Menopause supplements
what’s worth $30/month and what isn’t.

• Vitamin D3 + K2, 1,000–2,000 IU/day. The standard RDA of 600–800 IU/day under-shoots most peri women, especially through the winter months. Test 25-hydroxy vitamin D once; if you’re below 50 nmol/L, take 2,000 IU/day for three months and re-test. K2 helps direct calcium into bone rather than arteries.
• Omega-3 EPA/DHA, 1–2 g/day combined. If you eat oily fish (salmon, mackerel, sardines, herring) twice weekly, you may not need this. If not, supplement. Look for products with the IFOS or Friend of the Sea certification, these test for heavy metals and oxidation. Vegan alternative: algal DHA + EPA.
• Magnesium glycinate, 200–400 mg at night. For sleep, anxiety, muscle cramps, insulin sensitivity. Roughly half of adults fall below the recommended intake from food alone. Avoid magnesium oxide (poorly absorbed, mostly a laxative).
• Creatine monohydrate, 3–5 g/day. The evidence base for women 40+ has firmed up: muscle, strength, bone, mood, and emerging cognitive data. Look for the Creapure mark, the German source most studied. About $15–20 a month.

Done well, this stack is around $25–35/month total.

• B12 + folate if your blood test shows low or low-normal levels. Vegetarians, vegans, anyone on metformin or PPIs, and anyone over 60 should test annually.
• Ashwagandha (KSM-66), 300–600 mg/day if cortisol, stress and sleep onset are your dominant symptoms. Avoid in hyperthyroidism. Cycle off every 3 months.
• Psyllium husk, 6–15 g/day if you don’t hit 25 g of fiber from food. Cholesterol, blood sugar, gut health. Cheap and effective.
• Iron + ferritin retest if you have heavy peri periods or a vegetarian diet. Many women are running on empty here and call it “menopause fatigue”. Test before supplementing.
• Collagen peptides (Verisol, Fortibone), modest evidence for skin elasticity (Verisol) and bone density (Fortibone, 5 g for 4 years in one study). Optional.

• Black cohosh, meta-analyses do not show a meaningful effect over placebo for hot flashes. Product testing has found roughly a quarter of products don’t contain the labeled herb. Rare but real hepatotoxicity reports.
• Evening primrose oil, no consistent evidence for any menopause symptom. Modest evidence only for cyclical breast pain.
• Soy isoflavone extracts, if your diet is genuinely low in soy and you tolerate it, food sources (tempeh, edamame, miso) may have modest effects. Concentrated extracts marketed as “natural HRT” have not delivered in rigorous trials.
• “Natural progesterone” yam creams sold online, wild yam doesn’t convert to progesterone in the human body, despite the marketing. If a topical product genuinely contains progesterone and you’re also using estrogen, you risk endometrial cancer because topical progesterone doesn’t protect the uterus reliably. This is a hard rule.
• Compounded “bio-identical” hormones sold privately (lozenges, troches, pellets, custom creams), not the same as the body-identical HRT prescribed by a doctor or menopause clinic. FDA testing has found doses up to 200% above label. Stick to FDA-approved products via prescription.
• Multivitamins, for women without malabsorption, the evidence shows no benefit and some risk (high vitamin A and certain B-vitamin combinations have been associated with worse bone outcomes). Target deficiencies, don’t shotgun.
• High-dose vitamin E (≥400 IU), associated with higher all-cause mortality in meta-analyses. The marginal hot flash benefit isn’t worth it.
• Green tea extract at supplement doses, linked to liver injury (drinking green tea is fine; concentrated extracts are not).
• DUTCH test, salivary hormone panels, sold to justify supplement bundles. Not clinically useful in menopause management. The consensus across menopause specialists is the same here.

• NSF Certified for Sport / USP Verified, third-party batch tested for contamination and labeled-dose accuracy. Originally for athletes, useful for all of us.
• IFOS or Friend of the Sea, for fish oil purity (heavy metals, PCBs, oxidation).
• Creapure, the gold-standard creatine source.
• GMP-certified manufacture, minimum standard.

Brands to be cautious with: any MLM-style supplement (Forever Living, Arbonne, Juice Plus, Itworks, Plexus, etc.), the business model selects for hype over evidence. Anything sold by influencers on commission. Anything that arrives in a $79/month subscription box you forgot to cancel.

• Vitamin D and omega-3 with the largest meal of the day (fat-soluble, absorption matters).
• Magnesium glycinate 30–60 minutes before bed.
• Creatine any time, with water, daily, there’s no need for a “loading phase” for women 40+.
• B12 in the morning.
• Iron on an empty stomach with vitamin C, not with calcium or coffee.

Always check interactions if you’re on prescription medication, particularly St John’s wort (interacts with antidepressants, anticoagulants, the contraceptive pill, and many cancer drugs) and vitamin K supplements (interact with warfarin).