Which supplements should you take during perimenopause?

During menopause, it might feel like everything’s starting to fall apart. You can’t focus, are constantly hot and bothered, and your sleep is suffering, which makes everything ten times harder to cope with.

On top of these new pesky symptoms, the world still demands the same from you. Your work deadlines creep closer. Your kids need your attention. It’s dinnertime again and the laundry basket is overflowing. Where did that ironed school uniform get to anyway?

Our naturopaths have put together the key supplements you need to support the symptoms that arrive with the onset of perimenopause. Amidst the madness, there is ample opportunity during perimenopause to set the stage for good health in your later years.

So, let our naturopaths ease your load - these are the nutrients you need to support better wellbeing during perimenopause.

Magnesium for mental health, sleep, bones and muscles

A UCL study proved that women are 40% more susceptible to mood problems during perimenopause compared to premenopausal women.

Menopausal changes affect GABA’s ability to regulate the HPA axis, which governs your stress response, leading to increased stress sensitivity and higher risk for low mood.

Magnesium helps regulate the HPA axis and modulates GABA receptors, increasing their activity. Studies show that postmenopausal women with low mood have the lowest levels of magnesium, while those without symptoms have higher levels.

Systematic reviews by researchers show that magnesium supplementation has a beneficial effect on mental health, alleviating low mood and stress. A 2021 study showed that benefits to mental health improved significantly with regular supplementation, particularly during the first four weeks of treatment – and even more so when taken in combination with vitamin B6.

Sleep is affected by changes during perimenopause, and the bi-directional relationship between sleep and mental health can create a negative feedback loop, where poor sleep worsens mental health, which in turn can worsen sleep.

Magnesium is a superhero for your nervous system, able to stimulate your parasympathetic nervous system, also known as your rest and digest response – the state in which you heal, regenerate and relax. Magnesium has been proven to improve sleep quality and duration while reducing time it takes to fall asleep.

The menopausal transition can cause loss of muscle mass. A 2024 review showed that magnesium supplementation supports physical activity, boosting performance and recovery time, while reducing soreness and protecting you from muscle damage.

Bone health is also at risk during menopause, and low levels of magnesium are associated with lower bone density, so supplementing plays a protective role. Formulas like Cal / Mag 2:1 by Designs for Health, also provide calcium, which helps strengthen bone health. This supplement features calcium and magnesium in their optimal ratio for optimal cardiovascular, bone, muscle and mental health.

Calcium for bone and muscle health

Menopause is known as the ‘window of opportunity,’ a time in which you can protect your future health. This is particularly relevant for bone health.

Bone loss begins 1 to 3 years before your last period, and lasts between 5 to 10 years. Yearly, you lose approximately 2% of your bone mass, leading to around a 10-12% reduction in bone mineral density.

During perimenopause your levels of calcium decrease, leading to nutritional imbalances and bone health problems. These issues are more common among those with low vitamin D status as this nutrient supports calcium absorption.

Calcium can be found in the diet, but if you’re supplementing, it’s important not to take a calcium supplement alone, as this can impact heart health. Take calcium in a combined formula with magnesium like Cal / Mag 2:1 by Designs for Health.

Herbal adaptogens for hot flashes, night sweats, mental health and sleep

Night sweats and hot flashes are amongst the most common complaints during the menopausal transition. They fall within the category of vasomotor symptoms, which 80% of women experience during perimenopause and menopause. 

A 2021 study of 100 women showed that ashwagandha is an effective way to reduce symptoms like hot flashes and night sweats, improving quality of life, and supporting better sleep.

A 2025 study supports these findings, demonstrating that women supplementing with ashwagandha score significantly lower on the menopause rating scale, which assesses the severity of symptoms experienced. Numbers were particularly reduced in psychological and somatic scores.

There’s a building body of research which supports ashwagandha's power in relation to mental health, with studies showing its ability to reduce stress, low mood and sleeping problems - the latter is hinted in its latin name, Withania somnifera - somnifera meaning ‘sleep inducing’.

