Herbs & Supplements To Support Menopause & Reduce Symptoms
Certain herbs and supplements can help optimize hormones and reduce menopause symptoms.
In this blog you will learn which herbs and supplements reduce menopause symptoms. Read on for more info on the following:
- Black cohosh
- Soy isoflavones
- Red clover
- Maca root
- Sage
- Vitamin E
- Chastetree berry
Menopause marks the end of the reproductive years when menstrual cycles stop. It comes with a range of potential symptoms like hot flashes, night sweats, sleep issues, weight gain, cognitive issues, sexual issues (low/no libido, vaginal dryness), metabolic body changes, cardiovascular disease risk, osteoporosis risk and potentially other symptoms.
There are a huge number of supplements and herbs that claim to help with menopause symptoms. Often it is an individual experience, like menopause itself. Some things can work for some women while not for others. Interestingly, some things can work for a while, say for 6 months, and then stop being effective.
We highlight here the most effective and researched supplements and herbs for menopause symptoms. There may be others that work for you. For this reason, we encourage you to be curious and experimental with these natural approaches. Try different things to see what works best for you.
Black Cohosh
Black cohosh is used to relieve hot flashes, night sweats, mood swings, sleep disturbances and other menopausal symptoms.
Black cohosh reduces the frequency and intensity of vasomotor symptoms, i.e. hot flashes and night sweats. It has vasorelaxation properties which can decrease hot flashes and improve the quality of life for many women.
Black cohosh is anti-inflammatory and reduces joint pain and stiffness often seen in menopause. It calms the nervous system and can decrease anxiety and mood swings commonly associated with menopause (Hedaoo K, 2024).
The exact mechanism of action of black cohosh is unclear. It is thought to interact with serotonin receptors in the brain and affect temperature regulation. It has a serotonergic effect. It does not increase estrogen or have estrogenic effects. This makes it a good choice for women who want to avoid hormone replacement therapy. For example, breast cancer patients who take the medication Tamoxifen need to avoid HRT. Black cohosh is very helpful for women who need a natural alternative to hormone therapy (Hedaoo K, 2024).
One study looked at a combination of black cohosh, soy isoflavone, chasteberry and evening primrose oil (Rattanatantikul T, 2022):
- After 12 weeks, this supplement formula led to a statistically significant decrease in hot flashes, sweating, sleep issues, depression and irritability symptoms.
- C-reactive protein, a key marker of inflammation, decreased significantly.
- The cholesterol markers LDL-C and triglycerides were significantly lowered.
- This 4-herb combination was effective in improving menopause symptoms and general health markers in women in post-menopause.
Soy Isoflavones
Soy contains isoflavones which can alleviate the severity of menopausal symptoms (Yang Y, 2025). Soy isoflavones are phytoestrogens, which are plant-based estrogens. These phytoestrogens can assist in balancing hormone levels and reducing hot flashes, mood swings and other symptoms.
Phytoestrogens are similar to estrogen and can cause estrogen-like effects in the body. They balance estrogen by regulating estrogen receptors. Isoflavone phytoestrogens are found in legumes and particularly in soybeans. For this reason, soy-based supplements or food (tofu, edamame) can relieve menopause symptoms.
Soy and isoflavones can reduce the strength and frequency of menopausal symptoms (Erdélyi A, 2024) and (Vetrani C, 2022). Menopausal hot flashes are rarer in countries where people regularly eat soy in their normal diet (Erdélyi A, 2024).
The mechanism of action of soy involves:
- Phytoestrogens: The isoflavones in soy have estrogenic and anti-estrogenic effects. Isoflavones are structurally similar to estradiol and bind well to estrogen receptors. When estrogen levels are low (as in postmenopausal women), isoflavones have estrogen-like effects, whereas the effect is anti-estrogenic when estrogen levels are high. They modulate estrogen and act like an adaptogen, according to estrogen levels present in the body (Yang Y, 2025).
- Antioxidants: Soy has high levels of antioxidants, including isoflavones, vitamin E, polyphenols and selenium. Antioxidants reduce oxidative stress, protect cell health and improve overall health which is beneficial during menopause (Yang Y, 2025).
