Menopause Supplements Are Suddenly Everywhere, But Do They Actually Work?


Imagine going through menopause without actually dealing with menopause. Say goodbye to hot flashes, weight gain, and irritability. Painful intercourse is not a thing in your world. All you need is to take one or two pills a day.


If this sounds too good to be true, you’re right. There is no magic pill that can make menopause disappear. But with few options for menopausal care, women are vying for some form of control against these uncomfortable symptoms.

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Now more than ever, there’s a growing movement to support women during and after menopause, and several health companies are answering the call for help. Some fem-tech leaders are disrupting the menopause market with companies focused on undoing the stigma and inequality associated with menopause. Dietary supplement brands are claiming a major stake in this field as well. With more women searching for natural alternatives to pharmaceutical treatments, companies have seen a major boost in sales for herbal solutions. Financial experts forecast the menopause supplement industry to grow to 22.7 billion by 2028.


Dietary supplements may be part of the answer, but it all depends on whether they can back up their health claims. With little FDA oversight, it’s up to the consumer to investigate whether a supplement is good or all hype.

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The science on menopause supplements is mixed


The number one question when it comes to any type of drug is will it work. When it comes to menopause supplements, the answer is a maybe. It all depends on the ingredients.

Genistein


Genistein is a plant-based compound that mimics the impact of the hormone estrogen. It’s generally derived from soybeans or soy-rich foods and is available as a supplement. In 2011, a small study of 84 postmenopausal women found that after 12 weeks, women taking synthetic genistein had fewer hot flashes than those taking a placebo. Bonus: Their hot flashes were shorter, too.


At this point, few large-scale studies look at how genistein supplements impact long-term health. And researchers caution that genistein can potentially cause adverse effects at higher dosage and exposure levels. For example, one study found that breast cancer cell growth was stimulated by low concentrations of genistein and inhibited by higher concentrations. For this reason, it’s important to ask a healthcare professional before trying this supplement to ensure the pros outweigh any potential cons—and the same can be said for any supplement.

Saffron extract


Saffron extract has long been used for its mood-boosting effects, especially among those struggling with depression and anxiety. And more research findings suggest that saffron extract may also help to improve mood in women going through perimenopause, the time period right before menopause. Due to estrogen levels gradually declining during perimenopause, up to 50% of perimenopausal and postmenopausal women experience feelings of anxiety and depression, research notes.


While a supplement is not a substitute for seeking help from a mental health professional, taking a supplement with saffron extract likely won’t cause any harm and, for some, may help. One worth asking your doctor about is Phenology Daily Balance. It also contains genistein, so it can help with hot flashes, too.

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Image: Phenology.

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Black cohosh


One popular ingredient for getting rid of hot flashes and night sweats is black cohosh. This white-flowered plant has historically been used as a painkiller that calms the nervous system. It works by binding to opioid receptors found throughout the brain. For example, one brain imaging study found that activating opioid receptors in the hypothalamus (often called the control coordinating center of the brain) partially helped with resetting the body’s internal temperature for postmenopausal women. Black cohosh also targeted opioid receptors in the emotional areas of the brain which could affect a person’s perception of pain.


While black cohosh alleviates discomfort, does it actually get rid of hot flashes? The answer is mixed. A 2018 study found women taking black cohosh had a significant reduction in the severity and number of hot flashes compared to women taking other herbal remedies. Meanwhile, this phase 3 clinical trial failed to find any evidence between black cohosh and less hot flashes. In the study, women who took black cohosh for a month were 20 percent less likely to have hot flashes. However, those taking an identical-looking pill containing no medication showed a 27 percent decrease in hot flashes.


One reason for the conflicting results across studies is that not all black cohosh act the same way. One of the chemicals made from the plant is vital for regulating temperature but “not all black cohosh plants express the gene-encoding enzyme required to make this phytochemical,” explains Yufang Lin, MD, an integrative medicine specialist, to the Cleveland Clinic.

Evening primrose oil


Evening primrose is a yellow flower commonly used by Native Americans to heal bruises, wounds, and swollen skin. For menopause, the true value is the oil in its seeds. The oil contains omega-6s that help with creating the building blocks for several molecules. There is some research suggesting evening primrose oil can help with menopausal night sweats as it stops the blood vessel activity that causes these symptoms.


The medicinal oil has also been explored for treatment of the increased irritability, anxiety, and low mood women in menopause feel. In an 8-week trial, researchers found evening primrose oil helpful in improving people’s psychological symptoms during menopause, though they warn a longer trial is needed to truly understand the oil’s effectiveness and safety. Indeed, the National Institute of Health warns “there’s not enough evidence to support the use of evening primrose oil for any health condition” including menopause symptoms. A review by the American Academy of Family Physicians, for example, found no benefit in taking the oil everyday for six months and decreasing hot flashes.

Soy


A popular ingredient to soothe menopause symptoms is soy. Soybeans contain chemicals that mimic estrogen and the idea is that it helps with hot flashes and night sweats because it helps to compensate for the low estrogen production. Research on the plant has had conflicting results. There have been studies noticing a modest improvement with hot flashes and the number of times it happens.  Additionally, menopausal women seem to show lower blood pressure and a reduced risk for heart disease when regularly taking soy supplements. Meanwhile, other long-term trials have reported no change in menopausal symptoms or bone loss rate when taking soy supplements.

Valerian Root Extract


Valerian root has historically been used as a natural sleep aid because it acts like a sedative. The idea is that it raises the level of a brain chemical called GABA. Activation of GABA has a calming effect as it slows down neural activity, letting your mind relax enough to fall asleep. Since insomnia is a common complaint during menopause, valerian root can help someone sleep better.


The herb is also considered a phytoestrogen. Acting like estrogen, it is supposed to help restore balance to falling hormone levels. Taking a pill with a high dosage of valerian has helped lower the severity and frequency of hot flashes in menopausal women. According to the NIH, valerian is “generally safe for short-term use” in adults though how it affects the body with prolonged use is still questionable. They note that the studies between valerian root and menopausal symptoms are promising but there is little evidence to know for sure.

Things to consider when buying menopause supplements


The FDA does not regulate drug supplements so a product can technically be sold without proof they work. As long as the product does not claim to “diagnose, mitigate, prevent, or cure diseases,” everything is fair game. Another thing to consider is whether the natural ingredients found in supplements contain the right dosage to work or are safe to consume.


“Supplements are unregulated and can cause serious health problems, like liver toxicity,” Pelin Batur, MD, a menopause specialist, told the Cleveland Clinic. “Just because something comes from a health food store doesn’t necessarily mean it’s safe.”

Hormone therapy is an FDA-approved treatment for menopause symptoms


Hormone therapy remains the best way for relieving the range of symptoms you might encounter during menopause. As your ovaries produce less estrogen and progesterone during menopause, the treatment restores hormone levels with artificial hormones. It can be taken as a pill, patch, and as a topical medication.


There is limited research finding greater effects when people paired hormone therapy with dietary supplements.

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