With so many solutions promising to turn you into a well-rested, calm and blissed-out being, do any menopause supplements actually work or are they a waste of money? Read our guide to the science behind natural menopause supplements, including black cohosh, red clover, evening primrose oil, soy, flax seeds, valerian, bee pollen and devil’s claw.
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Decreasing hormones and menopause symptoms
Have you found yourself scouring the shelves of your local health food store for menopause supplements after struggling with hot flushes, erratic periods, angry outbursts or exhaustion? Desperate for help, you end up searching for the ultimate remedy.
Before we get into supplements for menopause, let’s take a step back and look at what’s happening to your body. Menopause symptoms are caused by decreased levels of the hormone oestrogen. While oestrogen’s main job is to regulate your menstrual cycle, the wide variety and the sheer number of menopause symptoms, from hot flushes to thinning hair, demonstrates how varied its effects are throughout the body.
Read more about the stages of menopause.
HRT is a regulated treatment for menopause symptoms
Hormone replacement therapy (HRT) is prescribed by doctors to treat menopausal symptoms and aims to replace the oestrogen which is no longer produced by your body. This is still the most effective way to reduce menopause symptoms and helps many people access a much-improved quality of life.
Various forms of HRT have been tested on large groups of patients (hundreds of thousands of them) and there is a lot of data on the safety, risks and benefits of using them. They are also produced in regulated laboratories with regular quality control testing, so the amount and quality of ingredients is closely monitored.
However, HRT isn’t for everyone. Your doctor may advise against using it due to certain medical conditions or risk factors. You may decide that your symptoms aren’t severe enough to warrant the possible, generally small, risks of taking this type of medication. Perhaps you are looking into the best supplements for menopause before going down the medical route – this guide will help you make an informed decision.
Read more about the HRT debate.
The science and safety of supplements for menopause
While some women may find natural menopause supplements useful, this type of treatment does not have the equivalent studies and data compared to HRT.
What have studies shown?
It can be extremely complicated for researchers and clinicians to decide whether a particular treatment is safe or effective. The most valued types of study are called systematic reviews or meta-analyses, which compare the results and methods of multiple trials.
When it comes to herbal remedies for menopause, these trials have often either been very small and less reliable, or non-existent. None of the over-the-counter menopause supplements have been tested on such a wide scale as prescribed forms of HRT. This means there is limited evidence of the benefits and risks of natural menopause supplements and uncertainty around their effectiveness.
Clinicians can give reasonably accurate estimates of effectiveness, safety and side effects of medically prescribed HRT, but we do not have enough data to provide similar information about herbal remedies for menopause and other natural menopause supplements. This is why we cannot consider natural menopause supplements as safe – we simply don’t know.
NICE guidelines advise doctors to explain to women who wish to try complementary therapies that the quality, purity and constituents of products may be unknown.
What natural menopause supplements are available?
The following are some of the common natural menopause supplements you might find in your local health food store or pharmacy, often suggested as the best supplements for menopause when you begin looking for herbal remedies. We’ve taken a look at the science behind whether they work or not.
Black cohosh
What is it? Black cohosh is a woodland herb of the buttercup family and is native to North America. It is said to alter the effect of oestrogen on various parts of the body and was historically used by Native Americans as a traditional treatment for gynaecological conditions.
Why do people use it? As well as being used as a menopause supplement, black cohosh is used for premenstrual symptoms, such as period pain, and bone health.
Does the science back this up? The evidence on black cohosh was mixed until a 2020 research review found that black cohosh helped treat psychological menopause symptoms like mood changes and vasomotor symptoms including hot flushes and night sweats. The study found that black cohosh was as good as low-dose oestrogen for these symptoms.
A later 2023 study similarly found that black cohosh can help hot flushes and overall menopause symptoms, but did not find that it improved anxiety or depressive symptoms.
This is very encouraging, but there are still questions to answer about black cohosh. Products available to buy aren’t regulated in the way prescription medicines are. They may vary in dose and even contents.
We have reassuring data on this supplement’s safety, but we don’t have enough to say for sure that it is safe in the long term. Black cohosh may also interact with other medications. For this reason, it’s important to be cautious and carefully weigh the risks and benefits.
