Supplements For Perimenopause

Table of Contents

Perimenopause, the transitional stage leading to menopause, can be challenging for many women. Hormonal fluctuations during this period often result in a wide range of signs, such as hot flashes, mood swings, irregular periods, sleep disturbances, and decreased bone density. While proper nutrition and a healthy lifestyle form the foundation for managing perimenopause, certain supplements can provide additional support. This article will explore the top supplements recommended for women navigating this transformative phase.

Calcium and Vitamin D

As women age, they become more susceptible to bone loss and osteoporosis. Calcium and vitamin D are crucial in maintaining bone health, making them essential supplements during perimenopause. Calcium helps in strengthening bones, while vitamin D assists with calcium absorption. It is recommended to consume 1,000-1,200 mg of calcium per day along with 600-800 IU of vitamin D. Dietary sources include dairy products, leafy greens, and fortified foods, but supplementation might be necessary to meet the daily requirements.


Magnesium is a mineral that is vital in various bodily functions, including nerve and muscle function and maintaining healthy blood pressure. Additionally, magnesium helps alleviate common perimenopausal symptoms such as anxiety, mood swings, and insomnia. The recommended daily magnesium intake is around 320-420 mg, which can be obtained through supplementation or by consuming nuts, seeds, whole grains, and leafy green vegetables.

Omega-3 Fatty Acids

Omega-3 fatty acids, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are essential fats that offer numerous health benefits. These healthy fats are known for their anti-inflammatory properties. They can help decrease the intensity and frequency of hot flashes and support overall cardiovascular health. Fatty fish like salmon, mackerel, and sardines are excellent natural sources of omega-3s. Still, fish oil supplements can be considered if dietary intake is inadequate.

Maca Root

Maca root is an adaptogenic spice that has gained recognition for its potential benefits in managing hormonal imbalances. It supports the endocrine system, which is crucial in regulating hormone production. Maca root improves energy levels, reduces mood swings, and enhances overall well-being during perimenopause. Additionally, it may help combat vaginal dryness, a common symptom caused by declining estrogen levels.

Black Cohosh

Black cohosh, derived from the root of the North American black cohosh plant, has been used for centuries to alleviate menopausal symptoms. Research suggests that black cohosh can help reduce hot flashes, night sweats, and mood swings. While the accurate mechanism of action is not fully understood, it is believed to have estrogen-like effects on the body. However, it is important to consult a healthcare expert before starting black cohosh supplementation, especially for those with liver conditions.

Vitex Agnus-Castus

Also known as chaste berry, Vitex agnus-castus is an herb traditionally used to balance hormones and regulate the menstrual cycle. During perimenopause, the menstrual cycle often becomes irregular, and Vitex can help support hormonal balance. It acts on the pituitary gland, encouraging the production of luteinizing hormone (LH) while suppressing the release of follicle-stimulating hormone (FSH). This helps to regulate estrogen and progesterone levels. However, it is advisable to consult with a healthcare professional before incorporating Vitex into your routine, especially if you have a history of hormone-related conditions.

Evening Primrose Oil

Evening primrose oil (EPO) is derived from the evening primrose plant’s seeds. It is the richest source of gamma-linolenic acid (GLA), an omega-6 fatty acid. GLA is converted into a substance that helps regulate hormonal balance. EPO often relieves breast pain, tenderness, and symptoms associated with hormonal imbalances, such as mood swings and dry skin. Taking EPO supplements containing at least 8% GLA is recommended, starting with a daily dosage of 500-1,000 mg. Again, consulting with a healthcare professional is advisable before starting any new supplementation regimen.


B vitamins, including B6, B12, and folate, are crucial for maintaining hormonal balance and overall well-being during perimenopause. These vitamins support energy production, reduce fatigue, and enhance mood and cognitive function. Vitamin B6, in particular, has been found to alleviate symptoms like mood swings, irritability, and breast tenderness.

While perimenopause brings about significant hormonal changes and various symptoms, incorporating appropriate supplements can help alleviate discomfort and support overall well-being. Calcium and vitamin D promotes healthy bones, magnesium aids in reducing perimenopausal symptoms, and omega-3 fatty acids support heart health and reduce hot flashes.

Black cohosh and vitex agnus-castus assist in hormonal balance. Evening primrose oil eases symptoms related to hormonal imbalances. It is essential to consult with a healthcare professional before initiating any supplementation regimen, as they can deliver personalized guidance based on your specific needs and medical history. Remember, supplements should complement a healthy lifestyle incorporating regular exercise, a balanced diet, and stress management techniques to optimize your well-being during this transformative phase.

