Which supplements actually help with menopause?
Red clover isoflavones and black cohosh have the strongest evidence for reducing hot flashes; soy isoflavones also help to some extent. For bone health, vitamin D is well supported. The effects are modest, and for severe complaints it is best to discuss the options with your doctor.
Among plant-based supplements, red clover isoflavones have the most concrete evidence for hot flashes. Meta-analyses find an average of nearly two fewer hot flashes per day compared with placebo. The effect is greatest in women who experience five or more hot flashes per day, at a dose of at least 80 mg per day, and with use of at least 12 weeks.
Soy isoflavones also work, but somewhat less powerfully: an average of around one fewer hot flash per day. No significant effect on night sweats has been demonstrated. Vaginal dryness does decrease slightly. A more recent meta-analysis found indications that soy isoflavones may also reduce psychosocial complaints, palpitations and headaches, but those studies are small, so that is not yet certain.
Black cohosh (an herbal extract) significantly reduces overall menopausal complaints and hot flashes compared with placebo. For anxiety and depression, no demonstrable benefit has been shown. If you also want to address psychological complaints, the combination of black cohosh with St. John's wort appears to work better than black cohosh alone. The available studies show no indications of harm to the liver, breast or uterus.
Vitamin D stands out for a different reason: it is the only supplement for which there is high certainty about safety, and there is moderate evidence that it reduces the risk of bone fractures. Vitamin D has been less thoroughly studied for complaints such as hot flashes. Nevertheless, it is relevant for women going through menopause, because bone loss accelerates during this phase.
Almost all studies in this field have limitations: the studies differ greatly from one another in design, doses used and measurement methods. The effects are modest and smaller than those of hormone therapy. For severe complaints, it is wise to discuss this with your doctor.
Based on multiple meta-analyses and systematic reviews (PMID 38189863, 27327802, 25263312, 40718787, 33920485, 37192826, 33021111, 41498229). All claims can be traced back to these sources.
What helps against menopause symptoms like hot flushes and mood swings?
Hormone therapy works best against hot flushes and night sweats. Those who cannot or do not wish to use it can choose from proven non-hormonal medications and psychological therapy. Herbal supplements have no demonstrable effect.
Does my weight and metabolism change during menopause?
During menopause, your body composition changes profoundly: more abdominal fat, less muscle and a lower resting metabolic rate. Exercise and nutrition demonstrably help, and discuss hormone therapy with your doctor as an additional option.
What complaints are most common during menopause?
The most common menopausal complaints are joint and muscle pain, fatigue and sleep problems; hot flushes are the most characteristic but do not top the prevalence rankings. If you recognise several of these complaints, it is worthwhile discussing them with your GP, who can consider what may help for each one.
Can you delay menopause with lifestyle or diet?
Avoiding smoking, eating less red meat, and eating more citrus fruit and oily fish appear to have a favourable influence on the age of menopause. However, evidence from controlled experiments is still entirely lacking.
Does the menopause disrupt my sleep, and what can help?
The menopause genuinely disrupts your sleep, primarily through hot flashes and hormonal changes. Cognitive behavioural therapy for insomnia (CBT-I) is the best first step; hormone therapy or melatonin may come into the picture after that.
Why do bones become more brittle after menopause, and what can help?
Bone loss after menopause is well understood and partly preventable: oestrogen deficiency is at the core, but good nutrition, exercise, hormone therapy and, where necessary, bone medication offer proven protection. Which approach suits you best is something to discuss with your doctor.