The Herbs & Supplements Most Women Need During Perimenopause

There's no doubt about it: The symptoms of perimenopause are no walk in the park. But there is good news!

There's so much we can do to smooth the transition into menopause and reduce symptoms. It all has to do with restoring balance to your body and supporting healthy levels of the most important hormones.

It takes a full lifestyle approach to balance hormones, including dietary changes, exercise, and mindfulness-based stress reduction. On top of that, there are specific herbs and supplements that can help you get there.

Let's dive into what you should know about perimenopause and how herbs and supplements may help.

Perimenopause is the transitional period from a woman's reproductive years to menopause. When it starts and how long this stage lasts varies from woman to woman.

Specifically, low estrogen can lead to poor memory and concentration, vaginal dryness, hot flashes, night sweats, and fertility struggles.

Low progesterone can lead to problems sleeping, anxiety, heavy cycles, and fertility struggles; and low testosterone can lead to poor motivation and drive, depression, and low libido and energy.

Certain herbs and supplements have been scientifically studied and may help ease menopause-related symptoms, support outcomes impacted by menopause symptoms (like sleep), or promote healthy aging and longevity in general.

Magnesium is the most soothing, calming mineral, and it's thought that it's one of the first nutrients depleted by stress. Magnesium promotes relaxation for deep and restorative sleep.

Sleep disturbances are quite common during perimenopause—impacting 40%-60% of women. So while magnesium doesn't work by magically stopping night sweats, it may help you fall asleep faster, stay asleep longer, and wake up feeling refreshed.

Look for an amino acid chelated form like magnesium glycinate, which has superior absorption.

Stress is the body's biggest hormone hijacker, and there's no pill, potion, or powder that's going to improve your symptoms if you're chronically and severely stressed.

Tackling this issue means making big changes like learning to set healthy boundaries and leaving a toxic relationship or a work environment. It also requires daily practice, which is where meditation, yoga, deep breathing, resting, and allowing time for mental downtime come in.

If you're already combating chronic stress by adjusting your habits and lifestyle, there are a few supplements that I recommend to help your body deal with leftover stressors.

L-theanine is also an amino acid, often found in the leaves of green tea, that converts to GABA in the brain. This means it supports the central nervous system, promoting a relaxed state.* Supplementing with L-theanine may help calm anxiousness, promote restful sleep, and bolster overall mood.

This compound is found naturally in green tea (and matcha) as well as nootropic (brain-supporting) supplements.

It's a good idea to have a nutritional analysis run by a functional medicine provider at any age, but it can be especially helpful during perimenopause.

Vitamin D is a key biomarker we look at for bone health. It plays a key role in absorbing calcium and growth. And low estrogen levels after perimenopause are linked to increased bone loss1.

You can get vitamin D through foods and sunshine2, however, it's challenging reach or maintain optimal vitamin D levels without a supplement. If you aren't already on a vitamin D supplement before starting menopause3, now's the time to consider it. (Here's our recommendations for the best vitamin D supplements out there).

Fish oil supplements pack a lot of the omega-3 fatty acids EPA and DHA. Fish oil is the concentrated and purified oil derived from the tissue of oily fish.

The EPA and DHA in fish oil are essential for a healthy heart. Menopause is also linked to heart concerns down the road. In addition to following a heart-healthy diet and getting enough physical activity, taking a fish oil supplement can help support healthy levels of cholesterol and triglycerides.

In my practice, I often use various herbal formulations to support normal hormone levels.* Herbs can take weeks to months to take full effect, but when you stick it out, they can be very effective.*

Rhodiola rosea (the name of the flowering plant) can help support the nervous system4, mood, mental clarity, work performance, and a healthy sleep cycle.

It can also help to support normal levels of neurotransmitters such as serotonin, dopamine, and norepinephrine, which are important for mental health.

If the patient is reporting high amounts of stress, I may recommend the adaptogenic herb ashwagandha.

Ashwagandha has been clinically shown to improve stress resilience and actually lower the stress hormone cortisol, which is higher for some women during the menopause transition5.

If a woman has low estrogen symptoms or we find low estrogen upon testing, I often recommend estrogen-enhancing herbs like red clover, isoflavones, and black cohosh.

To support progesterone, I typically recommend vitex, passionflower, and paeonae. To support testosterone, I recommend use of horny goatweed and tribulus.

This can get complicated, so it's best to work with a trained herbalist or integrative or functional medicine practitioner who can test your hormone levels and make specific recommendations.

There's always a possibility that a supplement may interact with a medication you're taking.

If you're receiving menopause hormone therapy or are on any other prescription or over the counter medications (whether that's for sleep, your cholesterol levels, etc.), it's also a good idea to check with healthcare professional to make sure everything you're taking plays nicely with each other.

Everyone has a different perimenopause experience. Some women may have more symptoms than others. And regardless of that, the drastic drop in the hormone estrogen that characterizes menopause is accompanied with other health concerns like bone loss and heart troubles.

And certain supplements can help you navigate this transition. By reducing stress, implementing healthy lifestyle choices, and correcting nutritional deficiencies, I have seen countless women enter the next phase of life with gusto.