Are the hormones in HRT enough for all your midlife health needs, or are any supplements advised?

The growth of menopause supplements seems at an all-time high, due to a combination of greater awareness of menopause and its symptoms, and perhaps an increased focus on living longer, healthier lives through diet and exercise. 

The new year – and possibly the algorithm’s assumption about resolution-making in January – appears to trigger a bombardment in our social media feeds showcasing all kinds of promises relating to losing weight, keeping fit and staying healthy, in which supplements are often highlighted.

As you know, at Health in Menopause, our focus is on evidence-based care and personalised guidance through your perimenopause and beyond. It will never be on selling you the latest overpriced potion or pill. It is of course, worth highlighting that in most cases, supplements are not as good as getting the nutrients we need from a healthy diet and they’re also not a substitute for HRT, which remains the most effective and well-studied treatment for perimenopause and menopause symptoms.

In this blog, we highlight some useful science backed supplements to consider alongside your HRT, we’ll mention other options worth trying, and outline those that the evidence (or lack of) suggests are best ignored.

The non-negotiable essential supplement

As mentioned, we all have individual vulnerabilities; some people have a greater need for certain supplements than others, and some supplements really benefit some women but not others.

There is however one supplement that we all need without exception.

Vitamin D (AKA the sunshine hormone!)

Any menopause clinician will recommend this as there is very good evidence to show vitamin D is key for good bone heath: improving bone strength and reducing the risk of fracture, as well as multiple other benefits related to immune health, mood, sleep and metabolism.

Vitamin D and calcium are often mentioned together because vitamin D helps your body absorb calcium and get it where it needs to be to build strength and density in the bones.

Most women get enough calcium from their diet, but if you’re vegan or follow a dairy-free diet you may want to calculate your calcium intake in more detail to see if you need to supplement it. You can do this Osteoporosis Foundation calcium calculator. 

Recommended:

For women over 50 years or anyone in postmenopause, or if you have a greater risk of osteoporosis (bone weakness), you may wish to take up to 1200mg of calcium per day. Before you’re 50 years, 700mg may be sufficient.

Vitamin D should be taken all year round in the UK as it’s hard to get enough of it from sun exposure alone. NHS guidance advises that adults need 10mcg (400IU) per day; however, we would usually advise women in and beyond menopause transition to take around 20-25mcg (800-1000IU) daily. And sometimes in specific circumstances we may advise higher still. It is important to get advice from a health professional if you wish to take higher doses of vitamin D, as too much can cause vitamin D toxicity and a build-up of calcium in the blood.

It is also usually better to combine vitamin D3 with vitamin K2, but this should be discussed with your clinician as it is not suitable for all.

Read more about keeping your bones strong and healthy our bone health guide.

Supplements definitely worth considering…

Magnesium

There are several reasons why we often recommend taking magnesium in the menopause transition as it is involved in a very long list of biological processes. It is known to activate the parasympathetic nervous system, which is responsible for making you feel calm and relaxed and it also regulates the hormone melatonin, which guides your body clock so can be beneficial to help sleep. Magnesium also helps your body absorb calcium, which as we have said, is needed for strong bones.

There are different types of magnesium that are often branded for different benefits such as sleep, constipation or muscle aches.

Magnesium glycinate is the primary one suggested for menopause transition and as an aid for sleep, anxiety, and muscle relaxation‍.

Recommended:

NHS guidelines recommend women up to 64 years should aim for 270mg of magnesium a day.

Magnesium supplements come in many different forms such as powder, capsule, tablet, liquid, gummy, creams or even Epsom Bath Salts. It’s often down to personal preference but make sure you use good quality products from reputable sources and consider the bioavailability of the type you are taking, e.g. how easily your body will it absorb it.

If you are having problems with sleep, as well as trying magnesium, take a look at our guide our sleep guide.

Vitamin B

B vitamins play a useful role in our health at all times and even more so during the menopause transition: supporting energy production, cell repair, helping to reduce fatigue, and supporting brain function, mood and heart health, to name but a few. The most helpful subtypes at menopause are vitamins B6, B9 (folate) and B12 but all the B vitamins play a crucial role. 

Omega 3

Omega 3 fatty acids support heart health at menopause by helping to reduce inflammation and maintain healthy cholesterol levels as estrogen declines in the body. Omega 3 also supports mood.

