Menopause & Perimenopause
The most consequential finding in this field is a Grade D: combined hormone therapy was tested at scale for primary prevention and stopped early for harm. That is a different question from treating symptoms, and this page keeps the two apart.
At a glance
The letters on this page
Twelve interventions on this page. Five carry a letter; seven are listed without one, with the reason.
How it is measured
What has been graded
WHI, 16,608 postmenopausal women. Stopped early: increased cardiovascular and breast-cancer risk. The D is for PRIMARY PREVENTION in that population. Treating menopausal symptoms is a different question this site does not grade, and the timing hypothesis is not settled here.
Strength and physical function in older adults. The strongest human trial evidence of anything on this page, and it is not a menopause product.
Lean mass preservation. Graded on the general older-adult literature, not on a menopause-specific trial.
Fracture and fall risk where deficiency is present. In already-replete adults the same record grades fracture prevention D. No concentration target is published.
The one intervention here with a graded use that names postmenopausal women, and the letter is D. Creatine is Grade A for strength with resistance training; bone density is a different endpoint and the trials did not deliver it.
Not graded for this use. Vitamin K2 is graded B on vascular calcification and bone-turnover markers. No trial in this corpus measured a menopausal endpoint, so no letter is shown here.
Not graded for this use. Collagen is graded B on tendon and skin endpoints in general populations. The cited trials did not enroll on menopausal status, so this use carries no letter.
Not graded for this use. Ashwagandha is graded B for cortisol, stress and sleep quality. Its cited trials were not menopause trials, so the B does not transfer to this use.
Not graded for this use. Magnesium is graded C for sleep quality in primary insomnia in older adults. That is a different population from menopausal sleep disturbance and the letter is not carried across.
Not graded for this use. Melatonin is graded B for delayed sleep phase disorder and jet lag and C for sleep onset in ordinary adult insomnia. None of those letters rests on trials in menopausal sleep disturbance, a different population. Nothing here supports a menopausal sleep claim.
Not graded for this use. Saffron is graded B for mild to moderate depression on small short trials in general populations. No menopause-specific trial is cited here.
Often suggested for hot flushes. On this site it is Grade D, Route 2, harm found: SELECT significantly increased prostate cancer and pooled RCTs show a hemorrhagic stroke signal. The harm was measured in other populations; the point is that it is not a benign default.
Not graded for this use. EBL's vitamin E record grades cancer prevention and major cardiovascular events, not hot flushes, so no letter is shown for this use.
Cautions
- •Hormone therapy decisions belong with a clinician who knows your history. Nothing on this page is a reason to start or stop a prescription, and the Grade D on this page is for primary prevention in the WHI population, not for symptom treatment.
- •Tamoxifen and aromatase inhibitors: several botanicals marketed for menopausal symptoms have estrogenic or estrogen-modulating activity. Any supplement here is a decision for your oncologist.
- •Anticoagulants and antiplatelets: vitamin K2 can counteract warfarin and other vitamin K antagonists, while high-dose vitamin E and omega-3 carry bleeding cautions. Read the contraindications on each record.
- •Iron and calcium can reduce levothyroxine absorption; levothyroxine is generally separated from either by at least four hours.
- •SSRIs and SNRIs are prescribed for vasomotor symptoms in some patients. This site does not grade that use, and it is a clinical decision rather than a supplement one.
This page is educational only. New or unusual bleeding after menopause always warrants prompt clinical evaluation. Severe vasomotor symptoms, bone loss on DEXA, or mood change that interferes with daily life should be assessed by a clinician rather than managed from a supplement list.Drug-Nutrient Depletion tool to check whether your current medications may be impairing sleep.
Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.