Featuring ashwagandha, Sereni-Pro is a firm favourite among practitioners and clients at IMI.

Two other herbal adaptogens worth mentioning are chaste and maca. These herbs alleviate night sweats and hot flashes while improving mood and sleep. Maca also helps support weight loss and better cardiovascular health. These formulas are available by prescription from a naturopath.

Fish oil to ease brain fog, hot flashes and night sweats

If you’re feeling woozy and struggling to concentrate during menopause, fish oil can help. Omega 3 fatty acids DHA and EPA are key for brain function.DHA makes up 90% of your brain’s polyunsaturated fatty acids, and 10-20% of the fats in your brain overall.

A 2022 review concluded that omega-3s improved learning, memory, cognitive function and blood flow to the brain. Studies show that higher blood levels of EPA and DHA are associated with larger total brain volume and hippocampal volume, which are both protective factors for memory and brain health as you age.

During perimenopause, you’re more at risk for mental health conditions. A 2023 study of 165 people with mental health conditions showed a reduction in symptoms when they were taking an omega 3 supplement.
Several studies have also shown the efficacy of fish oil in easing  joint pain, hot flashes and night sweats.

Our practitioners love Ultra Pure Fish Oil 800 by Vital Nutrients. Rigorously detoxified and independently tested to ensure it’s free from toxins. It provides fish oil in its triglyceride form, which is absorbed 70% better than other ethyl ester formulas.

Creatine for your brain, energy and muscles

Creatine has shot to stardom in the fitness world for its ability to support muscle health, promoting growth and strength. During a time when muscle mass is at risk of decrease, creatine can play a protective role for women going through perimenopause. It’s also known to support bone mineral density.

The benefits to bone and muscle health are amplified when creatine is paired with resistance training.

Its benefits during perimenopause aren’t limited to the physical - a 2025 study showed that creatine supports faster reaction times and reduced severity of mood swings in perimenopausal and menopausal women.
Creatine is key for supporting energy production, alleviating fatigue which is a common symptom during perimenopause.

Creatine Bioactive by Natroceutics features Creavitalis® an advanced creatine monohydrate used by scientists for its quality and efficacy. Studies show that over 95% of this formulation is absorbed into the bloodstream.

Probiotics to support your microbiomes

You may know that you have a gut microbiome, which consists of both good and bad bacteria, but did you know that you also have a vaginal microbiome?

During perimenopause and menopause, your vaginal microbiome undergoes changes. Your vaginal pH may increase and studies show that after menopause women have much lower levels of a type of good bacteria called Lactobacillus in their vaginal microbiome. This can lead to vaginal dysbiosis: an imbalance of bad bacteria.

As for the gut microbiome, research shows that during menopause, diversity decreases which is associated with digestive problems and dysbiosis.

Postmenopausal women have been shown to have a higher ratio of Firmicutes/Bacteroidetes in their gut microbiome which is linked to being overweight. A 2024 systematic review of six studies showed that probiotics reduce body weight and inches around your middle – even without dieting.

Probiotic supplementation may also play a protective role in heart health, which is more at risk after you hit perimenopause.

Ther-biotic Women’s Formula features strains known to nourish the gut and vaginal microbiome. It’s designed to bring vaginal pH and bacteria back into balance, providing protection against bad bacteria.

Multivitamin for foundational health

During perimenopause, your levels of vitamin D and B vitamins decrease. A quality multivitamin helps replenish nutritional imbalances while ensuring you have a solid baseline for good health throughout this transitional time.

Twice Daily Multi by Designs for Health features superior quality vitamins and minerals in easily absorbed forms to boost immunity, brain health and overall wellbeing.

Personalised support during menopause

These supplements provide a great starting point for supporting you during perimenopause – and personalised support from our naturopaths can help ensure that your treatment plan is specific to your needs.

Using testing, they can check if other factors are affecting you, conducting a comprehensive analysis of your symptoms to support you during this time of transition.

References
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