Perimenopause Supplements, What the Evidence Shows

Last updated 28 October 2026

Perimenopause rarely arrives as one big change. It tends to show up as a list of small ones, broken sleep, new aches, a shorter fuse, and a nagging sense that your body is working to different rules.

Perimenopause supplements are vitamins, minerals and plant extracts taken to support the body through the years before periods stop. The evidence is mixed. A few nutrients have authorised roles, several herbal remedies have been studied for hot flushes with small or inconsistent results, and none replaces hormone therapy, which remains the most effective treatment for hot flushes and night sweats (NAMS, 2023).

That is worth knowing before you fill a basket. This guide covers what the main perimenopause supplements are, what the research does and does not show, the safety points that matter, and the foundations that do the heavy lifting.

Key takeaways

• Hormone therapy is the most effective treatment for hot flushes and night sweats. A major 2023 review of non-hormone options did not recommend supplements or herbal remedies for them (NAMS, 2023).
• Some nutrients have authorised roles, such as vitamin D for normal bones and vitamin B6 for the regulation of hormonal activity (Great Britain NHC Register). Plant extracts such as black cohosh and red clover have mixed or weak evidence.
• Strength training, sleep, food and a conversation with your GP come first. Supplements can only sit alongside them.

Why perimenopause is a longevity issue

Perimenopause is not only about the symptoms you feel this year. It is also a turning point for the decades that follow. Falling oestrogen affects bone, muscle, the heart and the way the body handles inflammation, which is why NICE asks doctors to explain the importance of keeping muscle mass and strength through physical activity at this stage of life (NICE NG23).

The transition usually happens between 45 and 55, but it can start earlier (NHS). Those are the years when the habits that protect healthspan start to matter most. Not how long you live, but how many of those years you spend strong, capable and independent.

Inflammation is part of that story. Dr. Tom Maden-Wilkinson explains the research in our guide to menopause and inflammation, and why it sits at the centre of the five systems that shape how well we age.

What are perimenopause supplements?

The shelf is crowded, but most products fall into three groups.

• Vitamins and minerals. Vitamin D, B vitamins, magnesium, zinc and others. Some have authorised health claims in Great Britain.
• Plant extracts. Black cohosh, red clover, soy isoflavones and sage are the most common. They are usually sold for hot flushes and night sweats.
• Other compounds. Omega-3 fish oils, creatine, curcumin and PEA, which researchers have looked at for different reasons.

Many products combine several of these in one capsule. That makes it harder to know which ingredient, if any, is doing anything, and it makes the dose of each one worth checking.

Do perimenopause supplements work?

For hot flushes and night sweats, the honest answer is not very well. In 2023, The North American Menopause Society reviewed every non-hormone option. It recommended cognitive behavioural therapy, clinical hypnosis and some prescription medicines, and it did not recommend supplements or herbal remedies for these symptoms. It also concluded that hormone therapy remains the most effective treatment (NAMS, 2023).

UK guidance is a little more open. NICE says there is some evidence that isoflavones or black cohosh may relieve hot flushes. It also says many preparations exist, their safety is uncertain, they vary from one product to the next, and interactions with other medicines have been reported (NICE NG23).

That does not mean every supplement is pointless. It means the useful ones are mostly about filling gaps and supporting long-term health, not switching off symptoms.

The evidence, supplement by supplement

Here is what research has found for the supplements you are most likely to see. AEVUM wrote this guide, so we have tried to be fair to every ingredient, including the many we do not use.

Notice the pattern. The strongest entries are the dull ones, vitamin D and the B vitamins, with roles that are well established. The exciting-sounding ones have small trials, mixed results or no trials in perimenopause at all.

Vitamins and minerals with authorised roles

If you want certainty, start here. In Great Britain, only nutrients that have been assessed can carry a health claim, and the wording is fixed (Great Britain NHC Register). A few are relevant to this stage of life.

• Vitamin D contributes to the maintenance of normal bones and normal muscle function.
• Vitamin B6 contributes to the regulation of hormonal activity.
• Vitamin B1 (thiamine) contributes to normal psychological function.
• Vitamin C contributes to the reduction of tiredness and fatigue.
• Zinc contributes to normal cognitive function.

These are roles in the body, not treatments for menopause symptoms. Most people can get much of what they need from food. Vitamin D is the exception in a UK winter, which is why the NHS advises everyone to consider a daily supplement then (NHS).

Herbal remedies, black cohosh, red clover and sage

These are the products most often sold for perimenopause, and the evidence is the weakest. A Cochrane review of black cohosh found no significant difference from placebo for hot flushes, and the authors said evidence on its safety was inconclusive (Leach and Moore, 2012). A Cochrane review of phytoestrogens, which includes red clover and soy, found no conclusive evidence that they reduce hot flushes, although extracts high in genistein looked more promising in a few trials (Lethaby et al., 2013).

NICE also asks doctors to explain that the safety, quality and purity of unregulated preparations may be unknown (NICE NG23). If you have a personal history of breast cancer, or a high risk of it, speak to your doctor before trying any of them. NICE specifically flags serious interactions between St John's wort and medicines including tamoxifen, anticoagulants and anticonvulsants (NICE NG23).

What helps most in perimenopause

Foundations first. Supplements second. The options with the strongest evidence are not in a capsule.

