Menopause is a natural phase in women’s lives, characterized by a decrease in female sex hormones, especially estrogen. This process can cause several bothersome symptoms, such as hot flashes, night sweats, irritability, anxiety, depression, insomnia, decreased libido, vaginal dryness and urinary problems.
To relieve these symptoms and improve quality of life during menopause, many women turn to dietary supplements. These products are made up of vitamins, minerals, phytoestrogens, and other nutrients that can help balance hormone levels, improve bone health, prevent cardiovascular disease, and reduce the intensity of menopause symptoms.
Approximately two-thirds of perimenopausal women develop symptoms related to menopausal transition. Of these, only 10-25% of women seek traditional treatment and many often resist or become dissatisfied with conventional medical treatments. Although hormone therapy is still considered the first line of treatment for vasomotor symptoms, given the results published in Women’s Health, many women are reluctant to use exogenous hormones and are turning to botanicals and dietary supplement products for symptom relief.
In this text, we will explore some of the popular supplements to aid in menopause symptoms and understand how they can help women at this stage of life.
Soy-based foods and supplements have been the subject of much interest for reducing menopausal symptoms because of their high concentrations of phytoestrogens (formononetin, biochanin A, daidzein and genistein). The phytoestrogens found in soybeans/isoflavones have estrogenic properties, although the mechanism of action is not fully understood.
The most promising news for soy may be its positive effect on lipid profiles. A meta-analysis of 38 human studies on soy consumption provides compelling evidence for its positive effect on lipid profiles, including reduction of low-density lipids (LDL) and triglycerides and an increase in high-density lipid (HDL) levels.
Red clover (Trifolium pretense)
Red clover and soybeans share similar chemical profiles, both contain genistein, daidzein, formononetin, and biochanin A, but red clover has significantly higher levels of isoflavones. These isoflavonoid and coumestane components are considered responsible for estrogen-like effects. The use of red clover for menopausal symptoms is quite recent and similar to soy products, most studies show a minimal effect for relieving hot flashes. However, it may be relevant as a preventive treatment for osteoporosis, improvement in lipid profiles, and possibly cognition.
Black Cohosh (Cimicifuga racemosa)
Black cohosh is a perennial plant native to North America that has traditionally been used primarily by American Indians for a variety of “female complaints.” Next to soy, black cohosh is the most widely studied botanist for menopausal symptoms. It contains triterpene glycosides, flavonoids, aromatic acids and various other constituents, but the exact mechanism of action of this botanist has not yet been clearly understood. Recent data from the Institute of Health Center for Botanicals Dietary Supplements Research in Women’s Health demonstrates that black cohosh does not have an estrogenic mechanism of action, but rather acts on serotonin receptors and can relieve hot flashes and improve mood through a serotonergic effect.
Evening primrose oil
Evening primrose oil is commonly used as an alternative therapy with a rich source of omega-3 essential fatty acids (linoleic acid and gamma-linolenic acid). Although there is insufficient evidence to support the use for somatic symptoms of, the its efficacy and safety for mental health have been confirmed in several studies. The therapeutic effects of evening primrose oil can be attributed to the direct effects of omega-3s on immune cells and its indirect effects on the synthesis of eicosanoids, including prostaglandins, cytokines, and cytokine mediators.
Panax ginseng is characterized by anti-inflammatory properties. Randomized controlled trials have shown promising results for improving glucose metabolism and immune system. Possible mechanisms of action of ginseng include estrogen-related hormonal effects with a slight effect on depression, mood disorders, and sexual function. The main active compounds are ginsenosides, which have been shown to exert estrogen-like actions. However, the side effects are unclear and more studies are needed to evaluate the effects on endometrial heat and thickness.
The common name of this herb is fennel. It is characterized by the presence of palmitic acid and beta-sitosterol. It has antiandrogenic and anti-inflammatory effects and its main application is more hot flashes in postmenopausal women. Just as it can help anxiety in patients with depression. Vaginal fennel extract cream has shown an improvement in vaginal atrophy and sexual functions in menopausal women due to its estrogenic effects. No critical side effects have been reported.
Supplements and Menopause
In conclusion, menopause is a natural process in women’s lives that can cause various bothersome symptoms. To relieve these symptoms and improve quality of life, many women turn to dietary supplements such as soy/isoflavones, red clover, black cohosh, and evening primrose oil. Although hormone therapy is still considered the first line of treatment for vasomotor symptoms, many women are reluctant to use exogenous hormones and are turning to botanicals and dietary supplement products for symptom relief.
Each supplement has its specific benefits, such as lowering low-density lipids (LDL) and triglycerides, preventing osteoporosis, improving cognition, and relieving hot flashes and improving mood through a serotonergic effect. However, it is important to remember that supplements should be used with caution and always with the guidance of a health professional, to avoid unwanted side effects.
Health professionals should include in discussion with their patients all available approaches for the relief of menopausal symptoms, giving all the information for real customization of the approach to complaints at this critical stage of the woman’s life. In this perspective, nutraceuticals have their strengths for being great allies for the maintenance of symptoms. However, it is important to remember that nutraceuticals are not a one-time solution to menopausal symptoms and should be used in conjunction with other health care strategies, including healthy eating, regular physical activity, and medical therapies.
Does vitamin E help with menopause symptoms?
Watch the video on Science Play with Bruno César:
Physiological peculiarities of menopause
Supplements and menopause
: De Franciscis P, Colacurci N, Riemma G, et al. A Nutraceutical Approach to Menopausal Complaints. Medicine (Kaunas). 2019;55(9):544. Published 2019 Aug 28. doi:10.3390/medicine55090544
Article – Supplements and menopause
: Geller SE, Studee L. Botanical and dietary supplements for menopausal symptoms: what works, what does not. J Womens Health (Larchmt)
. 2005;14(7):634-649. doi:10.1089/jwh.2005.14.634