Menopause Supplement Guide: What Really Works According to Science
Menopause can feel like your body’s been hijacked—suddenly you’re not sleeping, your jeans don’t fit the same, and your moods are all over the place. As a dietitian who works with women navigating this transition, I see how overwhelming it can be to sort through the advice, especially when it comes to supplements.
The good news? There are a handful of nutrients and supplements that are truly backed by research to support your health during this time. From sleep to metabolism to muscle strength, here are the ones worth knowing about—no gimmicks, just science.
🦴 Calcium + Vitamin D (+ K!): Your Bone Health Foundation
One of the most important concerns during menopause is bone loss. As estrogen declines, your bones become more vulnerable to thinning—dramatically increasing the risk of osteopenia and osteoporosis. That’s why calcium and vitamin D remain non-negotiables in a midlife wellness plan.
Calcium is critical for building and maintaining strong bones. You can get it from leafy greens, dairy products, tofu, almonds, and fortified plant-based milks. [1]
Vitamin D helps your body absorb calcium, supports immune function, and plays a role in mood regulation. [2]
It’s a good idea to have your vitamin D levels checked annually with your routine labwork, especially if you live in a northern climate, have more melanin-rich skin, or are over the age of 50. People in these groups are less efficient at synthesizing vitamin D from sun exposure, making supplementation more important.
Aim for 1,000-1,200 mg of calcium and 800–1,000 IU of vitamin D daily, unless your labwork suggests otherwise. You can get it through a combination of food and supplementation, with 500mg of calcium being the optimal amount to supplement in a single dose.
Bonus tip: Consider pairing vitamin D with vitamin K2, which helps guide calcium to the bones (where you want it!) and away from soft tissues like arteries. This synergy can further support bone health and cardiovascular safety.
💪 Creatine: For Strength and Cognitive Support
You might associate creatine with bodybuilders, but it’s gaining ground as a supplement for postmenopausal women—and for good reason.
Loss of estrogen accelerates sarcopenia (muscle loss), which impacts strength, metabolism, and bone stability. Studies show that creatine (3–5g/day) helps preserve lean mass, especially when combined with strength training. Emerging evidence also suggests it may support cognitive function and reduce mental fatigue during aging. [3]
🌿 Magnesium: Sleep, Mood, and Blood Sugar Balance
Magnesium is involved in over 300 biochemical reactions in the body—many of which become more important during menopause. It plays a key role in:
Supporting deeper sleep
Reducing muscle tension and anxiety
Improving insulin sensitivity and blood sugar regulation
Because stress and aging reduce absorption, many women fall short. Magnesium glycinate or citrate are easy to find and great options if you want to supplement. Magnesium can have a laxative effect at higher doses so we recommend starting under 350mg.
Dietary sources of magnesium include leafy greens (like spinach), pumpkin seeds, almonds, black beans, avocado, and whole grains.
🧠 B Vitamins: Energy and Mental Clarity
Brain fog? Fatigue? B vitamins help produce neurotransmitters like serotonin and dopamine, essential for mood and cognition. [4] They also support red blood cell formation and energy metabolism.
B12 deficiency becomes more common with age due to decreased stomach acid.
B6 supports mood regulation and hormonal balance.
Folate is essential for DNA repair and cognitive function.
Dietary sources of B vitamins include eggs, leafy greens, whole grains, legumes, beef, poultry, fish, dairy products, and fortified cereals.
Supplementation may be helpful if intake is low, lab values are suboptimal, or symptoms like fatigue and cognitive fog persist. General recommendations include:
B12: 250–500 mcg/day (especially for vegetarians, older adults, or those on acid-suppressing medications)
B6: 1.5–2 mg/day
Folate: 400 mcg/day (from food and/or supplements)
Always consult your provider before starting high-dose B vitamins, especially if you have a medical condition or take medications.
❤️ Omega-3 Fatty Acids: Mood, Heart, and Inflammation
Omega-3s are anti-inflammatory powerhouses that support cardiovascular health and mood regulation. During menopause, your risk for heart disease rises, and omega-3s (particularly EPA and DHA) help offset that risk. [4]
They may also reduce the severity of mood swings and hot flashes in some women.
Aim for 1,000–2,000 mg EPA + DHA per day from fish oil or algae-based supplements.
Dietary sources include fatty fish like salmon, sardines, mackerel, and anchovies, as well as flaxseeds, chia seeds, walnuts, and algae-based sources.
