Some people may wish to take supplements, such as black cohosh and vitamins, to relieve menopausal symptoms. However, there is little evidence that these supplements have a significant effect on symptoms of menopause.
This article discusses common supplements that people may use to manage menopause symptoms. It also discusses the effectiveness and any potential side effects of these supplements.
Sex and gender exist on spectrums. For the purposes of this article, we use “male” and “female” to refer to a person’s sex assigned at birth. Learn more.
What are perimenopause and menopause?
Menopause is the clinical term for when a person’s estrogen levels drop and they stop menstruating. The age of menopause varies from 40–58 years of age, although females in the United States usually go through menopause around age 52Trusted Source.
However, menopause does not happen all at once. On average, it takes people about 4 years to transition into menopause. Perimenopause describes this transitional period. During this time, a person’s periods may change in:
- regularity
- duration
- heaviness
A person is going through menopause when they do not menstruate for 12 months.
Menopausal symptoms can develop during perimenopause and may include:
- hot flashes
- difficulty sleeping
- mood changes
- vaginal dryness
- loss of bone density
- increase in cholesterol levels
Learn more about the symptoms of menopause.
According to a 2005 review of studies, roughly two-thirds of womenTrusted Source have menopausal symptoms during perimenopause. Up to 90%Trusted Source of women seek advice from a healthcare professional about managing menopause symptoms. Menopause symptoms can vary widely from person to person and may last for several years.
It is important to remember that menopause supplements are not regulated by the Food and Drug Administration (FDA). Products may have proprietary blends, which means that the company does not list the amounts of the ingredients on the product packaging. Additionally, products may contain active or inactive ingredients that are not listed.
People should discuss taking supplements with a healthcare professional or a pharmacist. Some supplements may cause side effects and interact with prescription or nonprescription medications.
Menopause supplements
The National Center for Complementary and Integrative Health (NCCIH)Trusted Source states that there is no clear evidence that dietary supplements can relieve menopause symptoms. Additionally, the NCCIH notes that there is little research on the long-term safety of dietary supplements.
Learn more about natural remedies for menopause.
The following are some menopause supplements a person may use, alongside their effectiveness and any potential side effects.
Black cohosh
Black cohosh is one of the more commonTrusted Source herbal menopausal supplements.
Native Americans have used this plant to treat conditions such as fever, cough, and irregular menstruation. European settlers also used black cohosh to support female reproductive health.
More recently, people may use black cohosh to treat menopausal symptoms such as:
- hot flashes
- night sweats
- vaginal dryness
- irritability
Originally, scientists thoughtTrusted Source that black cohosh worked like estrogen. More recent studiesTrusted Source suggest that this herb works by mimicking the neurotransmitters:
- dopamine
- serotonin
- norepinephrine
However, there is no evidenceTrusted Source to suggest that black cohosh has an effect on hormone levels in the body, including estradiol.
Older studies suggested that black cohosh may be effective for the relief of menopausal symptoms, either aloneTrusted Source or in combinationTrusted Source with other herbs. However, more recent researchTrusted Source suggests that black cohosh has no significant effect on menopause symptoms. The authors note that more high-quality research needs to be conducted on this subject.
Learn more about black cohosh and menopause.
Side effects and safety
The National Institutes of Health (NIH)Trusted Source state that black cohosh does not appear to interact with any medications. However, people should always ask a healthcare professional before taking any supplements to make sure it is safe to use with other medications.
However, the Memorial Sloan Kettering Cancer Center warns that black cohosh may interact with the following medications:
- Tamoxifen: Black cohosh may interfere with the way tamoxifen works.
- Chemotherapy drugs: Black cohosh may increase the toxicity of the chemotherapy drugs doxorubicin and docetaxel.
- Cytochrome P450 3A4: This enzyme plays an important part in metabolizing medicines. Black cohosh may interact with drugs that this enzyme metabolizes.
