Lately there’s been a burst of attention on the symptoms women experience during perimenopause. While the focus on women’s health is positive, it’s also spurred a marketing boom. Whether it’s TikTok influencers or the shelves of your local pharmacy, perimenopause products - from “hormone-balancing” supplements to anti-aging skin care treatments - seem to be everywhere.
“There’s a lot of information about menopause out in the world right now, which is a good thing,” says Marie Wall, CNM, a certified nurse-midwife at Henry Ford Health. “Unfortunately, not all of that information is accurate.”
Wall offers insight on what works, what deserves skepticism—and how to sort through the marketing noise.
Menopause Supplements: Do Hot Flash Treatments Work?
Just visit the drugstore and you’ll see shelves full of supplements and vitamins aimed at middle-aged women. Many of these products claim to do things like “balance hormones.” Be wary of that marketing speak, Wall says: “A lot of these things you should take with a grain of salt.”
That said, there are some herbs and supplements with actual evidence behind them. Some products, for example, may help with hot flashes and night sweats that are common as hormone levels fall during perimenopause. Others might help women who struggle with insomnia and sleep disturbances.
“Many women prefer to start with a natural approach to managing menopause symptoms, and there are things that can help,” Wall says:
- Black cohosh: This North American woodland plant is sold over the counter as an herbal supplement. Studies have found it may help lessen perimenopausal symptoms like hot flashes.
- Soy: Soy-based foods (like soy milk and edamame) contain compounds that mimic hormones in the body. There’s evidence that eating soy products daily may help ease hot flashes and other menopause symptoms. And there is some evidence that supplements containing soy may also help, Wall says.
- Magnesium glycinate: This supplement is used as a sleep aid to improve insomnia, which becomes more common in perimenopause as estrogen levels decline.
Using Menopause Supplements Safely
If you’re interested in trying supplements, Wall recommends avoiding products that contain a mix of different herbs, vitamins or minerals. Such products tend to be named using broad terms like “perimenopause support.”
Taking multiple supplements at once, or taking them in high doses, can have unintended side effects like liver damage—especially if you’re taking them with other medications. “And if you try a bunch of things at once, it’s not clear how each of them is affecting you,” she adds.
Wall recommends talking to a healthcare provider about supplements before you start. Then, try them one at a time, sticking with each for at least three months. “It can take that long to know whether a supplement is having an impact on symptoms like hot flashes,” she says. “At that point you can reassess whether you want to continue or try something else.”
Vaginal and Urinary Symptoms of Menopause
Many women also experience what are known as the genitourinary symptoms of menopause, including:
- Vaginal dryness
- Vaginal itching
- Pain during sex
- A frequent or urgent need to urinate
- Pain or burning during urination
- Recurrent UTIs (urinary tract infections)
There are drugstore products that can help manage some of those symptoms. For symptoms like vaginal dryness and pain during intercourse, Wall recommends over-the-counter vaginal moisturizers. These include gels that can be applied inside the vagina and balms that moisturize the vulva. “Look for products that are marked as water-soluble, and avoid products with scents, which can affect your pH and cause irritation,” she says.
Those products can be helpful if you’re experiencing vaginal dryness and discomfort during sex. But if you’re also having urinary symptoms, like UTIs, you might want to consider vaginal estrogen creams. These prescription treatments replace declining estrogen levels in the vagina with a low dose of estrogen that doesn’t affect body systems beyond the vagina. “Vaginal estrogen is very safe and a great option if you experience urinary symptoms and over-the-counter measures aren’t helping,” Wall says.
Some women are also bothered by a lower libido during perimenopause and menopause. But instead of reaching for untested products that claim to increase sexual arousal, you might consider talking to your healthcare provider about testosterone, Wall says. Though testosterone is typically thought of as a male hormone, women produce it too—and that production declines in midlife and beyond. “For women with lowered libido, prescription testosterone can sometimes be really helpful,” Wall says.
Bioidentical Hormones and HRT
What about hormone therapy? Influencers sometimes tout the benefits of “bioidentical” hormones. These plant-derived compounds are processed to mimic the action of hormones in the body.
Some people think that because they’re “natural,” they must be safe. But that’s not always true, Wall says. “These products don’t have the same oversight as prescription medications, so you can’t always be sure they contain the ingredients and dosages they claim,” she says.
But bioidentical hormones aren’t your only option. Prescription hormone replacement therapy (HRT) is a safe option for many women experiencing a range of troubling menopause symptoms, Wall says.
Evidence-Based Perimenopause Treatments
Menopause can look very different from woman to woman. Some struggle with brain fog and night sweats, while others are most bothered by problems like thinning hair. Instead of reaching for vitamins that promise “hormone balance” or “menopause support,” it can help to talk to the experts, Wall says.
If you’re troubled by dry skin and thinning hair, for instance, you could spend a fortune on special creams and hair serums—or you could talk to a dermatologist for tailored advice. For mood changes like depression or anxiety, connecting with your primary care doctor or a mental health provider is a good first step. Wall also recommends gathering evidence-based advice from reliable sources like The Menopause Society.
Those approaches may not offer the quick fix promised by influencers, but they will lead you to evidence-based advice, Wall says.
Reviewed by Marie Wall, CNM, a certified nurse-midwife who sees patients at Henry Ford West Bloomfield Hospital.