🌾 Fiber: For Gut Health, Metabolic Support, Weight Management
Menopause can bring sluggish digestion, increased cholesterol, and blood sugar swings. Fiber helps with all of the above: [4]
Supports digestive regularity and feeds beneficial gut bacteria
Helps lower LDL cholesterol by binding bile acids in the gut, prompting the liver to use circulating cholesterol to produce more
Slows carbohydrate absorption and promotes steady blood sugar
Enhances satiety, which can support weight management
Dietary sources include whole grains (like oats, quinoa, and brown rice), beans, lentils, fruits (like berries and apples), vegetables, seeds, and nuts.
Target 25–30 grams per day from whole grains, vegetables, legumes, and seeds.
🔬 Inositol or Berberine: Metabolic Support
If you’re experiencing weight gain around the midsection, elevated blood sugar, or early signs of insulin resistance, inositol or berberine may offer targeted support.
Inositol (myo- and D-chiro forms) helps improve insulin sensitivity and may reduce markers of metabolic syndrome in menopausal and PCOS-related metabolic shifts. [5]
Berberine has been shown to lower fasting glucose and support lipid metabolism, with effects comparable to metformin in some studies. [6]
Always consult your provider before starting supplements, especially if you have a medical condition or take medications.
🌼 Collagen: Skin Elasticity and Hydration Support
As estrogen levels begin to decline in perimenopause, many women notice changes in skin elasticity and hydration. Collagen supplementation can offer meaningful support.
Collagen is a structural protein that supports skin firmness, joint cushioning, and connective tissue health. Natural production declines with age, and supplementing with 10–15 grams of hydrolyzed collagen peptides daily has been shown to improve skin hydration and elasticity. [7]
🌺 Black Cohosh: Relief for Hot Flashes (With Caution)
Black cohosh is a herbal supplement commonly used for vasomotor symptoms like hot flashes and night sweats. Some studies show improvement in these symptoms, though the evidence is mixed. [8]
Important considerations:
Black cohosh should not be combined with hormone replacement therapy (HRT) unless supervised by a healthcare provider.
It may affect liver function, so it’s not recommended for people with liver disease or elevated liver enzymes.
Always consult your provider before starting supplements, especially if you have a medical condition or take medications.
Final Thoughts: Science-Backed Support for a Complex Transition
Menopause doesn’t have a one-size-fits-all solution—but you don’t have to white-knuckle your way through it either. Thoughtfully selected supplements, combined with a personalized nutrition plan and active lifestyle, can make this transition more manageable. The key is choosing evidence-based support tailored to your body’s changing needs.
That said, not everyone needs all of the supplements listed above. Your needs will vary based on your individual symptoms, lab values, lifestyle, and health history. A trained dietitian or healthcare provider can help you interpret those findings and choose only the supplements that are right for you—nothing more, nothing less.
Remember: dietary supplements are not regulated by the FDA the same way medications are. Product quality and safety can vary widely. This blog is for educational purposes only and does not replace individualized medical advice. Always consult with your healthcare provider or a licensed dietitian before starting a new supplement.
Sources:
National Institutes of Health, Office of Dietary Supplements. (n.d.). Calcium - Consumer Fact Sheet. Retrieved from https://ods.od.nih.gov/factsheets/Calcium-Consumer/
National Institutes of Health, Office of Dietary Supplements. (n.d.). Vitamin D - Consumer Fact Sheet. Retrieved from https://ods.od.nih.gov/factsheets/VitaminD-Consumer/
Candow, D. G., et al. (2019). Effectiveness of Creatine Supplementation on Aging Muscle and Bone. Journal of Clinical Medicine, 8(4), 488. https://doi.org/10.3390/jcm8040488PMC
Gómez-Zorita, S., et al. (2023). The Importance of Nutrition in Menopause and Perimenopause—A Review. Nutrients, 15(1), 1. https://doi.org/10.3390/nu15010001PMC
Unfer, V., et al. (2022). Myo-inositol for insulin resistance, metabolic syndrome, polycystic ovary syndrome and gestational diabetes mellitus. International Journal of Molecular Sciences, 23(3), 1532. https://doi.org/10.3390/ijms23031532PMC
Zhang, Y., et al. (2021). Effect and mechanism of berberine against polycystic ovary syndrome. European Journal of Pharmacology, 893, 173796. https://doi.org/10.1016/j.ejphar.2021.173796ScienceDirect
Proksch, E., et al. (2014). Oral supplementation of specific collagen peptides has beneficial effects on human skin physiology: a double-blind, placebo-controlled study. Skin Pharmacology and Physiology, 27(1), 47–55. https://doi.org/10.1159/000351376PubMed
National Center for Complementary and Integrative Health. (n.d.). Black Cohosh: Usefulness and Safety. Retrieved from https://www.nccih.nih.gov/health/black-cohosh