Menopause supplements and vitamins - do they work?

Menopause is a term defining the number of processes that mark the end of menstruation. It might last anywhere from a couple of years to over a decade. The biggest change and all the menopausal symptoms happen because of a gradual decrease of hormone concentrations, mainly of estrogen.

Since menopausal symptoms reflect a big change happening in the organism, they can be uncomfortable and even painful. Many natural compounds in the form of supplements, teas, and foods can help level out the hormone concentrations and keep symptoms under control.

Keep reading and find out what are the first signals and stages of menopause, and which supplements you can take to make the process easier and more tolerable on your body.

What are the first signs of menopause?

Menopause starts occurring as the natural levels of the hormone estrogen, produced by the ovaries, start declining. This also means that the ovaries won't release eggs anymore, and the fertile period of life will slowly come to an end. 

The first symptoms of menopause can occur 4-7 years before the menopause itself begins. The symptoms might be:

• Unregular menstrual cycles,
• Hot flashes,
• Insomnia.

This will only mark the beginning of the menopausal period that every menstruating person will go through in their life. The first signals of menopause will appear between the ages of 45 and 55 (1). 

Stages of menopause

Menopause is overall a very lengthy process that can be divided into multiple stages. Let’s review what are the three stages of menopause:

• Perimenopause – can start even 8 years before the end of your menstruating period,
• Menopause – you officially enter menopause when you haven’t been menstruating for at least a year,
• Post menopause – this is the phase of your life that happens after you have stopped menstruating.

The levels of estrogen in the postmenopausal period are so low that you may be at a higher risk of developing osteoporosis, your pelvic floor structures might weaken, and you can be at an increased risk of developing cardiac diseases. 

What are the symptoms of menopause?

Every menstruating person can have different menopausal symptoms, and not everyone will experience all of them. However, all of the reported symptoms connected to menopause can be summarized into the following list:

• Changes and irregularities in the menstrual cycle,
• Hot flashes,
• Night sweats,
• Lower libido,
• Mood swings,
• Changes in skin conditions,
• Heart palpitations,
• Vaginal dryness,
• Headaches,
• Hair loss,
• Brain fog and memory loss,
• Anxiety
• Confidence loss.

Does menopause ever end?

Once menopause has occurred and you haven’t menstruated for at least 12 months, there is no going back to active menstruation. Symptoms will fade and your body will get used to the new hormone levels, so the "change" phase of menopause will eventually end.

It is important to understand the importance of menopause in our society. Since the population is growing, and the average life span is increasing, the number of menopausal women is growing. In 2021, the percentage of women aged 50 and older among all women on the planet was 26%, which increased from 22%, recorded in 2011. (WHO)

The more we learn about the experiences and symptoms of menopause, the better we will learn to handle it more safely and without the risk of developing post-menopausal health issues. Currently, it is almost impossible to predict when someone will go through menopause, but we know it can depend on body composition, overall health status, as well as sociological factors like family and culture. 

Treating symptoms of menopause 

The often uncomfortable symptoms of menopause can be aided with various foods, plant preparations like teas and extracts, dietary supplements, and/or hormone replacement therapy. 

Hormone replacement therapy

As menopause occurs due to a natural decrease in estrogen levels, hormone replacement therapy during that period focuses on replacing estrogen through medication. It often helps with the most prominent symptoms like hot flashes and loss of bone density, but there are some drawbacks to this approach. 

Estrogen can be replenished in many ways, which can be categorized into two types:

• Systemic therapy - high concentration of estrogen given through pills, patches, gels, sprays, and creams,
• Low-dose vaginal therapy - lower doses of estrogen found in similar forms like pills and creams and can effectively treat only vaginal symptoms of menopause. 

However, as with any unnatural intake of hormones, one has to be careful with balancing the doses, body weight, stage of menopause, etc. The first problem that can arise is the loss of balance between estrogen and progesterone. If you only take estrogen and progesterone levels remain low, estrogen could overstimulate the growth of our uterine tissue and cause cancer. That's why most treatments contain both estrogen and some form of progesterone at the same time. 

