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The Herbs & Supplements Most Women Need During Perimenopause

Stephanie Gray, DNP, M.S., ARNP
Author: Expert reviewer:
Updated on August 17, 2023
Stephanie Gray, DNP, M.S., ARNP
Functional Medicine Provider
By Stephanie Gray, DNP, M.S., ARNP
Functional Medicine Provider
Stephanie Gray, DNP, M.S., ARNP, ANP-C, GNP-C, ABAAHP, FAARFM, is a functional medicine provider and Amazon bestselling author of Your Longevity Blueprint. She co-owns the Integrative Health and Hormone Clinic in Hiawatha, Iowa.
Molly Knudsen, M.S., RDN
Expert review by
Molly Knudsen, M.S., RDN
Registered Dietitian Nutritionist
Molly Knudsen, M.S., RDN is a Registered Dietician Nutritionist with a bachelor’s degree in nutrition from Texas Christian University and a master’s in nutrition interventions, communication, and behavior change from Tufts University. She lives in Newport Beach, California, and enjoys connecting people to the food they eat and how it influences health and wellbeing.
August 17, 2023

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.

Tackling this issue means making big changes like learning to set healthy boundaries and leaving a toxic relationship or a work environment. It also requires daily practice, which is where meditation, yoga, deep breathing, resting, and allowing time for mental downtime come in.

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.


Research shows that supplementing with magnesium can help manage stress and promote relaxation for better sleep.*


L-theanine is also an amino acid, often found in the leaves of green tea, that converts to GABA in the brain. This means it supports the central nervous system, promoting a relaxed state.* Supplementing with L-theanine may help calm anxiousnesspromote restful sleep, and bolster overall mood.

This compound is found naturally in green tea (and matcha) as well as nootropic (brain-supporting) supplements.


L-theanine supplementation may help calm feelings of anxiousness.

Vitamin D

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.

Vitamin D is a key biomarker we look at for bone health. It plays a key role in absorbing calcium and growth. And low estrogen levels after perimenopause are linked to increased bone loss1.

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).


Maintaining optimal vitamin D levels in perimenopause and beyond is essential for bone health, which can be challenging to do without a supplement.

Fish oil

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.

The EPA and DHA in fish oil are essential for a healthy heart. Menopause is also linked to heart concerns down the road. In addition to following a heart-healthy diet and getting enough physical activity, taking a fish oil supplement can help support healthy levels of cholesterol and triglycerides.


Fish oil supplements offer a concentrated source of EPA and DHA omega-3 fatty acids to support heart health.


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.*

Rhodiola rosea (the name of the flowering plant) can help support the nervous system4, mood, mental clarity, work performance, and a healthy sleep cycle.

It can also help to support normal levels of neurotransmitters such as serotonin, dopamine, and norepinephrine, which are important for mental health.


Rhodiola rosea can help support the nervous system, mood, mental clarity, and a healthy sleep cycle.*


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.


Adaptogenic herbs like ashwagandha can help manage stress, especially for women in perimenopause who tend to have higher stress levels to begin with.

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.

The takeaway

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.

If you are pregnant, breastfeeding, or taking medications, consult with your doctor before starting a supplement routine. It is always optimal to consult with a health care provider when considering what supplements are right for you.
Stephanie Gray, DNP, M.S., ARNP author page.
Stephanie Gray, DNP, M.S., ARNP
Functional Medicine Provider

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.