Top Doctors Share the Best Supplements to Simplify Your Perimenopause Routine and Feel Your Best
- Dietary supplements can help alleviate common health challenges during perimenopause, with over 90 percent of women seeking help from healthcare providers for relief.
Dietary supplements are a $380 billion industry worldwide, but it's hard to know which ones we truly need, especially during perimenopause. We also want to simplify things in our busy lives, without having our kitchen cluttered with countless pill bottles. "Over 90 percent of women seek help from their healthcare provider around perimenopause," says Amy Shah, MD , author of I'm So Effing Tired . And she assures that supplements can provide some relief. So we asked top doctors for their go-to picks to build a simple, easy supplement stack, or daily supplement regimen, to deal with the common health challenges that come with this phase of life. Keep reading to learn the best supplement stack for women in perimenopause, sure to improve your symptoms and optimize your daily routine.
What is a supplement stack?
TikTok is filled with videos talking about "supplement stacks," but what does that term really mean? A supplement stack is two or more wellness products—like vitamins or minerals—that are taken together daily to achieve a specific goal. Consider the "safety in numbers" approach: Taking one supplement may help, but combining them can amplify benefits and create a powerful synergistic effect. This layered product approach was made popular by body builders looking to get jacked and define their 6-packs with the right supplement stacks. But now everyday people are looking to see what unique supplement stacks they can use to reach their own health goals, like improving perimenopausal symptoms. "It's a multi-layered program," says Jonny Bowden, PhD , certified nutrition specialist who is a huge fan of health supplements. In fact, he tells First, "I take 52 pills a day." But we're here to help you simplify things a bit.
Supplement stacks are a form of habit stacking
In addition, supplement stacking builds on the concept of healthy "habit stacking," which is well known in the behavioral modification world. Change can be hard, but people can override that defense mechanism by so-called habit stacking, that is, tethering a new behavior to an established one.
For example, if you're already in the habit of taking a multi vitamin at a certain time of day, it may be easy to stack on another supplement to that established habit. This approach can lead to more success with your supplement stack. Indeed, about 75 percent of people who start with tiny habits make them automatic within five days, says social scientist and Stanford professor BJ Fogg, PhD , author of Tiny Habits .
What supplement do you swear by for increased health and wellness?
The best supplement stack for women in perimenopause
1. Magnesium: The sleep aid for perimenopausal women
As many as 47 percent of women struggle with insomnia during perimenopause, and that number only increases during menopause, according to research from Harvard University and the National Institutes of Health. Hot flashes and nights sweats don't help either. But there is relief in the form of a mineral. "Listen, magnesium is one of those things that really can change your life," says Dr. Shah. "Magnesium supplementation, people have said, is life changing and I would be one of those people."
How does it work? It reduces the stress hormone cortisol and improves levels of the calming, feel-good hormone serotonin to help improve asleep." That's not all. Dr. Shah explains, "Magnesium in your diet has shown to be protective for your brain. It actually anti-ages your brain… improves the brain chemistry so it helps with hot flashes and with memory and cognition."
The problem: OB-GYN Mary Claire Haver, MD , author of The Galveston Diet , notes that "50 percent of Americans aren't getting enough magnesium." Plus, not all forms of magnesium can be properly absorbed in the body. So choose formulas that contain either magnesium glycinate or magnesium threonate. (Avoid weaker forms like oxide or citrate.) Aim to get a dose of 550 mg daily through diet and supplements. Magnesium is found naturally in leafy greens like spinach, plus nuts and seeds like pumpkin seeds.
2. Vitamin D and magnesium: A powerful perimenopause stack
Dr. Shah says vitamin D "goes hand-in-hand with magnesium." So it makes for a great supplement stack pairing. But what does vitamin D really do? "Vitamin D actually works as a hormone in your body," says Dr. Shah, boosting muscle strength and bone health. Those are two things women desperately need as they age, especially as cases of sarcopenia , or age-related muscle loss, are on the rise.
Dr. Shah adds, "Most women in perimenopause are deficient in vitamin D." Her advice: perimenopausal women should get between 2,000 and 4,000 IUs of vitamin D a day, which you can get from food, supplements and sunlight (although she cautions that most women aren't getting enough natural sunlight.) Her favorite supplement form: "Vitamin D3 is essential."