- Simvastatin: Black cohosh may increase the side effects a person experiences with simvastatin.
It is important to note that, as the FDA does not regulate black cohosh, it is difficult to know which ingredients a manufacturer uses for their product. Some products may haveTrusted Source adulterants, which means manufacturers may substitute black cohosh for similar synthetic ingredients.
The NIH states that, worldwide, there have been at least 83 casesTrusted Source of liver damage linked with black cohosh use. The organization says this may be partly due to adulterants and impurities. However, there has been no independent analysis of the link between black cohosh and liver damage.
Additionally, the amount of black cohosh may varyTrusted Source from supplement to supplement. This variance makes it more difficult to determine whether a person will experience side effects as a result of a higher dose.
Side effects from taking black cohosh may include:
- uterine bleeding
- breast pain
- musculoskeletal pain and discomfort
People who take larger doses may experience gastrointestinal effects such as bloating and cramping.
Less common side effects include:
Calcium and vitamin D
Every person has levels of calcium in their body. Adult females have around 1,200 grams (g)Trusted Source of calcium in their bodies, and this level remains consistent until estrogen levels drop during menopause.
Vitamin D also plays a role in bone health. During menopause, a person’s bone density may declineTrusted Source, leading to osteoporosis. Not having enough calcium and vitamin D is a risk factor for this condition.
The Women’s Health Initiative TrialTrusted Source investigated the effects of calcium and vitamin D supplements on menopausal symptoms. The participants took 1000 mg of calcium and 400 international units (IU) of vitamin D during the course of the study, and the researchers followed up with the participants after an average of 5.7 years.
The researchers found that there was no difference in symptoms between the group that took supplements and the group that did not. Sleep disturbances, energy levels, and emotional well-being were similar between the two groups, leading the researchers to conclude that calcium and vitamin D supplements are unlikely to have an effect on symptoms of menopause.
Side effects and safety
Females should aim to ingest 1,000 mg of calcium per day if they are 50 years of age or under, and 1,200 mg if they are over 50. The tolerable upper limit of calcium is 2,500 mg for those 50 or under, and 2,000 mg for those over 50.
Females 70 years or under should have 600 IU of vitamin D, with those over 70 needing 800 IU.
Not having enough calcium and vitamin D, or having too much, may cause side effects.
Calcium
Side effects of having too little calcium include:
- pins and needles feeling in the fingertips, toes, and lips
- muscle pains and cramps in the legs, feet, and stomach
- facial muscle twitches
- mood changes, such as depression, irritability, and anxiety
- fatigue
- rough and dry skin
- coarse hair and hair breakage
- easily broken fingernails
Side effects of having too much calcium, or hypercalcemia, include:
- vomiting
- drowsiness
- dehydration
- muscle spasms
- bone and joint pain
- irregular heartbeat
- high blood pressure
Vitamin D
Not having enough vitamin D can lead to bone conditions in adults and children. Children who do not have enough vitamin D may develop rickets, and adults may develop osteomalacia. These conditions can cause bone pain and lead to soft and weak bones.
Taking too many vitamin D supplements can lead to hypercalcemia.
Red clover
Red clover is a legume that containsTrusted Source isoflavones. Isoflavones are compounds that are similar to the hormone estrogen.
Red clover was traditionally used as a treatment for conditions such as:
- asthma
- whooping cough
- cancer
In recent times, people have used this supplement for:
- menopause symptoms
- osteoporosis
- high cholesterol
However, the NCCIHTrusted Source states that all studies investigating the effects of red clover on menopausal symptoms and bone density in menopausal females have had inconsistent results. There is not enough evidence to suggest red clover can effectively relieve symptoms of menopause.
Side effects and safety
The Memorial Sloan Kettering Cancer Center states that red clover can interact with the following medications:
- Anticoagulants: Red clover may increase the effects of these medications. However, more clinical research is needed.