Those with breast cancer should avoid black cohosh according to NICE guidelines.
Red clover
What is it? Red clover, a member of the legume family, has long been used as a folk remedy.
Why do people use it? Red clover contains isoflavones – plant-based compounds that mimic the effect of oestrogen in the body. The idea is that this mimicry helps ease menopause symptoms.
Does the science back this up? There is some evidence that red clover can help with certain menopause symptoms. NICE found that red clover significantly reduced anxiety and a large 2021 study also found that red clover reduced menopausal hot flushes.
However, NICE also say that results from trials on red clover are inconsistent, and as with other supplements, red clover products can contain variable ingredients at different strengths. This means that red clover might help, but you need to think carefully before trying it.
Word of warning, red clover can worsen some underlying conditions, including some cancers and endometriosis. Those with breast cancer should also avoid red clover according to NICE guidelines. Talk to your doctor about any concerns before you try it.
Evening primrose oil
What is it? The evening primrose family is easy to spot thanks to its tall stems and clusters of bright yellow flowers (although some species are white, pink or red). Originally thought to have originated in Central America, evening primroses are now found worldwide.
Why do people use it? Evening primrose seed oil is sold in capsules and, purportedly, helps with eczema, diabetic neuropathy and rheumatoid arthritis plus premenstrual disorders and breast pain.
Does the science back this up? There isn’t enough evidence to say whether evening primrose oil helps with any hormonal conditions, including menopausal symptoms. Early evidence suggests that it is likely to be ineffective. It has not been found to help with any of the other medical conditions listed.
Soy
What is it? Soy is a popular, legume-based food often used in vegetarian and Asian cuisine.
Why do people use it? Like red clover, soy is a good source of isoflavones – also known as plant oestrogens. As isoflavones have a similar structure to human oestrogens, they are thought to ease menopausal symptoms.
Does the science back this up? There have been a number of studies into the use of soy isoflavones for menopause, although the jury is still out. While a 2013 review found no benefit, other systematic reviews have found improvements in hot flushes. The evidence is inconsistent and part of the problem is that it’s very difficult to gather evidence on the effects of soy as doses and types of isoflavone vary widely.
Soy products and supplements are safe for most people in moderation if you want to try adding them to your diet. There are a few exceptions:
- NICE recommends that people with breast cancer should avoid soy supplements
- Those with a strong family history of either hormone-dependent cancers including breast and some types of ovarian cancer, thromboembolic events including PE, DVT and certain types of stroke, or cardiovascular disease should also seek personalised advice from a doctor before taking soy supplements
- See a doctor before adding soy products to your diet if you take thyroid medication, as soy can affect how it works
- Avoid soy and soy supplements if you have a soy allergy
Read more about soy, menopause and HRT.
Flax seeds
What is it? Flax – also known as linseed – is a plant found in temperate areas. It has been cultivated and used for thousands of years, primarily as the raw material for linen.
Why do people use it? Like soy products and red clover, flax seeds contain high levels of plant oestrogens. These are thought to mimic the effects of oestrogen in the human body and ease menopausal symptoms, which is why it’s often recommended as a supplement for menopause.
Does the science back this up? Evidence is still mixed, with early trials showing a range of results. As of yet, there is no clear evidence that flax eases menopausal symptoms. However, flax seeds are a generally nutritious food to include in a balanced diet. They are a good source of fibre and protein and have been linked with possible improvements in blood pressure, blood sugar and cholesterol.
Start your free online menopause assessment to see if HRT is right for you
Valerian
What is it? Valerian is a herb native to Europe and parts of Asia. It has been used since ancient times as it was thought to aid sleep.
Why do people use it? Valerian has long been thought to help with sleep issues, which is common during menopause.
Does the science back this up? Sadly not. A 2015 meta-analysis found that valerian had no effect on sleep. A few small trials have found some improvement of severity in hot flushes with valerian use, although more research is needed.
Read more about sleep issues in our symptoms library.
