

Perimenopause & Menopause 5 supplements to get your femal health back on track

Menopause is defined as the time in a woman’s life when her menstrual periods stop permanently, marking the end of the reproductive years. Menopause starts when a woman’s periods have stopped for 12 months. Perimenopause, which means “around menopause,” refers to the time during which a woman’s body transitions to menopause and can last from four years up to a decade. Both perimenopause and menopause are marked by a natural decline in estrogen and progesterone. The decrease in estrogen can cause a range of unpleasant symptoms, including hot flashes, night sweats, vaginal dryness, mood swings, disrupted sleep, insomnia, depression, irritability, anxiety, diminished concentration, decreased libido, and loss of bone density.

But there are natural supplements to alleviate symptoms associated with perimenopause and menopause. The following are five of the best.

1. Maca or Peruvian Ginseng

Also known by its scientific name Lepidium meyenii, is an edible starchy tuber that grows in the Andes mountains of Peru, where it has a long history of culinary and medicinal use. It resembles a turnip but tastes more like a potato. Like other starches, maca contains carbohydrates, protein, fats, and dietary fiber. It is also rich in plant sterols and flavonoids, and a good source of iron, magnesium, selenium, and calcium. Because maca acts like estrogen in the body, it stimulates hormonal activity in the ovaries via the pituitary gland and hypothalamus. Taking maca daily can reduce depression, anxiety, hot flashes, and interrupted sleep, and can increase libido. With its earthy and nutty flavor, powdered maca can be added to smoothies, oatmeal, baked goods, and energy bars. It is available in powder form, in capsules (usually 500 mg), and as a liquid extract. The optimal dose for medicinal use ranges from 1.5–5 grams per day.

Caution if you have thyroid issues: Maca contains goitrogens, which are substances that may interfere with the normal function of the thyroid gland. Use caution if you have impaired thyroid function.

2. Chaste Tree Berry

Also called vitex agnus-castus, is sometimes referred to as the “Woman’s Herb.” It is a shrub found in the Mediterranean and western Asia and bears violet flowers and berries. The medicinal parts are the dried berries and leaves. Chaste tree berries contain iridoids, flavonoids, progestins, and essential oils. They help normalize estrogen and produce progesterone by stimulating the pituitary gland to create more luteinizing hormone. Taking chaste tree berries can decrease the frequency and severity of hot flashes, night sweats, insomnia, anxiety, depression, and headache. Chaste tree berries come in the form of tinctures and capsules. Because it is a slow-acting herb, it may take eight weeks or more to experience benefits. Dosage is 500 to 800 mg of chaste tree berry per day.

Caution if you are taking medication for Parkinson’s disease. Chaste tree berries have a dopaminergic effect (i.e., they affect dopamine-related activity in the brain – that can disturb medications for Parkinson’s.)

3. Black Cohosh

Black cohosh is a member of the buttercup family and is native to North America. The root or rhizome (underground stem) is the part of the plant used in herbal preparations. Black cohosh contains phytoestrogens (plant-based estrogens), glycosides (sugar compounds), and isoferulic acids (anti-inflammatory substances). Black cohosh is a natural remedy for reducing hot flashes and night sweats. Yet it has more benefits: it reduces sleep disturbances, nervousness, and irritability, and increases libido and bone density. Dosages vary based on the manner in which it is consumed: powder, tincture, or tea. For dried powder, usually taken in a capsule, 40-200 mg per day is recommended. In liquid or tincture, 0.4-2 ml of a 60% solution is recommended. When consumed as a tea, more is needed because it is less easily absorbed: 1-2 g doses 3 times per day.

Caution if you suffer from liver disease. While there is only limited evidence that long-term high dosing of black cohosh can cause liver toxicity, speak with your doctor if you are currently taking other medications or supplements that may be linked to liver damage.

4. Damiana

Damiana is a shrub native to Central and South America. Because its leaves are used medicinally, it is sometimes referred to as Damiana leaf. Damiana is known for its relaxing yet stimulating effect: it calms the body while simultaneously improving energy. Damiana contains essential oils, antioxidants, and caffeine. Unlike other supplements used to treat perimenopause and menopause symptoms, Damiana does not increase or mimic estrogen. Rather it is used to increase overall wellness by reducing anxiety, stress, depression, and lethargy, and improving sleep. Damiana is available in herbal teas, tinctures, dried powder, and capsules. Doses for capsules are about 400–800 milligrams per day, usually split into three divided doses.

Caution if you are diabetic or hypoglycemic: very high doses of Damiana (over 200 grams daily) can change blood sugar levels.

5. DIM

DIM, or Diindolylmethane, is a phytochemical produced during the digestion of cruciferous vegetables such as broccoli, cauliflower, brussels sprouts, and cabbage. It is also available in supplements. DIM works to create a healthy balance of estrogen and testosterone. DIM works by helping the body metabolize estrogen, but it does not increase the level of estrogen. This reduces hot flashes and night sweats. DIM is available in capsules or tablets, and the recommended dosage is 100-200 mg per day. To obtain a sufficient amount of DIM, supplements are the way to go: there’s about 10 – 30 mg of DIM in one-and-a-half pounds of cruciferous vegetables!

Caution: DIM is not recommended for persons with kidney disease.

You can obtain these five supplements individually, or there are many products that combine them for effective and easy use.
Photo ©iStockPhoto

What is the average age women begin perimenopause?

Most women begin to experience hormonal change associated with perimenopause sometime in their 40’s. Since these symptoms can last from 4 to 10 years before the actual onset of menopause some women can begin experiencing perimenopause in their 30s as well. The average age of menopause (end of menstrual cycles) is 51.

Jamie J. Spannhake

Jamie Spannhake is a lawyer, mediator and certified health coach, and the author of "The Lawyer, the Lion, & the Laundry: Three Hours to Finding Your Calm in the Chaos." She is a partner at Berlandi Nussbaum & Reitzas LLP and writes and speaks on issues of interest to lawyers, including time and stress management, health and wellness, work-life balance, and effective legal writing. Learn more at and follow her on Twitter @IdealYear.