- Bone density maintenance: Isoflavones reduce the incidence of osteoporosis and help maintain bone density (Yang Y, 2025). Phytoestrogens can help prevent bone loss in aging women through their estrogen-increasing effects. Soy isoflavones have a bone-preserving effect on bone mass (Tang S, 2020). There is a significant positive correlation between soy proteins or isoflavone intake and Bone Mass Density (Tang S, 2020). The mechanism by which soybeans may play a protective role is unclear. It is thought that a metabolite of soy isoflavones may have a beneficial effect on bone loss (Tang S, 2020).
Soy and other phytoestrogens in the diet are somewhat controversial for women’s health and menopause. Research both for and against soy can be found:
- Phytoestrogens can be negative in the treatment of hormone-sensitive breast tumors (Erdélyi A, 2024).
- Prolonged use of estrogen agonists/antagonists in postmenopausal women is associated with an elevated risk of stroke, pulmonary embolism and DVT (Raina, 2024).
- One study recommends 20 mg/day of soy isoflavones during perimenopause for symptom reduction. This equals 80 g/day of soy in the form of tofu, tempeh or fermented soy products (Erdélyi A, 2024).
- Another study says 42 mg/day of soy isoflavones may have a tumor-reducing effect (Erdélyi A, 2024).
- In a third study, regular soy consumption did not increase breast cancer risk. But anti-estrogen therapy via the medication Tamoxifen is less effective with regular soy consumption (Erdélyi A, 2024).
There is not really a consensus on the effect of dietary soy on breast cancer and its treatment. The above-mentioned safe intakes of soy apply to soy foods in the diet and not soy isoflavones taken as dietary supplements (Erdélyi A, 2024). Supplements can be much more potent whereas eating soy foods is a natural way to get isoflavones.
If you are going to eat soy, be sure to eat organic, non-GMO, fermented soy. Eat the type of soy products traditionally eaten in Aisa. Modern, non-fermented GMO soy will not provide the same health benefits!
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Red Clover
Red clover contains isoflavones like soy does. Isoflavones increase estrogenic effects in the body to help with menopause symptoms. The main symptoms that can be improved by red clover are hot flashes and mood swings. Soy has a stronger effect on estrogen receptors. Red clover has a less potent effect via the isoflavones genistein, daidzein, biochanin A and formononetin (Fritz H, 2013).
Red clover, taken for 3 months and 6 months, improves somatic, psychological and overall menopausal symptoms (Yigit E, 2024):
- Red clover significantly decreases the rate and intensity of symptoms.
- The frequency of hot flashes and night sweats decreased significantly after 6 months of red clover treatment.
- Red clover reduces depression and anxiety.
Maca Root
Maca root can increase energy levels, balance hormones by supporting the endocrine system and improve mood. It addresses symptoms like fatigue, low libido and mood swings.
Maca powder decreased the severity of menopausal symptoms (Ulloa del Carpio N, 2024):
- It can decrease anxiety, depression, sexual dysfunction, hot flashes, excessive sweating and disrupted sleep patterns.
- Maca can improve general health, mental health, depression, anxiety and sleep issues.
How maca root works is not entirely understood but some of its actions are (Ulloa del Carpio N, 2024):
- Maca supports the HPA axis, the hypothalamus and pituitary glands. Maca improves mood, stress and hippocampal neurogenesis, through neurotransmitter activity.
- It modulates estrogen levels in the body. This relieves symptoms like hot flashes, night sweats and interrupted sleep. It modulates hypothalamus activity to secrete less cortisol during the stress response.
- Maca can decrease pro-inflammatory cytokines in the hippocampus. This reduces inflammation in the brain.
- Maca can increase BDNF (an important brain molecule) and serotonin receptors in the hippocampus, which helps mood.
- It increases glutathione peroxidase, the master antioxidant, which is important to reduce ROS or free radical production in the brain.
