Last week, I talked about my favorite supplements to improve , and the surprising ways they can also help women in menopause with other symptoms. There’s a broad range of supplements available to women who are interested in managing their menopause symptoms as naturally as possible. Judging from the interest and enthusiasm of the women I talk with, that’s most of you!

Let’s take a closer look at some of the supplements that target menopause symptoms, with an eye on how they also might affect sleep.

A decision to use supplements should be made in consultation with your physician, taking into account your individual history and risks. This is not medical advice, but I hope this discussion will give women a starting point for those conversations with their physicians about natural therapies to improve their sleep, protect their health, and reduce their uncomfortable symptoms during menopause.

When you talk to your doctor, be sure to discuss any supplements you’re considering and review potential interactions with any medications or other supplements you’re already using.

Many women who are interested in boosting their estrogen levels during and after menopause, but don’t want to use hormone replacement , turn to phytoestrogens. Phytoestrogens are chemical compounds found naturally in plants—compounds that both act like estrogen and affect the body’s own estrogen, when ingested.

Foods rich in phytoestrogens include:

• Soy and soy products (these are particularly high in phytoestrogens)
• Many vegetables and fruits, including oranges, broccoli, and carrots
• Other legumes, including peanuts, beans, and peas

Women who eat a plant-based , and particularly those who regularly consume soy products, are getting phytoestrogens through their diet—a factor that they should consider with their doctors when determining whether to further supplement with phytoestrogens during menopause.

There are three main types of phytoestrogens:

• Isoflavones
• Lignans
• Coumestans

Research shows phytoestrogens may reduce menopause symptoms including hot flashes and night sweats, and other mood problems, and cognitive difficulties including poor and lack of concentration. Phytoestrogens may also offer women in and beyond menopause protection against osteoporosis and bone loss, as well as benefits for cardiovascular, metabolic health, and cognitive performance. There’s also evidence suggesting phytoestrogens may have anti-cancer effects, including reducing risks for breast cancer.

Scientific studies have shown phytoestrogens improve sleep, therefore lowering sleep disturbances, reducing symptoms, diminishing daytime tiredness, and increasing sleep efficiency. 

The effects of phytoestrogens from food sources and supplements are complex. Because of their ability to act like and influence estrogen, a hormone, phytoestrogens directly affect the body’s endocrine system. Phytoestrogens can have both estrogenic (estrogen-promoting) and anti-estrogenic (estrogen-blocking) effects. Using phytoestrogens is a decision best made in consultation with a physician, considering a woman’s diet, age, individual health conditions and risks, other medications and supplements she’s already using, and the severity of her menopause symptoms. Because they can function like estrogen in the body, long-term use of phytoestrogens may carry similar risks as estrogen replacement therapy, and women with breast and other estrogen-influenced cancers, or who have risks for these cancers, may be advised not to use phytoestrogen supplements. Be sure to discuss both the potential benefits and potential risks with your physician before using phytoestrogen supplements.

Let’s look more closely at some of the phytoestrogen supplements used by women in menopause:

Genistein. This isoflavone may reduce the frequency and intensity of hot flashes and night sweats, and may also improve symptoms of  and anxiety, according to research. Genistein may offer protection to the cardiovascular system, and make it easier to avoid gaining weight. There’s also evidence linking genistein to a reduction in bone loss. Research shows this isoflavone may be helpful to sleep—thanks to its anxiolytic properties—and may increase amounts of non-REM sleep.

Daidzein. Another isoflavone, Daidzein works similarly to genistein. It’s been shown to relieve hot flashes, and may help reduce bone loss, on its own and in combination with calcium.

Red clover. An isoflavone extracted from the red clover plant, some studies show that this supplement can reduce hot flashes and night sweats—while other studies indicate the benefits of red clover to hot flashes is not significant. There’s also evidence suggesting red clover may have anti-anxiety effects, helping reduce and promote relaxation. For this reason, red clover may also help sleep.

Resveratrol. This phytoestrogen—best-known for its presence in red wine—has been shown to reduce chronic pain in post-menopausal women, many of whom will experience pain from osteoarthritis. Other research indicates resveratrol can benefit mood as well as improve brain function and cognitive performance in post-menopausal women. Studies show dietary resveratrol may help strengthen sleep-wake cycles. It’s ability to alleviate chronic pain and improve mood may also contribute to the sleep-promoting effects of resveratrol.

Flaxseed. A popular supplement for all-around health, flaxseed contains lignans that studies show may reduce hot flashes and night sweats. Research also indicates the benefits of flaxseed to cardiovascular health, and its role in lowering cholesterol.

