There's no doubt about it: The symptoms of perimenopause are no walk in the park. But there is good news!
There's so much we can do to smooth the transition into menopause and reduce symptoms. It all has to do with restoring balance to your body and supporting healthy levels of the most important hormones.
It takes a full lifestyle approach to balance hormones, including dietary changes, exercise, and mindfulness-based stress reduction. On top of that, there are specific herbs and supplements that can help you get there.
Let's dive into what you should know about perimenopause and how herbs and supplements may help.
What is perimenopause?
Perimenopause is the transitional period from a woman's reproductive years to menopause. When it starts and how long this stage lasts varies from woman to woman.
During this time, ovarian function begins to decline, leading to fluctuating and then lower hormone levels and the accompanying symptoms.
Specifically, low estrogen can lead to poor memory and concentration, vaginal dryness, hot flashes, night sweats, and fertility struggles.
Low progesterone can lead to problems sleeping, anxiety, heavy cycles, and fertility struggles; and low testosterone can lead to poor motivation and drive, depression, and low libido and energy.
Supplements for perimenopause
Certain herbs and supplements have been scientifically studied and may help ease menopause-related symptoms, support outcomes impacted by menopause symptoms (like sleep), or promote healthy aging and longevity in general.
Magnesium is the most soothing, calming mineral, and it's thought that it's one of the first nutrients depleted by stress. Magnesium promotes relaxation for deep and restorative sleep.
Sleep disturbances are quite common during perimenopause—impacting 40%-60% of women. So while magnesium doesn't work by magically stopping night sweats, it may help you fall asleep faster, stay asleep longer, and wake up feeling refreshed.
Look for an amino acid chelated form like magnesium glycinate, which has superior absorption.
Stress is the body's biggest hormone hijacker, and there's no pill, potion, or powder that's going to improve your symptoms if you're chronically and severely stressed.
If you're already combating chronic stress by adjusting your habits and lifestyle, there are a few supplements that I recommend to help your body deal with leftover stressors.
This compound is found naturally in green tea (and matcha) as well as nootropic (brain-supporting) supplements.
It's a good idea to have a nutritional analysis run by a functional medicine provider at any age, but it can be especially helpful during perimenopause.
You can get vitamin D through foods and sunshine2, however, it's challenging reach or maintain optimal vitamin D levels without a supplement. If you aren't already on a vitamin D supplement before starting menopause3, now's the time to consider it. (Here's our recommendations for the best vitamin D supplements out there).
Fish oil supplements pack a lot of the omega-3 fatty acids EPA and DHA. Fish oil is the concentrated and purified oil derived from the tissue of oily fish.
In my practice, I often use various herbal formulations to support normal hormone levels.* Herbs can take weeks to months to take full effect, but when you stick it out, they can be very effective.*
It can also help to support normal levels of neurotransmitters such as serotonin, dopamine, and norepinephrine, which are important for mental health.
If the patient is reporting high amounts of stress, I may recommend the adaptogenic herb ashwagandha.
Ashwagandha has been clinically shown to improve stress resilience and actually lower the stress hormone cortisol, which is higher for some women during the menopause transition5.
Other herbs may help depending on a person's hormone levels
If a woman has low estrogen symptoms or we find low estrogen upon testing, I often recommend estrogen-enhancing herbs like red clover, isoflavones, and black cohosh.
To support progesterone, I typically recommend vitex, passionflower, and paeonae. To support testosterone, I recommend use of horny goatweed and tribulus.
This can get complicated, so it's best to work with a trained herbalist or integrative or functional medicine practitioner who can test your hormone levels and make specific recommendations.
Supplements may interact with medications
There's always a possibility that a supplement may interact with a medication you're taking.
If you're receiving menopause hormone therapy or are on any other prescription or over the counter medications (whether that's for sleep, your cholesterol levels, etc.), it's also a good idea to check with healthcare professional to make sure everything you're taking plays nicely with each other.
Everyone has a different perimenopause experience. Some women may have more symptoms than others. And regardless of that, the drastic drop in the hormone estrogen that characterizes menopause is accompanied with other health concerns like bone loss and heart troubles.
And certain supplements can help you navigate this transition. By reducing stress, implementing healthy lifestyle choices, and correcting nutritional deficiencies, I have seen countless women enter the next phase of life with gusto.
Stephanie Gray, (DNP, MS, ARNP, ANP-C, GNP-C, ABAAHP, FAARFM), is a functional medicine provider who helps men and women build sustainable and optimal health and longevity so they can focus on what matters most to them. She has been working as a nurse practitioner since 2009 and completed a doctorate focusing on estrogen metabolism from the University of Iowa in 2011. Gray also has a masters in metabolic nutritional medicine from the University of South Florida’s Medical School. Her expertise lies within integrative, anti-aging, and functional medicine. She is arguably one of the midwest's’ most credentialed female healthcare providers combining many certifications and trainings. She was the first nurse practitioner in the state of Iowa certified through the American Academy of Anti-Aging Medicine’s Board of Anti-Aging Health Practitioners (ABAAHP). She completed their advanced fellowship in Anti-Aging Regenerative and Functional medicine in 2013. She became the first BioTe certified provider in Iowa to administer hormone pellets also in 2013. She continues to stay progressive with the study of natural hormone replacement therapy and nutrigenomic continuing to pursue her extensive education while she practices. This training allows her to provide her patients the most comprehensive care. She is the author of the FNP Mastery App and an author of the book Your Longevity Blueprint. She is co-founder of Your Longevity Blueprint Nutraceuticals with her husband, Eric. They own the Integrative Health and Hormone Clinic in Hiawatha, Iowa.