Here we discuss this with Gregory Charlop, MD, to get his thoughts on this topic.

NourishDoc: Hello, everyone. Well, I have a special guest today. Dr. Charlop. He is a physician and published author of Why Doctors Skip Breakfast. I didn’t even know that. But that’s what it’s written in the book about. He’s also an advocate for women’s and kids’ health and a big advocate for sustainable real estate. Thank you so much for joining me. I’m super excited to have you here.

Importance of iron supplements 

NourishDoc: So let’s talk a little about nutrition supplements, and If women start doing that, can they skip HRT or not? 

MD, Gregory Charlop: One of them is iron, so everybody needs iron. Women need iron, but women need more iron. It turns out before menopause, and I have, so if you’re a woman with a high iron diet, naturally, you eat a lot of red meat. For example, where you take iron supplements, you might be able to cut that back, and it’s not recommended that women after menopause even take iron supplements because they simply don’t need them. That much, and it’s probably true that unless you have anemia, you know you have to speak to your doctor. 

What About Calcium During Menopause?

But the flip side of the coin is calcium. So it turns out that women need more calcium after menopause during perimenopause than they needed before. So you know, the recommendations are that women before menopause, like in their twenties, get around a gram of calcium. That’s 1,000 milligrams. A day afterward. It would help if you had more. It would be best to have 1,200 milligrams or even more than that. So I love flax milk for those of you at home. There’s this great flack smoke. It’s got protein and Scott calcium. So I milk with they added, is a good one. There are a lot of different things you could take calcium supplements. Spinach has a lot of calcium, so you could eat there if you’re into canned fish, sardines, and things like that, especially with the bones in. That is a lot of calcium. So those are good ways of getting any more of it.

Use of omega-3 fatty acids

NourishDoc: what women do from a nutrition point of view to calm themselves.

MD, Gregory Charlop: Well, there are a few great things that you can do. One of them seems to have positive effects on mood. It certainly helps with the brain. They come in handy in old age, as you know. I recommend taking a relatively high dose of omega.3 s. So if you get those gel caps, I like the ones from Costco. They’re pretty cheap. They’re sustainably farmed, and I think they’re not as bad for the environment. You know, I would take 2 or 3 of those a day, and also, it’s kind of recommended that you have. 

Sleep and hygiene

But you know what another thing, and this is, I think, very important. It’s not nutrition, but there’s clear research that one of the best ways you can improve your mood is through sleep and exercise, which is true for everybody. But I think it’s especially true and especially important for Peri menopausal women, which is if you can get your sleep. Standardized. So you follow good sleep and hygiene as you go to bed simultaneously. Every day you get up at the same time. Every day you sleep in a cold, dark room. You don’t have caffeine late in the day. You don’t have alcohol light in the day. That type of thing helps with mood regulation. And, you know, feeling better and kind of being just kind of more even-keeled. 

Reduce the Risk Of Osteoporosis 

NourishDoc: Yeah, any particular type of exercise women should do to ensure they don’t get into osteoporosis. 

MD, Gregory Charlop: So osteoporosis is a big deal, and I see this. I have personally; I’m an anesthesiologist by training. I saw this where you have women that are otherwise very healthy. They’re still working. They’re caring for their grandkids. They’re doing everything, but it isn’t even a big deal if they have a fall. It’s not like they’re hit by a car. They fall on the stairs, and they trip on the sidewalk. They break a bone. And even though they could have surgery afterward, their lives are forever changed. By this, they often can’t do what they once could.

Many have chronic pain, and their ability to exercise afterward is reduced. Maybe they can’t work anymore. So something that happens in a blink of an eye can have life-changing? Consequences. So one of the best ways to prevent that is calcium and vitamin D, which we didn’t discuss. But you know you want to get at least 600. I use vitamin D a day. You really can’t get that through diet. You have to take that as a supplement. You just can’t get enough vitamin D through diet for most people, and then exercise.

You know, the really good things are impact exercises. So brisk, walks running if you like to run. If you play tennis, any of those things that have a sort of axial impact on your legs from running around fall pickleball is great. I’ve recently gotten into it. I love it. Everybody seems to like it. All those things will help strengthen your bones and reduce the risk of osteoporosis.


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