Supplements: What Has Evidence, What Doesn't

The menopause supplement market is enormous, loud, and mostly unregulated. Here's a sober walk down the aisle.

Reasonable evidence

• Vitamin D + calcium — for bone health, especially if you're low on sun or dairy. Get vitamin D levels checked; many women are deficient.
• Magnesium (glycinate) — modest evidence for sleep quality and restless legs; generally safe and inexpensive.
• Omega-3s — support heart and joint health; useful if you rarely eat oily fish.
• Creatine — surprisingly strong evidence for preserving muscle and supporting brain energy in midlife women, when paired with strength training.

Mixed or weak evidence

• Black cohosh — some trials show mild hot-flash relief, others none. Short-term use appears safe for most; quality varies wildly between brands.
• Soy isoflavones / red clover — gentle effects for some women, strongest in those whose gut bacteria produce equol (you can't easily know if that's you).
• Ashwagandha — early evidence for stress and sleep; long-term data thin.

Save your money

"Hormone-balancing" blends, detox products, and anything promising to "reset" your hormones. Hormones aren't a thermostat, and no capsule resets them.

Three rules before buying anything

1. One change at a time, or you'll never know what worked.
2. Tell your doctor — "natural" products still interact with medications (St John's Wort is notorious).
3. Pick brands with third-party testing. The label should match the bottle.

Supplements can support the foundations — they can't replace sleep, movement, and food.