- Cytochrome P450 enzymes: Red clover can inhibit some of these enzymes and may interact with medications that the enzymes metabolize.
- Methotrexate: Red clover may increase the toxicity of methotrexate, leading to severe vomiting and stomach pain.
Soy
Soy supplements commonly come in the form of soy protein, isoflavones, or a combination. People may use soy supplements to treatTrusted Source menopausal symptoms, high blood pressure, and high cholesterol, and to improve bone health and memory.
A 2015 review of studiesTrusted Source found that soy isoflavones can reduce the severity of hot flashes. However, the authors note that it took an average of 13.4 weeks for people to notice the effect of the soy isoflavones in comparison with 3.09 weeks when using estrogen hormone replacement therapy (HRT).
The NCCIHTrusted Source states that soy isoflavone mixtures may have a beneficial effect on bone health during menopause. However, the evidence is inconsistent.
Side effects and safety
People who are allergic to soy should not use soy supplements or ingest food or beverages that contain soy.
The NCCIHTrusted Source states that short-term use of soy protein and isoflavone supplements is safe. However, there has not been enough research into long-term use to verify its safety.
The organization also warns that soy may alter the way the thyroid functions in people who have an iodine deficiency. Additionally, as soy contains compounds that are similar to estrogen, people who are pregnant or breastfeeding should contact a doctor before ingesting soy.
The most common side effect of ingesting soy is digestive upset. People may experience symptoms such as constipation and diarrhea.
Ginseng
Ginseng is another herbal supplement that people may use to relieve menopausal symptoms.
A 2016 systematic reviewTrusted Source notes that many studies investigating the effectiveness of ginseng on symptoms of menopause are at a high risk of bias.
The authors note that ginseng may have a positive effect on:
- sexual function
- arousal
- total hot flash scores recorded by the participants
However, there is no evidence that this supplement affects:
- hot flash frequency
- a person’s hormones
- the thickness of the endometrium
Side effects and safety
Short-term oral use of ginseng for up to 6 monthsTrusted Source is usually safe for most people. However, experts may not recommend the use of ginseng in:
- infants
- children
- those who are pregnant or breastfeeding
People should contact a healthcare professional if they wish to take ginseng and are currently using medications such as calcium channel blockers, statins, or antidepressants. Ginseng may interact with these medications.
Some side effects of ginseng include:
- breast pain
- changes in menstruation
- increase in heart rate
- high or low blood pressure
- headache
- loss of appetite
St. John’s wort
St. John’s wort is a traditional European herbal remedyTrusted Source for various conditions, including depression and menopause symptoms.
Learn more about St. John’s wort.
Older researchTrusted Source found that St. John’s wort supplements had an effect on hot flashes. This study split 100 women into two groups, with one group taking the supplement and the other using a placebo. While there was no significant difference in the hot flashes the participants reported after 4 weeks, the researchers noted that women who took the supplement reported fewer hot flashes after 8 weeks.
However, the NCCIHTrusted Source states that there have not been enough studies to know whether St. John’s wort is an effective treatment for menopausal symptoms.
Side effects and safety
St. John’s wort can interact with various medicationsTrusted Source, causing them to be less effective. An incomplete list of medications that this supplement can interact with includes:
- antidepressants
- birth control pills
- cyclosporine, a medication that stops the body from rejecting donor organs
- heart medications such as digoxin and ivabradine
- HIV drugs such as indinavir and nevirapine
- cancer medications such as irinotecan and imatinib
- warfarin
- statins such as simvastatin
This supplement can cause the following side effects:
Summary
Menopause is a natural stage in life, but it can cause symptoms that negatively affect a person’s quality of life. Some people may wish to use natural supplements. However, there is little evidence that these supplements are effective, and many studies deliver inconsistent results.
People should contact a healthcare professional for advice before taking any dietary supplements. Some supplements can interact with prescription and nonprescription medications and may cause additional side effects.
