Perimenopause Supplements

Evidence-informed reviews of supplements commonly used during the perimenopause transition. Every entry includes what the research actually shows, not just what the label claims.

⚕️ Medical DisclaimerThis page is for educational purposes only. Supplements are not FDA-approved to treat perimenopause symptoms. Always discuss supplement use with your OB/GYN or physician — especially if you are taking hormonal therapy, antidepressants, or other medications. Individual responses vary significantly.

Evidence levels:StrongModerateMixedEmerging

Magnesium Glycinate

Evidence: Moderate

SleepAnxietyMuscle Tension

One of the most well-supported supplements for perimenopausal sleep and anxiety. Glycinate form is better tolerated than oxide.

⚠️Caution: May interact with certain antibiotics and blood pressure medications.

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Vitamin D3 + K2

Evidence: Strong

Bone HealthMoodImmune

Critical for bone density protection as estrogen declines. Most women are deficient. Test your levels before supplementing.

⚠️Caution: Get levels tested — over-supplementation can be harmful.

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Omega-3 Fish Oil

Evidence: Strong

MoodBrain FogInflammationHeart Health

Broad evidence base for cardiovascular health (increasingly important during peri), mood support, and cognitive function.

⚠️Caution: Blood thinning effects — discuss with doctor if on anticoagulants.

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Ashwagandha (KSM-66)

Evidence: Moderate

StressFatigueMoodSleep

Adaptogen with solid clinical data for stress and fatigue. KSM-66 is the most-studied form. May help cortisol and sleep quality.

⚠️Caution: Not for use during pregnancy. May interact with thyroid medications.

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Black Cohosh

Evidence: Mixed

Hot FlashesNight SweatsMood

Most studied botanical for hot flashes. Results are mixed in clinical trials. NAMS considers it a reasonable option with short-term use.

⚠️Caution: Limit to 6 months. Rare liver concerns reported. Not for hormone-sensitive conditions.

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Magnesium L-Threonate

Evidence: Emerging

Brain FogMemoryCognitive

Crosses the blood-brain barrier more effectively than other forms. Early research on cognitive support is promising but limited.

⚠️Caution: Emerging research — discuss with doctor before use.

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How we evaluate supplements: We look at clinical trial data (prioritizing RCTs), systematic reviews, and guidance from the North American Menopause Society (NAMS) and Mayo Clinic. We note when evidence is limited or mixed — even when a supplement is popular. We are not affiliated with any supplement brand.Learn more about our sources →