Further on, there is an increased risk of developing:

• breast cancer,
• blood clots,
• cardiovascular diseases. 

That's why it's really important to take this type of therapy only after consulting your doctor and thoroughly considering your age, family health history and symptoms. Those who entered perimenopause rather early, before they turned 45, might especially benefit from estrogen replacement therapy. 

Natural supplements for menopause

The so-called "natural" aids for menopause can be foods, vitamins, or supplements that can help alleviate some of the uncomfortable symptoms of the menopausal transition. 

Foods that help with menopause naturally

Careful food choices and a balanced diet can help you keep your symptoms under control, or at least help temporarily. Most of the foods here will be ones connected to keeping your:

• bones strong,
• gut healthy,
• mood up. 

Therefore, the foods you can add to your diet are:

• Fish - several scientific studies found that women who ate two portions of fish every week (especially tuna and salmon) experienced significantly fewer hot flashes than the ones who didn't eat any fish. It might be because of high concentrations of vitamin B6 and omega-3 fatty acids (2),
• Milk and fermented dietary products - yogurt, kefir, or acidophil milk have plenty of gut-healthy bacteria that will keep your digestion under control and replenish your calcium intake at the same time, 
• Soy - some plants like soy contain a lot of phytoestrogens, which are plant versions of the hormone estrogen. A higher intake of soy was found to lower the number of hot flashes experienced by menopausal women (3, 4). One of the other popular foods that contain phytoestrogen is yams. 

Try drinking a lot of water instead of sugary drinks, and eat plenty of green vegetables and grains during this period. Try to keep your caloric intake under control too. These pointers might help you keep your weight gain under control and reduce the risks of developing type II diabetes or a heart condition.

Try to lower your intake of alcohol, high-salt foods, and spicy foods. All of these were found to increase the incidence of menopausal symptoms, mainly hot flashes (5).

You can also take supplements with high concentrations of active compounds to help you aid symptoms more precisely. 

Best supplements for menopause

Supplements can be very helpful with symptoms of menopause, mainly because they are formulated to contain high amounts of active compounds.

However, one should not rely only on supplements to remain healthy, whether before or during the menopausal period. The focus should remain on healthy eating, exercising, and sleeping enough, and supplements should only help additionally. 

Calcium

One of the most important supplements for the menopausal period is calcium. As estrogen levels deplete from the organism, calcium concentrations also get lower. Calcium is very important for bone health and osteoporosis usually develops in women after they enter menopause. 

While it's best to take calcium through food, calcium supplements are more than welcome to replenish your levels. The recommended intake would be no more than 500 mg a day. 

Vitamin D

Another supplement related to bone health, along with the mineral calcium, is vitamin D. It is critical for the absorption of calcium, and those two always go together. 

The best way to maintain adequate amounts of vitamin D in the body is to take it in through food and get plenty of sunshine. Don't take more than 2000 IU (international units of activity) a day. 

Flaxseed

Flaxseed seeds are naturally rich in omega-3 fatty acids and fibers, as well as phytocompounds like lignins and phytoestrogen. It was claimed that flaxseed supplements can help aid menopausal symptoms, especially hot flashes. 

Research shows ground flaxseed supplementation can significantly improve life during the menopausal period, and some studies showed:

• ground flaxseed extract was effective as hormone replacement therapy in menopausal women (6),
• flaxseed extract significantly decreased menopausal symptoms and increased the quality of life (7),
• flaxseed supplementation significantly decreased the occurrence of hot flashes (8).

Doses of flaxseed extract commonly used in those studies are 1 gram per day. Taking flaxseed, especially in higher amounts, can cause bloating, diarrhea, and gas. 

