Whether it's hot flushes, brain fog or anxiety, experts explain which supplements to take to ease symptoms of menopause and perimenopause

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Davina McCall is on a mission to make menopause matter. Since her first menopause programme Davina McCall, Sex, Myths and the Menopause aired on Channel 4 in 2020 and her follow-up Davina McCall: Sex, Mind and the Menopause, which highlighted hormonal replacement therapy (HRT) shortages and the symptoms which are causing menopausal women to leave the work place, there’s been a spike in Google searches for supplements for peri- and menopause. 

Symptoms can begin anything up to a decade before our periods stop for good at the average age of 51, although one in 100 women has early menopause at the age of 40, according to leading menopause specialist Dr Louise Newson, who featured in the documentaries. 

Over the past year, Boots has seen a 61 per cent increase in sales of menopause products, from supplements to ease symptoms to lubricants to help with vaginal dryness, including  Vitabiotics' Menopace Plus, 16,  A. Vogel's Menoforce Sage 30 tablets, £13.50 and Boots' Menolieve Black Cohosh Root Extract, £10.

While perhaps the best-known symptoms of menopause are hot flushes and vaginal dryness, there are many lesser-known ones such as itching, tinnitus, migraines, acne, an altered sense of smell, breast tenderness, brain fog, anxiety which can begin in perimenopause and continue when you are post-menopausal (menopause is technically defined as the one year anniversary of your periods stopping.). Dr Newson lists 45 physical and 10 mental health symptoms on her menopause support app Balance  and every woman experiences them differently.

Advertising planner Rebekah Brown had symptoms in her mid-40s -anxiety, brain fog, complete loss of mojo and unhappy skin. “I felt so unattractive and joyless, like a walking black cloud,” she says. Her GP dismissed her suggestion that what she was experiencing was down to hormonal changes because she was still having periods and therefore “too young to be menopausal”. She began researching perimenopause supplements and couldn’t find anything in the supplements aisle that addressed that life stage, so she set about making her own plant-based smoothie powder. With the help of a naturopath she created MPowder Peri-Boost , £69, which launched in 2021, and Meno-Boost , £69, which is just out. I’ve tried both and take the Meno Boost, which has a well-researched ashwagandha  (called KSM-66) to manage stress, libido and mood, red clover for hot flushes and slippery elm for gut health. It also has a 20ug vitamin D , vital to help prevent bone loss, which accelerates at this stage. And yet I also take HRT; which brings me on to…

Are supplements HRT alternatives?

Caveat – they aren’t like-for-like alternatives. Dr Newson is keen to stress that while supplements can help with symptoms (as can HRT) they can’t address most of the long-term health risks that menopause creates for women caused by the loss of  oestrogen . They may make you feel better but aren’t an alternative to HRT in any way.

As she said in Davina’s first documentary, from an evolutionary perspective we were meant to die after menopause (cheery!) so we haven’t evolved to live without oestrogen for the 30 or so years that many of us live happily beyond menopause. Oestrogen, it turns out is vital for so many functions including cognition and cardiovascular health.

“There’s a huge misunderstanding that the menopause is hot flushes and sweats and periods stop and you get on with it. What [people] don’t realise is the health risks associated with low hormones - heart disease, osteoporosis, heart disease, dementia. The best time to start treatment to top up those hormones that are lowering is in the perimenopause, so your health risks reduce as much as possible.”

Supplements do have their place though. Dr Louise told me that specific ones are important at this life stage (indeed she sells her own under her clinic brand Newson Health ), vitamin D, probiotics, magnesium, fish oils and vitamin C. Phyto-oestrogen supplements (plant compounds which mimic oestrogen such as soy) can be useful early on. “With perimenopause, you can often help [hormone levels] by having phyto-oestrogens to top them up a little bit, ” she says. “But as soon as they start plummeting, you just can’t [top up hormones naturally] it’s impossible”

She adds: “If your symptoms are debilitating and you want to improve your symptoms short term then [supplements] are fine but you have got to remember that there are health risks with the menopause.”

The final word? “You should be looking at whether you need to supplement, but it shouldn’t be seen as an alternative to HRT.”

We spoke to experts about the best supplements to manage the symptoms of menopause and perimenopause; here’s what they recommended. (Always seek professional advice before taking supplements)

The symptom: Stress, anxiety and mood swings

The supplement:  Magnolia Rhodiola Complex, £28 for 60 capsules

During menopause and  perimenopause  your  oestrogen  and progesterone levels fall. When our hormones are off kilter, our adrenal glands, which modulate stress and energy levels, start producing more of the stress hormone  cortisol , hence why women could feel more stressed and anxious than usual.

"Mood swings can happen because the adrenal glands release excess cortisol," explains Shabir Daya, pharmacist and founder of online pharmacy  Victoria Health  “Some women may find their moods fluctuating because oestrogen levels vary from week to week, month to month and so on."

He suggests taking Magnolia Rhodiola Complex to rebalance your mood and lower your cortisol levels. “It relaxes your muscles and nerves and has also been proven to reduce your cortisol levels and boost  serotonin  levels,” he advises.

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The symptom: Fatigue

The supplement:  A Vogel Menopause Support, £14.99 for 60 capsules

Fatigue, and struggling to get through the day without feeling exhausted are a common symptom of menopause but is one that can be hard to attribute to the menopause alone. We all lead busy, tiring lives right? Well yes, but if you’re also going through the menopause feelings of exhaustation can hit at any time, regardless of whether you’ve been burning the candle at both ends or not.