You can read more about heart health and reducing your risk of cardiovascular disease our heart health guide.

Zinc

Zinc supports immune function and skin health, which can be a concern at menopause. It also plays a role in hormone metabolism and cognitive function, potentially helping to support mood and memory.

What about our diet?

Good question! Here is Dr Sarah Ball with the answer:

“Ideally all of our essential vitamins and minerals (with the exception of vitamin D) would come from our diet. However, we are all at increasing risk of deficiencies due to multiple factors such as modern farming practices and increased stress. The menopause is also a time at which our requirements for multiple nutrients (e.g. those listed above) does increase. Using a selected number of supplements can support our whole health and better support the actions of any HRT we may choose to use at this time.

During your consultation we can discuss your diet in general and any supplements we might suggest, either as individual products or sometimes a supplement that contains multiple vitamins/minerals e.g. a methylated multi-nutrient is sometimes a good option to consider as it contains the recommended amounts of these key nutrients in a bioavailable form in one product.”

Others we might recommend for some people

• Turmeric: good for liver support and joints 
• Creatine for muscle strength, and brain fog
• Valerian, L-theanine, saffron, and holy basil may help with low mood and anxiety
• Berberine, cinnamon, myoinositol may bring metabolic benefits as part of a weight loss programme

Supplements that have little to no evidence base

Phytoestrogens

Supplements containing plant-derived compounds called phytoestrogens are often advertised for menopause. The small amount of estrogen contained in these is not the same as the estrogen we produce in our bodies.

There have been some studies that suggest Black cohosh can benefit hot flushes however other studies have shown varied results or no benefit at all with taking Black cohosh and this has been linked with a risk of liver toxicity.

If you’re experiencing hot flashes, night sweats or palpitations, you can read more advice our hot flushes guide.

Other supplements containing phytoestrogens such as Soy, Isoflavones, or Red Clover do not have clear evidence that they improve menopause symptoms. While there is a lack of strong evidence, some people choose to take these if they feel they cannot or don’t wish to take HRT.

Other ‘menopause’ supplements and remedies

Often branded and marketed to help in menopause but with conflicting evidence to back up their claims, the following products persist in this space due to anecdotal reviews (including good old placebo effect), attractive marketing and packaging and celebrity endorsement. But some carry risks or interact with other medications, so caution is advised. However, for some individuals any particular supplement may be beneficial.

Examples:

• evening primrose oil
• chasteberry
• ginseng
• dong quai
• ashwagandha
• maca root
• lion’s mane mushroom

What about ‘All-In-One’ menopause formulas?

You may have seen adverts featuring combination products with several ingredients in one powder, or capsule. These can appear to provide a convenient, cost-effective option but if the marketing is making grand promises and claims to cure every possible menopause symptom, it is best to be sceptical. If the nutrient list is overly long, this can dilute dosages. Most products are unregulated and don’t list ingredient amounts or dose levels. The reality is that most marketed menopause supplements have no scientific basis for such claims.

Nutrigenomic testing

Our clinicians, Alice, Sarah and Lindsey have all completed training in nutrigenomic testing.

Dr Sarah Ball explains more:

“Nutrigenomic testing is essentially looking at an individual’s DNA to learn their specific genetic vulnerabilities. By understanding which genes could benefit from lifestyle modifications, especially dietary, any deficiencies or vulnerabilities can be targeted, and this can inform the personalised advice we offer in clinic. We all favour a ‘food first’ approach when advising women but often supplements are very helpful to adjust a deficiency more rapidly and sometimes for longer term maintenance.”

If you are interested in nutrigenomic testing, speak with one of our clinicians for more information. Whilst we do not directly offer this service, we can explain what it involves, how it might support you as an individual and signpost you to a trusted provider of this service. 

Dr Sarah Ball joined an Instagram live with Fiona Clarke (@fiona_clarke_writes) this month and from about half way through, you can hear her thoughts on supplements at menopause.

Wrapping up

So, what’s the best strategy for most when it comes to deciding about supplements? Focus on good nutrition, take vitamin D, and consider magnesium, vitamin B, Omega 3 and zinc. Remember to exercise regularly, stay on top of your stress levels and try and get good quality sleep. Seek personalised advice from our clinicians that is tailored to your symptoms if you wish. 

And remember, if something sounds too good to be true…it probably is.

Last updated: May 2026