Bonus: If you're taking vitamin D3, try stacking it with vitamin K2 to improve absorption. Women's health expert Emi Hosoda, MD , explains, "K2 is a traffic cop for vitamin D in the body. It makes sure it gets to the right places. Taking vitamin D without K2 can cause things like kidney stones and bone spurs and calcium deposited where you do not want it." One combo brand to try: Nature Made D3 + K2
3. Omega-3s for mood
Health experts agree, body inflammation is the root of most age-related illnesses. But making sure to get enough omega-3 fatty acids is a way to dial down that internal stressor on our brain that can cause everything from mood swings to memory lapses, especially as our menstrual cycle becomes unpredictable.
Dr. Shah says, "You cannot have a healthy, anti-inflammatory body if you are low in omega-3s, especially during perimenopause." These cell-supporting oils are "a great way to lower your inflammation, improve your gut health and hormone health," says Dr. Shah. Omega-3s are found in foods like fatty fish, especially wild-caught salmon, ground flax seeds and walnuts.
Yet, we're still terribly deficient. Dr. Haver explains, "Americans are not getting enough omega three fatty acids, and we're getting way too much Omega six fatty acids." Sounds like a subtle difference, but she explains, "the breakdown products of omega three fatty acids are anti-inflammatory, and the breakdown products of omega six fatty acids are pro inflammatory."
That makes omega-3s an ideal perimenopause and menopause supplement to add to any stack. Learn more about our ideal "omega balance" here . One product to try: Nordic Naturals Ultimate Omega gummy chews for 1200 mg of omega-3s. Or Dr. Haver created a blended product called The 'Pause Nutrition that combines (or stacks) omega 3, plus vitamin D and vitamin K together and contains 3 g of healthy fish oil.
4. Berberine for insulin and weight control
Many women, as they age, have increased trouble managing their blood sugar, which in turn triggers weight gain. Dr. Hosoda recommends, "Berberine is a good option for helping with insulin levels as we enter menopause." She should know. She lost 100 pounds in her 50s, despite being insulin resistance, with the help of eating right and taking natural supplements. Berberine is a bioactive compound derived from plant roots and common in eastern medicine. It is proven to control the blood-sugar spikes that cause belly fat storage, giving the supplement the nicknames "natural Metformin " and " nature's Ozempic ." Impressively, research shows berberine lowers blood sugar by up to 57 percent, compared to the prescription diabetes drug Metformin, which only lowers it by 25 percent.
Check with your doctor before starting berberine as if can interact with some drugs. One brand to consider: NAOMI Berberine .
5. Urolithin A for anti-aging
During perimenopause, some people are looking for targeted supplements that support and protect the mitochondria, the tiny energy factories in each and every cell of the body. "The part of your cell which ages the fastest is the mitochondria—it is the most susceptible to damage from free radicals and toxins," Dr. Hosoda explains. "Your age is really your mitochondrial age. Without healthy mitochondria your cells are not healthy, and you are prone to all the problems of aging."
One approach to slow this aging is supplementing with a class of compounds called urolithin A, touted by biohacker Dave Asprey and health expert Casey Means, MD . Dr. Means explains that urolithin A works two ways in the body: "By acting as an antioxidant…and by stimulating the critical process of mitophagy, a mitochondrial quality-control mechanism that allows for degradation of damaged and superfluous mitochondria." She adds, "I think it's a valuable supplement with significant clinical research behind it." One study-backed brand to try: Mitopure .
Don't rely on a supplement stack alone
One word of caution as you prepare to build your personal supplement stack. Food and lifestyle choices still matter. Dr. Haver says, "The most important thing: you cannot out-supplement poor nutrition. Supplements are meant to supplement a good, nutritious, healthy balanced diet. No way around it."
Dr. Means agrees. She says, "I love some of these supportive supplements but it's not a replacement for the basics" like eating whole foods and walking for exercise .
And of course, when stacking supplements, talk to a health care provider to make sure you aren't doubling up or wasting time and effort. The above supplements tend to be healthy and safe, but not all health supplements should be taken together.
And remember: You can stack more than just supplements
When trying to improve perimenopausal health you can look beyond just supplements. Consider stacking or combining healthy foods, like how eating rice and beans tin the same meal creates a complete protein with all the amino acids of meat. Or how you can stack your regular walking routine with added layers of benefit like walking with a weighted backpack , also known as "rucking" (good for perimenopausal weight loss and bone building), or walking backward (good for strengthening joints and balance as we age.) Bottom line: Look for creative ways to layer more healthy habits into your day.
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan .
