Approaches

5-HTP

A naturally occurring amino acid and precursor to serotonin. Derived from the seeds of Griffonia simplicifolia. Used for mood support, sleep, and appetite regulation. Relevant to perimenopausal women experiencing low mood, anxiety, and sleep disturbance linked to declining oestrogen's effect on serotonin.

Ashwagandha

An adaptogenic herb from Ayurvedic medicine. Used to reduce cortisol, improve stress resilience, support sleep, and enhance energy. Some evidence for improving thyroid function and reducing menopausal anxiety. Increasingly popular among perimenopausal women.

B-Complex

A combination of water-soluble B vitamins including B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B9 (folate), and B12 (cobalamin). Support energy metabolism, red blood cell production, nerve function, and mood. Particularly relevant to hormonal health via their roles in methylation, oestrogen metabolism, and neurotransmitter synthesis.

Bacopa Monnieri

An Ayurvedic herb used traditionally for cognitive enhancement. Studied for memory, attention, and information processing speed. Used by perimenopausal women for brain fog and cognitive decline associated with hormonal changes. Effects typically require 8–12 weeks of consistent use.

Berberine

A bioactive alkaloid found in several plants including goldenseal, barberry, and Oregon grape. Used for blood sugar management, metabolic health, and PCOS-related insulin resistance. Some research compares its glycaemic effects to metformin, though it is not a licensed medicine in the UK.

Black Cohosh

A herbal preparation from the root of the North American black cohosh plant. One of the most widely used herbal remedies for menopausal hot flushes and night sweats. Evidence is mixed; some trials show modest benefit for vasomotor symptoms. Not recommended alongside HRT.

Boron

A trace mineral involved in bone metabolism, oestrogen and vitamin D utilisation, and cognitive function. Some research suggests it may support bone mineral density and reduce urinary calcium excretion in postmenopausal women. Also proposed to influence oestrogen metabolism.

Calcium

An essential mineral for bone health, muscle function, and nerve signalling. Postmenopausal women are at increased risk of calcium deficiency and osteoporosis due to declining oestrogen. The UK RNI is 700mg/day, though many postmenopausal women require supplementation alongside vitamin D, particularly if dietary intake is low.

Collagen Peptides

Hydrolysed collagen protein broken into small bioactive peptides for absorption. Used for skin elasticity, joint health, and bone support. Relevant to menopausal women because oestrogen decline accelerates collagen loss (approximately 30% in the first 5 years post-menopause), affecting skin, joints, and connective tissue.

CoQ10

A fat-soluble antioxidant naturally produced by the body, with levels declining with age. CoQ10 is involved in mitochondrial energy production and has been explored for fertility support, cardiovascular health, and as an adjunct in statin therapy.

D-Chiro-Inositol

A stereoisomer of inositol often used alongside myo-inositol for PCOS management. Plays a distinct role in insulin signalling, particularly in non-ovarian tissues. Typically combined with myo-inositol in a 40:1 ratio. Excessive D-chiro-inositol alone may impair oocyte quality.

DIM

A compound derived from the digestion of indole-3-carbinol, found naturally in cruciferous vegetables such as broccoli and cabbage. Used to support oestrogen metabolism, particularly to promote conversion to less potent oestrogen metabolites. Popular for PMS, hormonal acne, and oestrogen dominance.

Evening Primrose Oil

An oil extracted from the seeds of the evening primrose plant, rich in gamma-linolenic acid (GLA). Traditionally used for breast pain (mastalgia), PMS, and menopausal hot flushes. Evidence for hot flush reduction is modest. Also used for skin health and inflammation.

Holy Basil

An adaptogenic herb from Ayurvedic medicine. Used for stress management, cortisol modulation, blood sugar regulation, and immune support. Some clinical trials show benefit for generalised anxiety and stress-related symptoms. Consumed as a tea or supplement.

Inositol

A naturally occurring carbohydrate with vitamin-like properties. Myo-inositol is widely studied for PCOS, supporting insulin sensitivity, ovarian function, and reducing androgen levels. Also used for anxiety and OCD in higher doses. Relevant to hormonal health throughout the reproductive years.

Iodine

An essential trace element required for thyroid hormone synthesis. The UK RNI is 140mcg/day. Iodine deficiency can impair thyroid function and is common in some UK populations, particularly those who do not consume dairy or fish. However, excess iodine can worsen autoimmune thyroid conditions including Hashimoto's thyroiditis.

Iron

An essential mineral for red blood cell production and oxygen transport. Iron deficiency and iron deficiency anaemia are common in women of reproductive age due to menstrual blood loss, and in perimenopause when cycles may become heavier. Symptoms overlap significantly with menopausal symptoms, including fatigue, brain fog, and mood changes.

L-Theanine

An amino acid found naturally in green tea. Used for promoting relaxation without sedation, reducing anxiety, and supporting sleep quality. Popular with perimenopausal women experiencing anxiety, racing thoughts, and sleep-onset difficulty.

Licorice Root

A herbal preparation from the root of Glycyrrhiza glabra. Used traditionally for adrenal support, digestive health, and inflammation. Contains glycyrrhizin, which inhibits cortisol metabolism. DGL (deglycyrrhizinated licorice) has the glycyrrhizin removed and is used specifically for digestive support without blood pressure effects.

Lion's Mane Mushroom

A medicinal mushroom used traditionally in East Asian medicine for cognitive support and nerve health. Increasingly used by perimenopausal women experiencing brain fog, poor concentration, and memory difficulties. Available as a powder, capsule, or tincture.