Bee pollen
What is it? Also known as bee bread or ambrosia, this is the yellow stuff that bees harvest from flowers. The exact composition varies markedly depending on the plants from which it is gathered, but bee pollen is generally thought to be rich in proteins, vitamins, minerals and fatty acids.
Why do people use it? Bee pollen is claimed to have multiple beneficial effects on a range of conditions including menopause.
Does the science back this up? A few small studies have found improvements in vasomotor menopause symptoms with the use of bee pollen, but there is not enough evidence of benefit to routinely recommend it.
Warning, bee pollen may cause serious reactions in those who have pollen allergies. Also, it may be contaminated with harmful substances including pesticides and other toxins.
Devil’s Claw
What is it? Native to South Africa, this herb earned its name thanks to the slightly sinister, hooked appearance of its fruit. It is also known as grapple plant, wood spider and hook plant.
Why do people use it? Devil’s claw is used in traditional medicine as a painkiller, especially for back pain and arthritis. Some use it for joint pain that may be associated with menopause.
Does the science back this up? Possibly. A 2016 Cochrane review found that devil’s claw reduces low back pain more than placebo, although this evidence was limited and further study is needed.
Learn more about menopause and aches and pains in our symptoms library.
Top tips if using supplements for menopause
1. Ensure that you are using supplements safely
Talk to your doctor before starting any natural menopause supplements. They will be able to tell you if any herbal remedies for menopause interfere with certain treatments you are taking or make worse any underlying health conditions you have. This is particularly important if you have any hormone-dependent conditions, including breast cancer, endometriosis, fibroids, uterine cancer or ovarian cancer.
2. Read the label
Only buy regulated menopause supplements. Look for the Traditional Herbal Registration (THR) Certification Mark. This means that the product is regulated by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) and meets certain quality and safety standards.
3. Buy from trusted stores
Avoid shopping online – as you have no idea what you are buying – and buy from established high street stores.
Find out more with our menopause symptoms library.
Final word
So should you give it a go? Ultimately, this is a personal decision. As you can see, the majority of supplements have limited evidence to support their use or confirm their long-term safety, so you may want to save your money.
Remember to check in with your doctor before using natural menopause supplements, especially if you have any doubts about your symptoms, if you have any medical conditions or take any prescribed medicines.
If you are thinking about menopause supplements as part of a wider approach to menopause, take this time to evaluate your lifestyle and review your exercise, nutrition, sleep and stress levels. Improving lifestyle choices has a proven, positive effect on many menopause symptoms.
Find out more about menopause on our blog.
- Gov.uk, About the THR scheme
- Castelo-Branco C, Gambacciani M, Cano A, Minkin MJ, Rachoń D, Ruan X, Beer A-M, Schnitker J, Henneicke-von Zepelin, H-H, Pickartz, S 2020, ‘Review & meta-analysis: Isopropanolic black cohosh extract iCR for menopausal symptoms – an update on the evidence’ Climacteric, vol. 24, no. 2, pp. 109–119
- Sadahiro R, Matsuoka LN, Zeng B-S, Chen K-H, Zeng B-Y, Wang H-Y, Chu C-S, Stubbs B, Su, K-P, Tu Y-K, Wu Y-C, Lin P-Y, Chen T-Y, Chen Y-W, Suen M-W, Hopwood M, Yang W-C, Sun C-K, Cheng Y-S, Tseng P-T 2023, ‘Black cohosh extracts in women with menopausal symptoms: An updated pairwise meta-analysis, Menopause, vol. 30, no. 7, pp. 766–773
- Kanadys W, Barańska A., Błaszczuk A, Polz-Dacewicz M, Drop B, Kanecki K, Malm M. 2021, ‘Evaluation of Clinical Meaningfulness of Red Clover (Trifolium pratense L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials’, Nutrients, vol. 13, no. 4, p. 1258
- National Institute for Health and Care Excellence (NICE) 2023, ‘Early and locally advanced breast cancer: diagnosis and management‘ [NICE Guideline 101]
- National Institute for Health and Care Excellence (NICE) 2019, ‘Menopause: diagnosis and management‘ [NICE Guideline 23]
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