A Vogel Menopause Support Tablets are a herbal supplement that are specifically formulated to target the tiredenss and fatigue experienced during the menopause. They work by addressing the hormonal changes that can cause menopausal fatigue. The tablets contain isoflavones, antioxidants that are similar in structure to oestrogen, they come from fermented soy, plus hibiscus extract which is a source of iron, both are known to boost energy and reduce fatigue. The herbal remedy also contains 405g  magnesium , a mineral that is thought to help maintain a normal nervous system and promote better sleep by sending nerve signals to the muscles and brain to tell them to relax.

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The supplement:  CBD Support Mellow, £37.95 for 60 capsules

"CBD is useful for reducing anxiety, promoting relaxation and helping to achieve restful sleep, plus it helps to reduce muscle tension, restlessness and fatigue," says Healthspan's medical director Dr Sara Brewer.

Each CBD Support Mellow capsule contains five mg of a  distilled and pure CBD with ingredients proven to support psychological and cognitive function, mental performance and your nervous system, including a full complex of B vitamins and vitamin C, plus essential minerals magnesium and zinc.

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The symptom: Sleep disturbance

The supplement:  Viridian Nutrition Cherry Night, £27.75 for 150 grams

“At night, serotonin is converted into  melatonin , which is your sleep hormone,” explains Shabir. “If you have sufficient levels in your body you will have your six to eight hours a night. However, cortisol [which we can have an excess of in menopause and perimenopause] prevents the uptake of serotonin to the brain.”

This powder, which should be added to water and drunk half an hour before bedtime contains an extract of cherries, which are rich in naturally occurring melatonin. “It won’t send you to sleep on day one, but over the weeks as you build up your melatonin levels you will notice a difference in your sleep pattern,” Shabir says. “It also contains  magnesium  to relax muscles and red dates, which have nerve-calming properties.”

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The symptom: vaginal dryness

The supplement:  Pharma Nord Omega-7 Sea Buckthorn Oil, £43.95 for 150 capsules

One in four women suffers from vaginal dryness, in menopause according to Shabir. The neck of the womb is designed to release a slightly acidic lubricant that keeps everything moist and supple and also prevents infection. It produces less lubricant during perimenopause and menopause. “Taking a good quality essential fatty acid omega 7 supplement, such as Pharma Nord Omega-7 Sea Buckthorn Oil will help to rectify this,” says Shabir.

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The symptom: Hot flushes and night sweats

The supplement:  Sage Complex, £25 for 90 capsules

“In my opinion, nearly every woman over the age of 35, with a few exceptions, should consider the use of phytoestrogen supplementation on an ongoing basis,” says Shabir. “Phytoestrogen is a scientific term for naturally-occurring plant compounds that are chemically similar to oestrogen and thus mimic oestrogen, often without side effects.

“Victoria Health's Sage Complex contains the right amounts of varied phytoestrogens to achieve hormonal balance. It contains natural herbs that help to mimic the female hormones and help alleviate common menopausal concerns including hot flushes, night sweats and vaginal dryness," he continues.

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The supplement:  Healthspan MenoSerene, £17.95 for 60-day supply

This is also good for hot flushes, says Dr Sarah Brewer. “This supplement includes 40 mg soy extract and 50 mg flax extract which both provide a significant oestrogen boost for women whose own levels are falling due to perimenopause and menopause. It also includes sage extract (which reduces sweating and hot flushes) to support hormone balance.”

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The symptom: low libido

The supplement:  Healthspan Black Cohosh Menopause Relief, £19.95 for 60 tablets

“Black cohosh a traditional herbal medicine believed to reduce menopausal symptoms through normalising the oestrogen-progesterone balance,” explains Dr Sarah Brewer. “It also has an effect on dilation of blood vessels and helps to relieve hot flushes, night sweats, low libido, anxiety and mood swings as well as improving sleep quality.”

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The symptom: Brain Fog

The supplement:  Life Extension Neuro-Mag, £32 for 90 capsules

“There is a strong link between hormones and neurotransmitters in the brain,” says Shabir. “When hormone levels are low [as in menopause] brain function can be affected often resulting in the inability to focus or in some cases an inability to recall information.”

This supplement includes magnesium which is essential for cognitive function to reach the brain tissues. It helps out when oestrogen dips.

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The symptom: joint pain

The supplement:  Victoria Health Superior Joints, £30 for 60 capsules

“Oestrogen protects our joints from degeneration and has anti-inflammatory properties. Low oestrogen levels will often affect the joints causing the symptoms of arthritic pain and unlike other menopausal symptoms, joint pain will not diminish even after the hormones level out so this is a good time to start taking a supplement to help," says Shabir.

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The symptom: fluid retention

The supplement:  Solgar Vitamins Nettle Leaf Extract, £19.75 for 60 capsules

During menopause the fluctuations between oestrogen and progesterone stop following the usual monthly pattern which can make fluid balance difficult causing fluid retention. Nettle leaf supplements work as mild diuretics, helping to eliminate excess water retention, particularly around the legs.

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The symptom: Bone loss

The supplement:  Viridian Vitamin D3, £6.50 for 30 capsules

Vitamin D is essential in menopause to help prevent bone loss, which accelerates at this life stage. Dr Louise Newson told menopause site  MPowered  that this is her vitamin D of choice. "I have taken vitamin D for many years and will continue to do so," she said. "Taking vitamin D has many effects including to our bones, brain and immune function. It is very cheap and readily available."

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MORE GLOSS: This is Davina McCall's exact HRT routine