Sage
Sage leaf extract can be used to manage hot flashes and other menopausal symptoms. Sage can reduce the frequency and severity of hot flashes and help regulate sweat production during menopause. (Moradi M, 2023)
Sage has an effect on the frequency of hot flashes over time (Moradi M, 2023):
- 8 weeks of 100 mg of sage extract daily reduced the frequency of hot flashes.
- The severity of hot flashes declined significantly after taking sage for 10-12 weeks.
- 100 mg of sage daily for 3 months improved sleep disorders and forgetfulness in menopausal women.
In another study, the severity of hot flashes, night sweats, panic and fatigue all declined and focus/ concentration increased, after taking sage extract (Dadfar F, 2019).
Vitamin E
Vitamin E has a positive effect on menopausal symptoms. It has antioxidant properties and can reduce hot flashes and improve vaginal dryness.
- At 500 mg of Vitamin E twice a day, anxiety, insomnia and hot flashes improve in some women (Feduniw S, 2023).
- Vitamin E combined with omega 3 fatty acids significantly reduced the intensity of hot flashes (Feduniw S, 2023).
- Breast cancer survivors may also benefit from vitamin E as it does not increase estrogen.
Excessive intake of vitamin E can have side effects like possible nausea, diarrhea and other GI issues. High doses of vitamin E may raise blood pressure and have blood-thinning effects.
Chastetree Berry or Vitex
Chasteberry can help balance hormone levels, particularly progesterone. It can decrease vasomotor symptoms, mood swings, anxiety, sleep disturbances, irritability and general menopausal symptoms (Naseri R, 2019).
Chastetree’s mechanism of action is through hormones. It can stimulate the pituitary gland to balance progesterone and estrogen levels (Naseri R, 2019). Plant components such as flavonoids directly affect the pituitary gland, which increases progesterone and can improve symptoms. Chastetree contains phytoestrogens, which are estrogen agonists. If estrogen is low, as in menopausal women, chasteberry has strong estrogenic effects (Naseri R, 2019).
What Other Herbs & Supplements can help with Menopause Symptoms?
- Ashwagandha is an adaptogenic herb used to reduce stress and anxiety and may help manage mood swings during menopause.
- Magnesium helps with sleep, relaxation, mood and irritability associated with menopause. Magnesium improves cartilage and bone matrix calcification, increasing bone strength. Given that osteoporosis risk increases in menopause, magnesium is beneficial to decrease the risk of osteoporosis and promote bone development.
- Omega 3 fatty acids or fish oil decreases inflammation, supports brain function and hormonal balance, which can improve mood issues often seen in menopause. The omega 3 fatty acids EPA and DHA are important for cognitive function, emotional well-being and skin health. Omega 3 may help reduce hot flashes. Be sure to use a clean nontoxic source of fish oil to avoid potential environmental toxins.
- Probiotics improve gut health, digestive issues and mood disturbances. Good gut health is important for hormone metabolism and mood regulation.
- 5-HTP can decrease hot flashes. 5-HTP is a precursor to serotonin and can thus help with mood regulation. Some women see an improvement in vasomotor symptoms with 5-HTP. Research on 5-HTP does not show significant improvement in menopausal hot flashes but anecdotal evidence in some women shows it can be very helpful with hot flashes and night sweats.
- Adaptogens such as rhodiola and holy basil regulate stress, support mood and boost cognitive health.
- Ginseng can increase energy, mood and overall well-being during menopause.
- Evening primrose oil is thought to reduce severity but not frequency of hot flashes although strong scientific evidence is lacking.
It is sometimes necessary to experiment with the different options to see what works for you. If you are taking medication(s), it is best to check with a medical professional as there may be contraindications with herbs, supplements and medication.
HRT is another option to manage menopause symptoms. It is the strongest treatment available. If these herbal and supplement solutions don’t work for you, and you have tried diet and lifestyle adjustments, then HRT might be the next step to take. Come see us at the Medicine with Heart functional medicine clinic if you have questions or need advice on HRT for managing menopause.
If you are suffering from menopause symptoms, then get in touch with us at the Medicine with Heart clinic. We can help to manage symptoms, optimize your menopause experience and get your health back on track!
