Supplements for menopause

The menopause supplement stack — rationale by ingredient

Vitamin D3 1,000–2,000 IU/day (test 25-OH-D and correct to 30–50 ng/mL)

Vitamin D supports calcium absorption, muscle function, immune function, and probably mood. Post-menopause is a period of accelerated bone loss; vitamin D adequacy is foundational. Test and target rather than supplementing blindly. Megadose annual bolus regimens have been associated with increased falls in older adults — daily or weekly modest dosing is safer.

Magnesium glycinate 200–400 mg elemental at bedtime

Magnesium supports sleep onset and quality (the night sweat / wake / can't get back to sleep loop is the dominant sleep complaint in menopause), reduces leg cramps and restless-legs symptoms common in this period, supports bone matrix function as a calcium cofactor, and modestly supports mood. The glycinate form is well-tolerated chronically without laxative effect.

Calcium — dietary first; supplement only the gap to 1,000–1,200 mg total/day

Get as much calcium as possible from food (dairy, fortified plant milks, leafy greens, calcium-set tofu, sardines). Supplement only the dietary shortfall. Maximum 500–600 mg in a single dose for absorption. Calcium citrate is better absorbed than carbonate, particularly with PPIs. Excess supplemental calcium (>1,500 mg/day) has been associated with cardiovascular risk signals in some analyses — modest dose.

Vitamin K2 (MK-7) 100–180 µg/day

Activates osteocalcin (directs calcium into bone) and matrix Gla protein (prevents vascular calcification). The Knapen postmenopausal trial supports K2 for bone density and reducing vascular calcification. Contraindicated with warfarin — coordinate with prescriber.

Creatine monohydrate 3–5 g/day

Post-menopause is the inflection point for sarcopenia (age-related muscle loss). Creatine plus resistance training is among the best-evidenced anti-sarcopenia interventions. Falls — not bone density alone — drive osteoporosis fracture risk; muscle and balance preservation matter at least as much as bone density. Some emerging signal for cognitive support in older women.

Omega-3 (EPA/DHA) 1–2 g/day with a fat-containing meal

Cardiovascular co-benefit (the menopause lipid shift is unfavourable), modest joint pain and arthralgia support, mood support, and possible cognitive support. The 2024 atrial-fibrillation signal at pharmaceutical doses (1.8–4 g/day) means cardiology should be involved at higher doses if there is arrhythmia history.

Saffron (Affron) 28 mg/day or Saffron 30 mg/day

Mild mood support, modest sleep quality improvement, and a small hot-flash signal in some trials. Pairs well with the broader menopause supplement layer; cleaner safety profile than St. John's Wort and easier to layer with other medications.

Protein 1.0–1.2 g/kg/day (or 1.2–1.5 g/kg for active women)

Adequate protein supports muscle preservation, bone matrix synthesis, and satiety in an era when body composition shifts unfavourably. Distribute across meals (25–30 g per meal). Whey or plant protein supplementation to gap-fill if dietary intake is short.