• Talk to your GP about hormone therapy. It is the most effective treatment for hot flushes and night sweats, and should be considered within 10 years of the final period for women who are good candidates (NAMS, 2023).
• Cognitive behavioural therapy. Recommended for hot flushes in the 2023 review (NAMS, 2023).
• Strength training. Muscle and bone are the infrastructure of later life. NICE asks doctors to explain the importance of keeping muscle mass and strength through physical activity (NICE NG23). Our guide to joint health covers how to load joints safely.
• Sleep and food. A steady sleep routine and a diet rich in vegetables, oily fish and fibre support everything else, including the inflammatory balance Tom covers in menopause and inflammation.

How to choose a perimenopause supplement

If you decide to try one, these checks will save you money.

• Named ingredients and doses. Every active ingredient should be listed with an amount per serving.
• Claims that match the rules. Be wary of products that promise to balance hormones, stop hot flushes or replace HRT. Food supplements cannot legally make those claims.
• One change at a time. If you add several products at once, you will not know which one helped, or which one caused a problem.
• Medicines first. Check with a pharmacist if you take any prescription medicine, especially blood thinners or treatment after breast cancer.
• Realistic expectations. Trials have mostly run for weeks to months, and many found small or no differences.

Where Daily Vitals fits in

Daily Vitals is not a menopause supplement, and it does not claim to treat any symptom. It contains no hormones and no phytoestrogens. Daily Vitals is a daily longevity formula with ten ingredients, and it sits alongside the foundations above.

What we can say is that vitamin C contributes to the reduction of tiredness and fatigue, vitamin B1 contributes to normal psychological function, and zinc contributes to normal cognitive function (Great Britain NHC Register). Because it contains curcumin, Daily Vitals is not suitable if you are trying to conceive, pregnant or breastfeeding. You can see every ingredient on our ingredients page. Feel better now. Age better later.

Safety and when to speak to your GP

See your GP if your periods change in a way that worries you, if you bleed after sex or between periods, or if symptoms are affecting your work, sleep or mood. Perimenopause is common, but it is worth ruling out other causes, and there is effective treatment.

Speak to your GP or pharmacist before starting any new supplement if you take prescription medicines, or have had breast cancer or are at high risk of it. Do the same if you are trying to conceive, pregnant or breastfeeding, are due to have surgery, or have a medical condition. Some ingredients can interact with medicines, including blood thinners and tamoxifen. Always follow the dose on the label, and remember that a food supplement should not replace a varied diet or medical advice.

Frequently asked questions

What supplements are good for perimenopause?

Vitamin D is advised for everyone in a UK autumn and winter (NHS), and vitamins such as B6, B1, C and zinc have authorised roles in the body (Great Britain NHC Register). Herbal remedies such as black cohosh and red clover have mixed or weak evidence for hot flushes.

Do perimenopause supplements actually work?

For hot flushes and night sweats, the evidence is weak. A 2023 review of non-hormone treatments did not recommend supplements or herbal remedies for them (NAMS, 2023). Some nutrients support normal body functions, which is different from treating symptoms.

Can supplements replace HRT?

No. Hormone therapy remains the most effective treatment for hot flushes and night sweats (NAMS, 2023). Speak to your GP about whether it is right for you.

Is black cohosh safe?

A Cochrane review found no clear benefit over placebo for hot flushes and said the evidence on safety was inconclusive (Leach and Moore, 2012). NICE notes that the safety of these preparations is uncertain and that interactions with medicines have been reported (NICE NG23). Speak to your GP or pharmacist first.

Should I take vitamin D in perimenopause?

The NHS advises everyone to consider 10 micrograms of vitamin D a day in autumn and winter, and some people all year round (NHS). Vitamin D contributes to the maintenance of normal bones (Great Britain NHC Register).

When does perimenopause start?

Menopause usually affects women between 45 and 55, but it can happen earlier (NHS). Perimenopause is the stage before periods stop, and symptoms can begin several years before.

Keep reading
Menopause and inflammation, when menopause turns up the volume
Joint supplements and longevity, what the evidence shows
CRP blood test and longevity, what inflammation markers show

References

Farshbaf-Khalili, A. et al. (2022). Clinical efficacy of curcumin and vitamin E on inflammatory-oxidative stress biomarkers and primary symptoms of menopause in healthy postmenopausal women, a triple-blind randomized controlled trial. Journal of Nutrition and Metabolism, 6339715. doi.org

Great Britain Nutrition and Health Claims (NHC) Register. Department of Health and Social Care. gov.uk

Leach, M.J. and Moore, V. (2012). Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database of Systematic Reviews, CD007244. doi.org

Lethaby, A. et al. (2013). Phytoestrogens for menopausal vasomotor symptoms. Cochrane Database of Systematic Reviews, CD001395. doi.org

Mah, J. and Pitre, T. (2021). Oral magnesium supplementation for insomnia in older adults, a systematic review and meta-analysis. BMC Complementary Medicine and Therapies, 21(1), 125. doi.org

Medoro, A. et al. (2024). Palmitoylethanolamide in postmenopausal metabolic syndrome, current evidence and clinical perspectives. Nutrients, 16(24), 4313. doi.org

Mohammady, M. et al. (2018). Effect of omega-3 supplements on vasomotor symptoms in menopausal women, a systematic review and meta-analysis. European Journal of Obstetrics, Gynecology and Reproductive Biology, 228, 295–302. doi.org

NAMS (2023). The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause, 30(6), 573–590. doi.org

NHS. Menopause and perimenopause. nhs.uk

NHS. Vitamin D. nhs.uk

NICE (2015, updated 2026). Menopause, identification and management (NG23). nice.org.uk

Smith-Ryan, A.E. et al. (2021). Creatine supplementation in women's health, a lifespan perspective. Nutrients, 13(3), 877. doi.org