Menopause: medicines, supplements and what really helps
Menopause is a natural stage of life when periods stop. It usually starts at around the age of 51.1 Many women experience hot flushes, poorer sleep or mood swings during this time.
In this article, you will learn which medicines help most, what studies show about supplements and why calcium and vitamin D are especially important after menopause.
In brief. The most effective way to relieve hot flushes is hormone replacement therapy, chosen by a doctor.2 Herbal supplements are also a popular choice, but their effect may differ from woman to woman.34 Calcium and vitamin D help to reduce the loss of bone mineral in post-menopausal women.5
What are the most common symptoms?
- hot flushes and night sweats;
- disturbed sleep;
- mood swings, anxiety;
- vaginal dryness;
- difficulty concentrating.1
Symptoms may start before menopause and continue for several years.1 They are different for every woman.
Medicines: what can a doctor offer?
| Treatment | What it is prescribed for | What is worth knowing |
|---|---|---|
| Hormone replacement therapy (HRT) | Hot flushes, sleep, mood | The most effective option. Benefits and risks are assessed individually.2 |
| Local oestrogen products | Vaginal dryness | They act locally, and only a small amount of hormone enters the body.2 |
| Non-hormonal medicines | When hormones cannot or should not be used | They are chosen by a doctor.2 |
What this means for you. If symptoms get in the way of your life, do not be afraid to talk to your doctor about them. HRT is not suitable for everyone, but for many women its benefits outweigh the risks.2
What can you do yourself?
- Wear several thin layers of clothing rather than one thick one. When a hot flush comes, you can simply take a layer off. Keep the bedroom cool and put a glass of cool water next to your bed.1
- Notice what triggers your hot flushes. Often it is coffee, alcohol or spicy food.1
- Exercise regularly – this is important for both mood and bones.1
- Cognitive behavioural therapy may help you cope more easily with hot flushes and anxiety.2
Calcium and vitamin D for bones
After menopause, bones lose minerals faster. Calcium and vitamin D help to reduce the loss of bone mineral in post-menopausal women. Low bone mineral density is a risk factor for osteoporotic bone fractures.5
To obtain this effect, women over 50 need a daily intake of at least 1,200 mg of calcium and 20 µg of vitamin D from all sources combined.5
Example. A glass of milk contains about 300 mg of calcium, and 30 g of hard cheese about 200 mg. If you eat 2 servings of dairy products a day, you may need a supplement to provide only part of your calcium.6
What do studies show about herbal supplements?
Black cohosh. In a review of 16 studies involving more than 2,000 women, there was not enough evidence that it reduces hot flushes.3 Liver damage has been reported in rare cases, so women with liver disease should not take it.7
Soy and red clover isoflavones. A review of studies found no convincing evidence that they reduce hot flushes, although in some studies the benefit was small.4
Sage. In some EU countries, sage leaf preparations are registered as traditional herbal medicinal products for reducing excessive sweating.8
Before taking herbal supplements, consult your doctor, especially if you are taking hormones or have a hormone-dependent condition.
Selected products for women over 50
Commercial information. These are products available in our shop. This is not a ranking of effectiveness. Before buying, check the composition and instructions for use on the product page.
Calcium Citrate with Vitamin D - 200 vcaps - Life Extension
Calcium citrate with vitamin D3: 200 mg of calcium and 2.5 µg of vitamin D per serving. Adjust the dose according to how much calcium you get from food.9
Vitamin D3 - High Potency - 1000 IU - 25 mcg - 60 capsules - Swanson
25 µg (1,000 IU) of vitamin D3 per capsule. If you take it together with a calcium supplement, add up the amount of vitamin D from both products. The capsule contains gelatin.10
Soy Isoflavones - Standardized - 750 mg - N60 - Swanson
750 mg of soy germ complex per capsule, standardised to 1.8% isoflavones – that is about 13.5 mg of isoflavones. Take 1 capsule per day.11
Sage Leaf Extract - 30 ml - Nature's Answer
Alcohol-free liquid sage leaf extract, where 1 ml is equivalent to 1,000 mg of leaves. The manufacturer recommends 1 ml 3 times a day with a small amount of water.12
Frequently asked questions
How long do menopause symptoms last?
Usually for several years, but the duration varies greatly. In some women they continue for longer.1
Can supplements be taken together with HRT?
Calcium and vitamin D can usually be combined without problems. Discuss herbal supplements, especially those containing isoflavones, with your doctor.
When should I see a doctor?
If symptoms interfere with daily life, or if vaginal bleeding occurs a year or more after your last period.1
Scientific references
- NHS. Menopause. nhs.uk
- NHS. Menopause – Treatment. nhs.uk
- Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 2012;(9):CD007244. doi:10.1002/14651858.CD007244.pub2
- Lethaby A, Marjoribanks J, Kronenberg F et al. Phytoestrogens for menopausal vasomotor symptoms. Cochrane Database Syst Rev. 2013;(12):CD001395. doi:10.1002/14651858.CD001395.pub4
- Commission Regulation (EU) No 1228/2014 on authorising the use of certain health claims made on foods and referring to the reduction of disease risk. EUR-Lex
- NIH Office of Dietary Supplements. Calcium – Fact Sheet for Health Professionals. ods.od.nih.gov
- NIH National Center for Complementary and Integrative Health. Black Cohosh. nccih.nih.gov
- European Medicines Agency, HMPC. European Union herbal monograph on Salvia officinalis L., folium. ema.europa.eu
- Life Extension. Calcium Citrate with Vitamin D, 200 capsules. Product label.
- Swanson. Vitamin D3, 1000 IU, 60 capsules. Product label.
- Swanson. Soy Isoflavones Standardized, 750 mg, 60 capsules. Product label.
- Nature's Answer. Sage Leaf Extract, 30 ml. Product label.
Disclaimer. This article is for information purposes only and does not replace a consultation with a doctor or pharmacist. Medicines to relieve menopausal symptoms are prescribed by a doctor. Food supplements are not intended to treat or prevent diseases and do not replace a varied diet and a healthy lifestyle.