Black cohosh

Black cohosh is the name for the root of a plant named Cimicifuga racemosa L. Other names for this plant are black bugbane, black snakeroot, rattle-top, or fairy candle. Indigenous people of North America have been using it for centuries for menstrual and menopausal pains, and it is also traditionally used in Chinese medicine to treat arthritis and muscle pain. In the Western world today, it is mostly used to treat symptoms of menopause.

Black cohosh extracts and formulations that contain it are claimed to decrease the impact of menopausal symptoms. So far, the scientific evidence seems to support that claim and multiple studies have confirmed it, especially for reducing hot flashes (9). 

The base of this effect is a phytochemical contained in black cohosh which acts similar to serotonin and can regulate body temperature. However, it seems not every black cohosh root has this molecule.

Typical doses of black cohosh are from 40 to 128 mg daily, usually taken through capsules or tinctures. Black cohosh supplements can cause some side effects, such as:

• headache,
• nausea,
• cramping,
• vaginal spotting. 

Taking black cohosh supplements for longer than a year might cause some liver issues, and people with breast cancer should not take it. 

Which supplements not to take for menopause?

While some supplements are shown to be effective in menopause, some are not proven efficient and can even be dangerous, like:

• Soy - while you can eat soy and soy products, taking soy supplements can be dangerous for our health. Soy contains a lot of phytoestrogens, and supplements contain it in high amounts, which become like an uncontrolled hormone in your body. 
• Primrose oil - many claim this oil can ease hot flashes, but it causes diarrhea, nausea, and blood clots without any health benefits being scientifically proven. 

 In any case, consult your doctor before taking any supplements. 

 

Literature:

1. Menopause. (2022) WHO. 
2. T. Odai, M. Terauchi, A. Hirose, K. Kato, M. Akiyoshi & N. Miyasaka (2019) Severity of hot flushes is inversely associated with dietary intake of vitamin B₆ and oily fish, Climacteric, 22:6, 617-621, DOI: 10.1080/13697137.2019.1609440
3. Chen MN, Lin CC, Liu CF. Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric. 2015 Apr;18(2):260-9. doi: 10.3109/13697137.2014.966241.
4. Chen MN, Lin CC, Liu CF. Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric. 2015 Apr;18(2):260-9. doi: 10.3109/13697137.2014.966241. 
5. Archer DF, Sturdee DW, Baber R, de Villiers TJ, Pines A, Freedman RR, Gompel A, Hickey M, Hunter MS, Lobo RA, Lumsden MA, MacLennan AH, Maki P, Palacios S, Shah D, Villaseca P, Warren M. Menopausal hot flushes and night sweats: where are we now? Climacteric. 2011 Oct;14(5):515-28. doi: 10.3109/13697137.2011.608596
6. Colli MC, Bracht A, Soares AA, de Oliveira AL, Bôer CG, de Souza CG, Peralta RM. Evaluation of the efficacy of flaxseed meal and flaxseed extract in reducing menopausal symptoms. J Med Food. 2012 Sep;15(9):840-5. doi: 10.1089/jmf.2011.0228.
7. Cetisli NE, Saruhan A, Kivcak B. The effects of flaxseed on menopausal symptoms and quality of life. Holist Nurs Pract. 2015 May-Jun;29(3):151-7. doi: 10.1097/HNP.0000000000000085.
8. Ghazanfarpour M, Sadeghi R, Latifnejad Roudsari R, Khadivzadeh T, Khorsand I, Afiat M, Esmaeilizadeh M. Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis. Avicenna J Phytomed. 2016 May-Jun;6(3):273-83. PMID: 27462550.
9. Mehrpooya M, Rabiee S, Larki-Harchegani A, Fallahian AM, Moradi A, Ataei S, Javad MT. A comparative study on the effect of "black cohosh" and "evening primrose oil" on menopausal hot flashes. J Educ Health Promot. 2018 Mar 1;7:36. doi: 10.4103/jehp.jehp_81_17.