Black cohosh. I hear from a lot of women wondering about this supplement for menopause symptoms. The root of the black cohosh plant has a long history of use in Native American traditional medicine to treat menstrual symptoms and symptoms of menopause. Black cohosh is often regarded as a phytoestrogen, but more recent research suggests it may not have estrogenic effects in the body—however, the precise mechanisms of black cohosh are not yet fully understood. Research shows black cohosh may alleviate night sweats and hot flashes, as well as lowering anxiety, and reducing vaginal dryness. It’s also been shown to improve sleep, likely because of its stress and anxiety lowering capabilities. Some scientists raise questions about the research of black cohosh and its effectiveness for menopause symptoms, pointing specifically to inconsistency in the analysis and reporting of black cohosh studies.

Evening primrose oil. While not a phytoestrogen itself, evening primrose is sometimes found in combination with phytoestrogens in supplements that target women’s health and menopause symptoms. It is also available on its own, and used to treat menopause symptoms including hot flashes. High in omega-6 fatty acids, evening primrose oil may reduce inflammation, ease pain, help support brain function, and contribute to bone health.

Vitamins for sleep and menopause 

Here are some of the vitamins most often recommended for women in menopause. It’s important to consult with your physician before adding a new vitamin to your regimen. Also, some research shows vitamins, when taken as a multivitamin or multiple individual vitamins taken simultaneously, may have disruptive effects on sleep. We need more research into the effects of vitamin supplements on sleep to better understand what sleep-promoting or sleep-disrupting side effects may exist.

Vitamin E. Vitamin E is a powerful , and may help lower inflammation. Vitamin E also may contribute to reduced stress and risk for depression, as well as providing protection for your heart and your brain. Research also suggests Vitamin E may help menopausal women with hot flashes and night sweats.

B Vitamins. The B vitamins have a broad range of benefits that may be useful to women in menopause, including stress reduction, immune system protection, a rise in energy and mood, and protection for cognitive functions including memory.  In particular Vitamin B6 increases the production of serotonin, which can help with symptoms of depression and anxiety. (Serotonin is also involved in the production of melatonin, the essential sleep hormone.) Vitamin B12 has been shown to increase energy and to reduce mental and physical symptoms of fatigue.

Vitamin D. Vitamin D is an important nutrient for women of all ages, and can have particular value for women in menopause. Technically, Vitamin D is considered a hormone when produced by the body naturally, in response to sunlight. It’s important for bone health: a lack of vitamin D can put women at risk for weakening bones, bone injury, and bone pain, especially with age. Vitamin D can also assist in maintaining a healthy weight. I’ve written before about the potential benefits of Vitamin D for sleep, and the science that suggests maintaining healthy levels of Vitamin D can improve both the quality of sleep and the amount of sleep you get.

Maca is the common name for a plant native to Peru, which has a long history of use in traditional medicine. One species of this plant, Lepidum peruvianum, is scientifically recognized for its broad array of health benefits for both men and women. Lepidum peruvianum has several natural, active compounds that are biochemically related to the hormones women lose throughout the menopausal transition, including estrogen, progesterone, and . This natural supplement may be a beneficial therapy for women in menopause who are seeking non-hormonal treatments for their symptoms, and to protect and enhance their long-term health, sleep, and performance.

However it is important to be aware that not all maca is created equal. This is a complex plant species, with an array of active compounds. Lepidum peruvianum has no fewer than 13 phenotypes, each with its own different physiological effects. Most are beneficial, but some potentially harmful for women if they use the wrong phenotype for them. When seeking out maca as a supplement, it’s critical to know you’re getting the right phenotypes of the maca plant for your needs—and that the product you’re purchasing is accurate in its label and contents.

Recently I’ve been studying up on Maca-GO®, which has been shown in a growing body of scientific research to be more effective than any other natural alternative to date in relieving menopausal symptoms and it is the first to demonstrate in published clinical trials statistically significant support in helping balance women’s hormones during perimenopause and menopause. Maca-GO® (commercially known as Femmenessence) has been developed with specific, concentrated and standardized phenotype formulations of Lepidum peruvianum to support women’s health and address symptoms during a woman’s reproductive years, perimenopause and postmenopause.

Scientific studies of Maca-GO® show it may deliver some pretty broad benefits for women in perimenopause and postmenopause, including:

• Restored hormone balance, including increases in estrogen and stabilization of progesterone and FSH levels
• Cardiovascular benefits, including reductions in blood pressure, rises to the “good” HDL cholesterol and reductions to the “bad” LDL cholesterol, a lowering of overall cholesterol levels, and significant reductions to triglycerides
• Maintenance of a healthy body weight
• Bone health, including increase to bone density
• Improvements to mood, including alleviation of depression, anxiety and stress
• Reductions in hot flashes and night sweats
• Improvements to sleep
• Increases to energy and physical performance

This is an impressive list, and in the clinical trials it worked for 17 out of 20 women (85 percent). I look forward to seeing more research on the benefits of maca. While the studies on Maca-GO® demonstrated benefits for sleep in peri- and postmenopausal women, I will be interested to see if there is a specific phenotype ideal for men and women just for sleep.

Michael J. Breus, PhD, DABSM