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The Herbs & Supplements Most Women Need During Perimenopause

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.
Image by Sarah FitzGerald / Stocksy + iStock
Last updated on April 29, 2022

In perimenopause (aka the transitional period into menopause), the ovaries begin to decline, leading to lower hormone levels and the symptoms that come with them.

Specifically, low estrogen can lead to poor memory and concentration, vaginal dryness, hot flashes, night sweats, and fertility struggles.

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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.

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. And interestingly, my recommendations for women going through perimenopause are similar to what I would tell a woman in her 20s experiencing PMS, or even a man with low sperm count or low testosterone.

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. Here's where to start:

1-2. Manage stress with magnesium and L-theanine*

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.

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 better sleep.*

Severe deficiency can lead to anxiety, panic attacks, depression, and muscle cramps. Look for an amino acid chelated form like magnesium glycinate, which has superior absorption.*

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.*

Summary

Research shows that supplementing with magnesium can help manage stress and promote relaxation for better sleep.*
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3-4. Correct deficiencies by supplementing with vitamin D and fish oil*

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.

Identifying any specific deficiencies can help you create a targeted supplement routine. Even without running a test, however, it's safe to assume you may need a few specific nutrients that many women are frequently deficient in.

Omega-3s, zinc, selenium, magnesium, and vitamin D are common ones that are also critical for hormone health—so you'll want to address deficiencies before you enter perimenopause.

The good news is that taking a high-quality capsule multivitamin, omega-3-rich fish oil, and extra vitamin D may be just what you need to cover your bases.

Summary

Taking a high-quality capsule multivitamin, omega-3-rich fish oil, and extra vitamin D can help with any deficiencies before you enter perimenopause.*
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5-6. Try adaptogenic herbs like rhodiola and ashwaganda

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.*

If the patient is reporting high amounts of stress, I may recommend adaptogenic herbs like Eleutherococcus senticosus, schisandra, and ashwagandha.*

Rhodiola rosea can help support the nervous system, 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.*

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.

Remember: Perimenopause doesn't have to be as tough as many of us assume it'll be. It's all about knowing what you can do to help your body through this transition.

By reducing stress, working to detox the body through healthier lifestyle choices, and correcting nutritional deficiencies, I have seen countless women overcome their perimenopausal symptoms.

Summary

Specific herbs can help support normal hormone levels.* Adaptogenic herbs like Eleutherococcus senticosus and ashwagandha can help manage stress.* Rhodiola rosea can help support the nervous system, mood, mental clarity, and a healthy sleep cycle.*
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
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.