Maca Root

A Peruvian root vegetable used traditionally as an adaptogen. Marketed for energy, libido, and hormonal balance. Some small trials suggest benefit for menopausal symptoms and sexual function. Not oestrogen-based and considered safe for women who cannot take HRT, though evidence is limited.

Magnesium Glycinate

A highly bioavailable form of magnesium bound to glycine. Supports sleep quality, mood, muscle relaxation, and bone health. Commonly used by women to ease perimenopause symptoms including insomnia, anxiety, and restless legs. Better tolerated than magnesium oxide with less laxative effect.

Melatonin

A hormone produced by the pineal gland that regulates the sleep-wake cycle. Available on prescription in the UK (Circadin for adults over 55) and as an unlicensed supplement. Used for sleep-onset difficulty, jet lag, and circadian rhythm disruption. Melatonin production declines with age and may be further disrupted during perimenopause.

Myo-Inositol

The most abundant stereoisomer of inositol, widely studied for PCOS and insulin resistance. Acts as an insulin-sensitising agent, supporting ovarian function and metabolic health. Often used in combination with D-chiro-inositol in a 40:1 ratio reflecting physiological levels.

NAC

A sulphur-containing amino acid derivative and precursor to glutathione, the body's primary intracellular antioxidant. Studied for PCOS (insulin sensitisation, ovulation support), endometriosis (inflammation reduction), and liver health. Also used as a mucolytic and in paracetamol overdose treatment.

Omega-3

Polyunsaturated fatty acids including EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) from fish oil, or ALA from plant sources. Support cardiovascular health, brain function, inflammation, joint health, and mood. Evidence for benefit in menopausal depression and cardiovascular risk reduction.

Phosphatidylserine

A phospholipid found in high concentrations in brain cell membranes. Used for cognitive support, cortisol modulation, and stress resilience. Some evidence for blunting the cortisol response to exercise and psychological stress. Used by perimenopausal women for brain fog and HPA axis support.

Probiotics

Live microorganisms intended to confer a health benefit. Different strains have different evidence profiles. Relevant to hormonal health via the gut-hormone axis (oestrobolome), with the gut microbiome playing a role in oestrogen metabolism, immune regulation, mood (gut-brain axis), and metabolic health.

Red Clover

A herbal supplement containing isoflavones (formononetin, biochanin A, daidzein, genistein) that have weak oestrogen-like activity. Used for menopausal hot flushes and bone health support. Some evidence for modest reduction in hot flush frequency.

Rhodiola Rosea

An adaptogenic herb traditionally used in Scandinavian and Russian folk medicine for fatigue, stress resilience, and cognitive function. Some clinical evidence for improving stress-related fatigue and mild depression. Used by perimenopausal women for burnout, energy, and stress adaptation.

Saffron Extract

A standardised extract from the stigma of Crocus sativus. Used for mood support, with several RCTs showing benefit for mild to moderate depression comparable to some SSRIs. Also studied for PMS, appetite control, and libido. Relevant to perimenopausal women experiencing mood fluctuations.

Sage

An herbal remedy derived from the sage plant. Used traditionally and in some clinical studies to reduce hot flushes and night sweats in menopausal women. Available as a tea, tincture, or standardised extract (e.g., Menoforce). One of the few herbal options with some clinical trial evidence specifically for hot flushes.

Selenium

An essential trace mineral important for thyroid function, immune health, and antioxidant defence. The UK RNI is 60mcg/day for women. Particularly relevant for women with thyroid conditions, as selenium is required for the conversion of T4 to active T3. Some evidence for reducing thyroid antibodies in Hashimoto's thyroiditis.

Soy Isoflavones

Plant-derived compounds from soybeans with weak oestrogen-like activity. Consumed through diet (tofu, soya milk, edamame) or in concentrated supplement form. Studied for reduction of hot flushes, bone density support, and cardiovascular health in menopausal women.

Spearmint Tea

Spearmint (Mentha spicata) consumed as a tea or extract. Studied for its anti-androgenic properties in women with PCOS, hirsutism, and hormonal acne. Two cups of spearmint tea daily has been associated with reduced free testosterone levels in small clinical trials.

Turmeric / Curcumin

Curcumin is the primary active compound in turmeric. It has anti-inflammatory and antioxidant properties and has been explored for joint pain, endometriosis-related inflammation, and general inflammatory symptoms associated with hormonal conditions.

Vitamin C

A water-soluble vitamin with antioxidant properties. Essential for collagen synthesis, immune function, and iron absorption. The adrenal glands contain some of the highest vitamin C concentrations in the body, and levels are depleted during chronic stress. Some practitioners use higher-dose vitamin C for adrenal support, though evidence for this specific indication is limited.

Vitamin D3

The most biologically active supplemental form of Vitamin D. Essential for calcium absorption, bone health, immune function, and mood regulation. The NHS recommends all adults consider supplementing, particularly in autumn and winter. Especially important for perimenopausal and postmenopausal women given the role in bone density.

Vitamin K2

A fat-soluble vitamin that plays a role in calcium metabolism, directing calcium into bones and teeth rather than soft tissues and arteries. Often taken alongside vitamin D3 and calcium for bone health. Increasingly recognised for cardiovascular health in postmenopausal women.

Vitex

An herbal extract from the chaste tree berry. One of the most studied herbal remedies for PMS, cyclical breast pain, and irregular menstruation. Has dopaminergic activity and is thought to lower prolactin levels. Not recommended for use during HRT or pregnancy.

Zinc

An essential trace mineral involved in over 300 enzymatic reactions. Supports immune function, wound healing, thyroid hormone production, and reproductive health. Relevant to PCOS (androgen metabolism), thyroid function (T4 to T3 conversion), and skin health (acne). The UK RNI for women is 7mg/day.