the risk of osteoporosis. This condition weakens bones and makes them more likely to fracture during a fall.
Treatment Can Help Manage Symptoms
If your perimenopause symptoms are affecting your life, you don’t need to suffer in silence. Effective treatment can help manage symptoms of perimenopause and may include:
- Antidepressants, which can help manage hot flashes and mood swings
- Hormonal birth control, which can regulate your menstrual cycle and prevent irregular bleeding
- Hormone replacement therapy (HRT)
- Vaginal moisturizers or estrogen supplements, which can alleviate dryness
Lifestyle changes, such as avoiding certain foods, limiting alcohol and caffeine, may also help relieve hot flashes and night sweats. Women can also try practicing mindfulness to reduce their stress levels. Mindfulness can also be a way for women to help themselves better cope with hot flashes.
Pros of Perimenopause Supplements
Many perimenopausal women are interested in the use of herbal supplements to treat their symptoms. For one, you can easily find these supplements at drug stores or natural food markets. For women who don’t have insurance or who have high deductibles, they may seem like a cost-friendly option to a doctor’s visit and prescription medications. Supplements may also seem like a healthier alternative to HRT, especially for women who have had breast cancer or who are at high risk of breast cancer and cannot increase their estrogen levels.
Common Perimenopause Supplements
Several vitamins and supplements are advertised as helping with perimenopause symptoms, including:
- Vitamins/Minerals
- Calcium. Taking calcium can help with preventing bone loss. But not every woman needs extra calcium supplementation, and it can have side effects such as kidney stones and gastrointestinal problems.
- Vitamin E. Some research has found vitamin E supplements may reduce hot flashes, but other studies are inconclusive. Vitamin E can also interact with blood thinners.
- Supplements
- Black cohosh. Decades of studies on this herb have found varying levels of effectiveness in treating a range of perimenopause symptoms. Recent studies have found women reported no difference in symptom relief compared to a placebo. Additionally, it has been associated with gastrointestinal problems, rash and acute hepatitis.
- Dong quai. This herb is traditionally used in Chinese medicine for women’s health issues. However, no conclusive research has found that it helps perimenopause symptoms, and it may interact with medications such as blood thinners.
- Evening primrose oil. Little research exists on this supplement, but it has not been proven to help with symptoms.
- Flaxseed. Studies have found mixed results as to whether flaxseed capsules reduce hot flashes.
- Omega-3 fatty acids. No research has proven these capsules reduce hot flashes, but they could be beneficial for your heart health.
- Red clover. Studies are mixed as to whether this herb reduces any perimenopause symptoms.
- Soy. Soy products such as tofu are a great addition to a heart-healthy diet, and they may or may not help reduce hot flashes.
Supplements Are Not Approved by the FDA
In addition to the lack of proven effectiveness, there is another drawback to taking over-the-counter herbal supplements and even vitamins or minerals. Unlike medications, the U.S. Food and Drug Administration (FDA) does not approve supplements. So, any supplement you buy:
- Has not been tested by the FDA to make sure it works for the purpose stated
- Has not gone through rigorous safety testing
- May not contain what the label says it does
- May not contain the levels of supplement listed on the label
While some brands of supplements and vitamins voluntarily adhere to industry safety standards, those standards are much looser than the government standards for over-the-counter and prescription medications. But brands are not required to follow those standards.
This means one bottle of black cohosh could have — and likely does have — a completely different formulation of the supplement than another brand. Even if one supplement does help with your perimenopause symptoms, another formulation of the same herb might not. The American College of Obstetricians and Gynecologists also warns that some supplements may even have dangerous levels of hormones, including estrogen and testosterone, making them not safe for breast cancer survivors.
Talk to a Gynecologist About Your Options
If perimenopause or menopause symptoms are affecting your life, it’s time to talk with a gynecologist. Your provider can assess your symptoms and work with you to provide solutions, even if you already know HRT isn’t for you. Your women’s health specialist can also counsel you about the safety of any supplements you might want to try so you won’t have any unexpected interactions with medications.
It is important to let all of your providers know all of the medications and supplements you are taking at every appointment. This will help prevent adverse interactions and overmedication.
You may also want to talk to your provider about other complementary and alternative therapies to use in addition to supplementation. Research has found benefits from yoga, aromatherapy, acupuncture and exercise for the relief of menopausal symptoms.
More to Read
- How Are Menopause and Mental Health Connected?
- Change Is Coming: Recognizing the Signs of Menopause
- Your Top Priority During Perimenopause? Your Health
- What Symptoms Should You Discuss With Your Gynecologist?
- Osteoporosis: Exercises to Improve Bone Health
- Calcium Supplements for Osteoporosis
Medically reviewed by Marie Ramez Nakhoul, MD.
